title: Effectiveness of Percutaneous Celiac Plexus Ablation in the Treatment of Severe Cancer Pain in Upper Abdomen and Evaluation of Health Economics.
abstract: OBJECTIVE
  To compare the effectiveness, adverse effects, and cost-effectiveness of percutaneous neurolytic celiac plexus block (NCPB) versus traditional medication strategies for the treatment of patients with advanced cancer having severe upper abdominal cancer pain.
  
  
  METHODS
  This retrospective study included 81 patients with advanced upper abdominal cancer admitted to The Sixth People's Hospital Affiliated to Shanghai Jiaotong University between January 2013 and July 2014. The patients were divided into percutaneous NCPB (treatment) and medication for pain (control) groups. The outcomes were measured in terms of Numeric Rating Scale (NRS) score and Karnofsky Performance Status (KPS) score before treatment and on the 3rd, 7th, 14th, and 28th days posttreatment. The effectiveness and cost-effectiveness of the therapy were assessed using analysis of the health economics.
  
  
  RESULTS
  The improvements in NRS score (1.42 ± 1.09 vs 4.03 ± 0.96, P < .01) and KPS score (65.55 ± 9.09 vs 63.03 ± 8.961, P < .01) in the treatment group were significantly superior compared to the control group on the 7th day of treatment, followed by no significant difference between the 2 groups on the 14th and the 28th day of treatment. Health economics evaluation revealed that the medicine-specific costs and total health care costs were significantly reduced in the treatment group compared to the control group ( P < .05), but no significant differences between the 2 groups ( P > .05) were seen in the costs of hospitalization, examinations, and treatment.
  
  
  CONCLUSIONS
  The percutaneous NCPB method shows promising results and better cost-effectiveness for treating patients with advanced cancer having severe upper abdominal pain.
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: He
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Hongqiang
authors.initials: H
authors.lastname: Liu
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Saibo
authors.initials: S
authors.lastname: Wang
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Baocheng
authors.initials: B
authors.lastname: Zhao
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zheng
authors.affiliation: 2 Department of Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.affiliation: 1 Department of Interventional Oncology, Dahua Hospital, Xuhui District, Shanghai, China.
authors.forename: Donghao
authors.initials: D
authors.lastname: Xie
mesh_terms: D015746:Abdominal Pain / Q000191:economics / Q000601:surgery*; D059787:Acute Pain / Q000191:economics / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000191:economics / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000191:economics / Q000379:methods; D002447:Celiac Plexus / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: cancer pain; celiac plexus ablation; clinical trial; health economics; percutaneous neurolytic celiac plexus block; upper abdominal pain