Cost-effectiveness of intraperitoneal chemohyperthermia in the treatment of peritoneal carcinomatosis from colorectal cancer.
OBJECTIVE
Our purpose was to assess the cost-effectiveness of intraperitoneal chemohyperthermia (IPCH) compared to palliative chemotherapy (STANDARD) against peritoneal carcinomatosis arising from colorectal cancer.


METHODS
We performed a retrospective study of 96 patients whose peritoneal carcinomatosis had been diagnosed between January 1998 and December 2003 and treated either with IPCH or with palliative chemotherapy in French comprehensive cancer centers. Patients were followed up over a 3-year period. Effectiveness was measured by restricted mean survival at 3 years. The Bang and Tsiatis method was used to handle cost-censored data. The confidence limits of the mean cost per patient in each group and the mean incremental cost per life-year saved were computed using 1000 bootstrapreplicates. We also computed an acceptability curve for the incremental cost-effectiveness ratio (ICER).


RESULTS
We found that IPCH improved survival and was more costly than STANDARD treatment. Over a 3-year observation period, IPCH yielded an average survival gain of 8.3 months at the additional cost of euro58,086 (95% confidence interval 35,893-112,839) per life-year saved.


CONCLUSIONS
The ICER of IPCH is acceptable given the severity and burden of peritoneal carcinomatosis for which there is no alternative curative treatment.
Bonastre
Julia
J
Health Economics Department, Gustave Roussy Institute, Villejuif, France. bonastre@igr.fr
Chevalier
Julie
J
Elias
Dominique
D
Classe
Jean Marc
JM
Ferron
Gwenaël
G
Guilloit
Jean Marc
JM
Marchal
Frédéric
F
Meeus
Pierre
P
De Pouvourville
Gerard
G
D000970:Antineoplastic Agents / Q000191:economics*; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology*; D003362:Cost-Benefit Analysis; D006801:Humans; D006979:Hyperthermia, Induced / Q000191:economics*; D017059:Models, Econometric; D010166:Palliative Care / Q000191:economics*; D010534:Peritoneal Neoplasms / Q000628:therapy*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents