We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Cost-effectiveness of screening for recurrent hepatocellular carcinoma after liver transplantation.
- Authors
Ladabaum, Uri; Cheng, Shan L; Yao, Francis Y; Roberts, John P
- Abstract
The effectiveness of screening and treatment of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT) remains undefined. Our aim was to evaluate the potential cost-effectiveness of screening for recurrent HCC after LT. We constructed a Markov model of the natural history after LT for HCC. We superimposed screening with computed tomography, alpha-fetoprotein, and chest X-ray every six months for 1-5 yr after LT, with resection for treatable recurrence. Screening only those whose explant pathology exceeded Milan Criteria (MC) for two yr cost $ 138,000/life-yr gained, and the incremental cost of screening all patients was $ 340,000/life-yr gained. Screening for longer than two yr incurred progressively higher incremental costs/life-yr gained. The most critical variable in sensitivity analyses was the survival benefit of finding a resectable recurrence. With the most favorable assumptions for a two-yr screening duration, screening those whose explant pathology exceeded MC cost $ 91,000/life-yr gained. In conclusion, screening for HCC recurrence after LT would probably yield most of its benefit in the first two yr, but at a relatively high cost/life-yr gained. Screening for two yr in only those whose explant pathology exceeds MC may be relatively cost-effective depending on the survival benefit of resection.
- Publication
Clinical transplantation, 2011, Vol 25, Issue 2, p283
- ISSN
1399-0012
- Publication type
Journal Article
- DOI
10.1111/j.1399-0012.2010.01212.x