Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma.

BACKGROUND & AIMS: Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in early stage HCC (Milan criteria). METHODS: As first step, a meta-analysis of the pertinent literature of the last decade was performed. Seventeen studies fulfilled the inclusion criteria: 3,996 patients underwent resection and 4,424 underwent RFA for early HCC. Data obtained from the meta-analysis were used to construct a Markov model. Costs were assessed from the health care providers perspective. A Monte-Carlo probabilistic sensitivity analysis was used to estimate outcomes with distribution samples of 1,000 patients for each treatment arm. RESULTS: In a 10 year perspective, for very early HCC (single nodule