Abstract 723P
Background
Both surgery and ablation including radiofrequency ablation (RFA) are options for the treatment of small hepatocellular carcinoma (HCC). Despite increasing evidence about the efficacy of surgery vs. RFA for HCC treatment, the data on long-term medical expenditures for this patient group has not been reported yet. This study aims to assess cumulative medical expenditures up to 5 years from the initial interventions in patients who underwent surgery or RFA for small HCC.
Methods
The study population consisted of patients who were enrolled in our clinical trial (SURF trial; UMIN000028292). Data on clinical factors after initial interventions and medical expenditures for 5 years from the initial interventions were collected and combined with the data from our clinical trial. The recurrence-free survival (RFS) and overall survival (OS) analysis were adjusted using the inverse probability of treatment weighted (IPTW) analysis. Multiple generalized linear regressions were used to assess cumulative medical expenditures adjusting for confounders.
Results
Of 503 patients included in this study, 268 patients underwent surgery (the surgery group) and 235 patients underwent RFA (the RFA group). Medical expenditure data were available for 141 undergoing surgery and 147 undergoing RFA. The IPTW-adjusted RFS and OS did not differ significantly between the groups (RFS, hazard ratio [HR] 0.93, P = 0.565; OS, HR, 1.37, P = 0.184). The median net medical expenditure of the initial treatment was significantly higher in the surgery group than in the RFA group: 11,094 USD vs. 4,638 USD, P = 0.001. The incremental cost-effectiveness ratio of the surgery group vs. the RFA group was 156,272 USD/life year. The adjusted cumulative medical expenditures at 5 years after the initial interventions did not differ significantly between the surgery group and the RFA group: 27,561 USD vs. 25,308 USD (P = 0.351).
Conclusions
The difference in medical expenditures between surgery and RFA at the time of intervention gradually closed the gap over time. This information may help clinicians to improve the understanding of the cost-effectiveness of surgery vs. RFA for the treatment of small HCC.
Clinical trial identification
UMIN000028292.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
The 106th Annual Congress of JSS Memorial Surgical Research Fund.
Disclosure
All authors have declared no conflicts of interest.