Percutaneous Cryoablation of Metastatic Lesions from Colorectal Cancer: Efficacy and Feasibility with Survival and Cost-Effectiveness Observations

Table 4

Preliminary cost-effectiveness estimates. Cost-effectiveness estimates for BSC and six established therapies (6–9) for widespread mCRC are noted in conjunction with liberal estimates of cost for MCA. Our proposed adjunctive cost-effectiveness ratio, or ACER, was used to calculate the estimated cost of MCA when paired with systemic regimens.

	BSC	5-FU	5-FU with LV	FOLFOX	FOLFIRI	FOLFIRI + BV	CX and IR	MCA
LYG	0.52	0.71	1.57	1.65	1.66	1.69	0.81	1.97
Total cost ($)**	$4,233	$12,344	$55,793	$94,693	$61,781	$78,245	$37,723	$73,900*
$/LYG	$8,140	$17,386	$35,537	$57,390	$37,217	$46,299	$46,572	$37,513
ACER; (Cost/LYG)***	$39,661	$43,779	$65,834	$85,580	$68,874	$77,231	$56,661	Mean: $62,517

∗Assumes 1.9 cryoablation procedures per patient and more image intensive followup.
∗∗A conversion factor of 1.67 from pounds to dollars was used to allow easier comparison and conforms to the difference between established definitions of cost efficacy of $100,000 [28].
∗∗∗ACER: adjunctive role for, MCA: assumes costs are additive and divided by a total LYG of 1.97 for MCA.
MCA: multisite cryoablation.
5-FU: 5-fluorouracil.
LV: leucovorin.
FOLFOX: 5-FU, leucovorin, and oxaliplatin.
FOLFIRI: 5-FU, leucovorin, and irinotecan.
BV: bevacizumab.
IR: irinotecan.
CX: cetuximab.