Cost-effectiveness of radical hysterectomy with adjuvant radiotherapy versus radical radiotherapy for FIGO stage IIB cervical cancer

Abstract

Yanlan Chai,* Juan Wang,* Tao Wang, Fan Shi, Jiquan Wang, Jin Su, Yunyi Yang, Xi Zhou, Hailin Ma, Bin He, Zi LiuDepartment of Radiation Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China *These authors contributed equally to this work Objective: Recent literature reports that radical hysterectomy followed by adjuvant radiotherapy has comparable progression-free survival and overall survival compared to radical radiotherapy for International Federation of Gynecology and Obstetrics stage IIB cervical cancer. Now, we evaluate the cost-effectiveness (CE) of these two treatment regimens.Primary and secondary outcome measures: A decision-tree model was constructed comparing CE between treatment arms using the published studies for overall survival rates and treatment-related toxicity rates for 5 years. The cost data were obtained from the hospital system of the First Affiliated Hospital of Xi’an Jiaotong University. Effectiveness was measured as quality-adjusted life year (QALY). Treatment arms were compared with regard to costs and life expectancy using incremental CE ratio, and the results were presented using costs per QALY.Results: The mean cost was $10,872 for radical hysterectomy followed by adjuvant radiotherapy versus $5,702 for radical radiotherapy. The incremental CE ratio for surgery-based treatment compared to radiotherapy-based treatment was –$76,453 per QALY.Conclusion: Radical radiotherapy would be a cost-effective method for FIGO stage IIB cervical cancer and would be favored in settings where resources are limited. Keywords: cost-effectiveness, cervical cancer, FIGO stage IIB, surgery, radiotherapy

Keywords

• Cost effectiveness
• cervical cancer
• FIGO stage IIB
• surgery
• radiotherapy