In the short term, neo-adjuvant chemotherapy (NACT) was found to be more cost-efficient than primary surgery in women with advanced stage epithelial ovarian cancer. Additionally, NACT resulted in a greater boost to quality-adjusted life-years per patient.
[Photo: Dr. Daniel Erim (left) and Dr. Stephanie Wheeler]
These findings are the result of a recent study co-authored by Dr. Daniel Erim, doctoral student, and Dr. Stephanie Wheeler, associate professor, both in the department of health policy and management at the University of North Carolina Gillings School of Global Public Health.
Neo-adjuvant chemotherapy is a first step used to shrink a tumor before the primary treatment – typically, surgery. The study compared the cost-effectiveness of two treatment plans, each with a seven-month time horizon. In one plan, patients in a randomized controlled trial received three cycles of NACT, followed by surgery, followed by three additional cycles of chemotherapy. In the other, plan, patients received primary surgery followed by six cycles of chemotherapy.
The analysis, which considered elements including possible complications of chemotherapy versus surgery, treatment costs and quality-adjusted life-years gained, showed that the treatment plan including NACT resulted in a savings of $7,034 per patient and offered an average 0.035 quality-adjusted life-year increase.
In the short term, therefore, neo-adjuvant chemotherapy is a cost-effective alternative to primary surgery in women with advanced stage epithelial ovarian cancer. These results may translate to longer-term cost-effectiveness as well; however, data from the randomized controlled trials is continuing to mature.
The full article, “Cost effectiveness of neo-adjuvant chemotherapy followed by interval cytoreductive surgery versus primary cytoreductive surgery for patients with advanced stage ovarian cancer during the initial treatment phase,” was published online Dec. 19, 2017, in the journal Gynecologic Oncology.