PURPOSE: The Swedish Rectal Cancer Trial (SRCT) demonstrated that a short-term regimen of high-dose fractionated preoperative radiotherapy (5 x 5 Gy) reduced the local recurrence rates and improved overall survival. This has had an impact on the primary treatment of rectal cancer. The current study investigated the cost-effectiveness of the new combined approach. METHODS AND MATERIALS: After an 8-year follow-up, in-hospital and outpatient costs related to the treatment of rectal cancer and its complications were analyzed for 98 randomly allocated patients who participated in the SRCT from a single Swedish health care region. The costs were then related to the clinical data from the SRCT regarding complications, local and distant recurrences, and survival. RESULTS: The total cost for a nonirradiated patient was US$30,080 compared with US$35,268 for an irradiated patient. The surgery-alone group had increased costs related to local recurrences, and the radiotherapy group had increased costs for irradiation and complications. With a survival benefit of 21 months (retrieved from the SRCT), the cost for a saved year was US$3654. Sensitivity analyses for different rates of local recurrences, the costs related to complications and less marked survival benefit showed that this figure could vary up to US$15,228. CONCLUSION: The cost for a life-year saved in these data was US$3654. This figure could reach US$15,228 in the most pessimistic setting of the sensitivity tests, a cost still comparable with other well-accepted medical interventions.
RCT Entities:
PURPOSE: The Swedish Rectal Cancer Trial (SRCT) demonstrated that a short-term regimen of high-dose fractionated preoperative radiotherapy (5 x 5 Gy) reduced the local recurrence rates and improved overall survival. This has had an impact on the primary treatment of rectal cancer. The current study investigated the cost-effectiveness of the new combined approach. METHODS AND MATERIALS: After an 8-year follow-up, in-hospital and outpatient costs related to the treatment of rectal cancer and its complications were analyzed for 98 randomly allocated patients who participated in the SRCT from a single Swedish health care region. The costs were then related to the clinical data from the SRCT regarding complications, local and distant recurrences, and survival. RESULTS: The total cost for a nonirradiated patient was US$30,080 compared with US$35,268 for an irradiated patient. The surgery-alone group had increased costs related to local recurrences, and the radiotherapy group had increased costs for irradiation and complications. With a survival benefit of 21 months (retrieved from the SRCT), the cost for a saved year was US$3654. Sensitivity analyses for different rates of local recurrences, the costs related to complications and less marked survival benefit showed that this figure could vary up to US$15,228. CONCLUSION: The cost for a life-year saved in these data was US$3654. This figure could reach US$15,228 in the most pessimistic setting of the sensitivity tests, a cost still comparable with other well-accepted medical interventions.
Authors: Dermot T McDowell; Fraser M Smith; John V Reynolds; Stephen G Maher; Collette Adida; Paul Crotty; Eoin F Gaffney; Donal Hollywood; Brian Mehigan; Richard B Stephens; M J Kennedy Journal: Int J Colorectal Dis Date: 2009-07-11 Impact factor: 2.571
Authors: Fraser M Smith; William M Gallagher; Edward Fox; Richard B Stephens; Elton Rexhepaj; Emanuel F Petricoin; Lance Liotta; M John Kennedy; John V Reynolds Journal: Ann Surg Date: 2007-02 Impact factor: 12.969
Authors: M Barbieri; H L A Weatherly; R Ara; H Basarir; M Sculpher; R Adams; H Ahmed; C Coles; T Guerrero-Urbano; C Nutting; M Powell Journal: Appl Health Econ Health Policy Date: 2014-10 Impact factor: 2.561
Authors: Mostafa Abd Elwanis; Doaa W Maximous; Mohamed Ibrahim Elsayed; Nabiel N H Mikhail Journal: World J Surg Oncol Date: 2009-06-09 Impact factor: 2.754
Authors: Phil Quirke; Robert Steele; John Monson; Robert Grieve; Subhash Khanna; Jean Couture; Chris O'Callaghan; Arthur Sun Myint; Eric Bessell; Lindsay C Thompson; Mahesh Parmar; Richard J Stephens; David Sebag-Montefiore Journal: Lancet Date: 2009-03-07 Impact factor: 79.321