Assessment of Treatment Cost-effectiveness Using a Colorectal Cancer Mutation Profile
Menée aux Etats-Unis à l'aide d'un modèle mathématique intégrant des données de la littérature scientifique, cette étude évalue, en fonction du profil moléculaire de la tumeur, le rapport coût-efficacité de trois modalités thérapeutiques (traitement endoscopique, colectomie laparoscopique ou colectomie par voie ouverte) chez les patients atteints d'un cancer colorectal de stade T1
For the first time we are aware of, Jang et al have used novel genetic mutation biomarkers instead of clinicopathologic features to estimate the most cost-effective treatment with the greatest added quality-adjusted life years (QALYs) among patients with stage T1 colorectal cancer (CRC). One QALY equates to 1 year in perfect health. The incremental cost-effectiveness ratio was used to summarize the cost-effectiveness of the health care intervention per QALY.Current approaches to therapy selection are based on estimates of nodal disease risk using pathologic features, such as depth of submucosal invasion (ie, >2000 μm), lymphovascular invasion, histologic grade, or tumor budding after endoscopic polypectomy. The higher the risk of nodal metastasis, the greater the need for surgical intervention (ie, laparoscopic or open). Initial attempts at endoscopic resection (eg, endoscopic mucosal resection, endoscopic submucosal dissection) have no adverse effects on long-term outcomes.