ABSTRACT

Objective

The aim of the present study was to evaluate the cost-effectiveness ratio of surgical treatment options for small hepatocellular carcinoma (SHC) by using the decision tree model and providing a reference for the clinical therapeutic decisions for SHC.

Methods

The data of 719 cases with SHC in the BCLC 0-A who were treated in the past were collected. The survival duration and treatment cost of patients in each experimental group after hepatic resection (HR), radiofrequency ablation (RFA), and orthotopic liver transplantation (OLT) were statistically analyzed.

Results

For SHC with a diameter of less than 3.0 cm, HR, RFA, and OLT had similar cost-effectiveness ratios. OLT could achieve a longer life expectancy, but it was greatly affected by the dropout rate while waiting for the liver donor. RFA was preferred when the willingness to pay (WTP) < 2,5000 RMB/QALY, OLT was preferred when WTP > 75,000 RMB/QALY, and HR was preferred when WTP was between the two.

Expert opinion

HR in SHC with OLT had the longest life expectancy, but due to the limitations of organ sources, OLT was the preferred treatment option when the WTP was large enough.

中文翻译：

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小肝癌肝切除、射频消融和肝移植的成本效益分析

摘要

客观的

本研究旨在利用决策树模型评估小肝癌（SHC）手术治疗方案的成本效益比，为SHC的临床治疗决策提供参考。

方法

收集了719例既往接受过治疗的BCLC 0-A级SHC病例的资料。对各实验组患者在肝切除（HR）、射频消融（RFA）和原位肝移植（OLT）后的生存时间和治疗费用进行统计分析。

结果

对于直径小于 3.0 cm 的 SHC，HR、RFA 和 OLT 具有相似的成本效益比。OLT可以达到更长的预期寿命，但在等待肝脏供体时受辍学率的影响很大。支付意愿（WTP）<25000元/QALY时首选RFA，WTP>75000元/QALY时首选OLT，WTP介于两者之间时首选HR。

专家意见

SHC 联合 OLT 的 HR 预期寿命最长，但由于器官来源的限制，当 WTP 足够大时，OLT 是首选的治疗方案。