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Abstract：
BACKGROUND: Desmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain.
METHODS: A cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (€ 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.
RESULTS: The total cost for percutaneous cryoablation (€ 5774.78/patient-year) was lower than the total cost for conventional surgery (€ 6780.98/patient-year), yielding cost savings up to € 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results\' robustness.
CONCLUSIONS: Percutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.
UNASSIGNED: This manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.
CONCLUSIONS: • Desmoid tumours are locally aggressive and may require local therapy. • Percutaneous cryoablation procedure is less invasive than the conventional surgery. • Cost comparison shows savings associated to percutaneous cryoablation use.
METHODS: A cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (€ 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery.
RESULTS: The total cost for percutaneous cryoablation (€ 5774.78/patient-year) was lower than the total cost for conventional surgery (€ 6780.98/patient-year), yielding cost savings up to € 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results\' robustness.
CONCLUSIONS: Percutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain.
UNASSIGNED: This manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process.
CONCLUSIONS: • Desmoid tumours are locally aggressive and may require local therapy. • Percutaneous cryoablation procedure is less invasive than the conventional surgery. • Cost comparison shows savings associated to percutaneous cryoablation use.
摘要：
背景：纤维瘤瘤（DTs）或深部纤维瘤病是良性软组织肿瘤，有时在当地具有侵略性，需要在某些情况下进行干预。手术一直是黄金标准,但是新的微创技术，如经皮冷冻消融已经证明了它们的有效性，减少卫生资源和并发症。该研究旨在比较经皮冷冻消融术和常规手术治疗腹外和/或腹壁DTs患者的总费用。西班牙当地消融治疗的候选人。
方法：建立了成本分析模型。专家小组提供了有关经皮冷冻消融技术资源消耗的数据，并验证了用于目标人群估计的流行病学。来自当地成本数据库的单一资源成本（2022欧元）。对3家西班牙医院的54例手术病例进行了回顾性分析，以根据该患者样本中确定的诊断相关组（DRG）代码的成本估算常规手术的成本，按每个DRG比例加权。每种替代方案的总费用包括干预费用和并发症费用，考虑到4.5％的经皮冷冻消融术和18.0％的手术部位感染的小手术需要清创。
结果：经皮冷冻消融的总费用（5774.78欧元/患者年）低于常规手术的总费用（6780.98欧元/患者年），在西班牙估计有资格接受干预的80例DTs患者的整个队列中，在1年内可节省高达80,002欧元的成本。单向灵敏度分析证实了结果的稳健性。
结论：经皮冷冻消融术与传统手术相比，可以节省西班牙DT患者的治疗成本。
■这份手稿从西班牙国家医疗保健系统的角度，深入了解了与经皮冷冻消融术治疗韧带样型肿瘤有关的节省带来的经济影响，为健康决策过程提供有用的信息。
结论：•纤维瘤是局部侵袭性的，可能需要局部治疗。•经皮冷冻消融术比常规手术创伤小。•成本比较显示与经皮冷冻消融术使用相关的节省。
方法：建立了成本分析模型。专家小组提供了有关经皮冷冻消融技术资源消耗的数据，并验证了用于目标人群估计的流行病学。来自当地成本数据库的单一资源成本（2022欧元）。对3家西班牙医院的54例手术病例进行了回顾性分析，以根据该患者样本中确定的诊断相关组（DRG）代码的成本估算常规手术的成本，按每个DRG比例加权。每种替代方案的总费用包括干预费用和并发症费用，考虑到4.5％的经皮冷冻消融术和18.0％的手术部位感染的小手术需要清创。
结果：经皮冷冻消融的总费用（5774.78欧元/患者年）低于常规手术的总费用（6780.98欧元/患者年），在西班牙估计有资格接受干预的80例DTs患者的整个队列中，在1年内可节省高达80,002欧元的成本。单向灵敏度分析证实了结果的稳健性。
结论：经皮冷冻消融术与传统手术相比，可以节省西班牙DT患者的治疗成本。
■这份手稿从西班牙国家医疗保健系统的角度，深入了解了与经皮冷冻消融术治疗韧带样型肿瘤有关的节省带来的经济影响，为健康决策过程提供有用的信息。
结论：•纤维瘤是局部侵袭性的，可能需要局部治疗。•经皮冷冻消融术比常规手术创伤小。•成本比较显示与经皮冷冻消融术使用相关的节省。
