Abstract
Objective
Pancreatic cancer is a digestive malignancy with dismal prognosis. The advent of Heidelberg TRIANGLE dissection technique brings a turning point to improve the chance of survival. Our study aimed to evaluated the cost-effectiveness of open pancreaticoduodenectomy (OPD) versus OPD combined with TRIANGLE operation (OPD-TRIANGLE) for patients with pancreatic cancer from the perspective of healthcare system in China.
Methods
Two hundred forty-six patients with pancreatic cancer who underwent OPD or OPD-TRIANGLE from January to September 2022 were enrolled in this study. We performed a decision tree model to assess clinical and economic implications of different surgical strategies. Estimation of health utilities was based on published literature, while costs were acquired from the hospitals, clinical expert consultations, and other local charge. The incremental cost-effectiveness ratio (ICER) was regarded as the primary outcome. Uncertainty of the findings was addressed via sensitivity analyses and scenario analyses.
Results
The results indicated that OPD-TRIANGLE group yielded additional 0.0402 QALYs at an incremental cost of US$1501.83 compared with OPD group, and the corresponding ICER was US$37,358.96 per QALY. The probabilities of OPD-TRIANGLE as the prior option were 52.8% at the WTP threshold of 60,000 US$/QALY. The main factors lined with costs incorporating total medical costs and operation-related costs. With 5–20% price reduction of OPD-TRIANGLE, the outcomes were also economically attractive.
Conclusion
The findings of this population-based study suggested that OPD-TRIANGLE was likely to be cost-effective for patients with pancreatic cancer when compared against OPD. Further in-depth studies should be conducted to provide more comprehensive evidence.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
The clinicopathological data and expense data of the patients with pancreatic cancer were provided by the Jiangsu Province Hospital. We sincerely thank the hospital for supporting our research and all the experts of Pancreas Center for their professional guidance and suggestions. Furthermore, we are grateful to Jiaojie Shen for supporting the language guidance on our text.
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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
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All authors contributed to the study. Conceptualization, study design, data analysis, and original draft of the manuscript were performed by YB and MZ. Material preparation and data extraction were provided by PW, YW and BW. Supervision as well as review was responsible for XL and HD. All authors commented on previous versions of the manuscript. Meanwhile, all of them read and approved the final manuscript.
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Bao, Y., Zhang, M., Wu, P. et al. Cost-effectiveness of open pancreaticoduodenectomy with or without Heidelberg TRIANGLE operation for pancreatic cancer in China. J Cancer Res Clin Oncol 149, 16705–16715 (2023). https://doi.org/10.1007/s00432-023-05406-6
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DOI: https://doi.org/10.1007/s00432-023-05406-6