Early-Stage HCC Ablation Cost Lower Than Other Surgical Alternatives

A comprehensive Surveillance, Epidemiology and End Results (SEER)-Medicare short-term cost evaluation in early-stage hepatocellular carcinoma (HCC) patients demonstrated lower total costs for ablation than for surgical alternatives, according to the American Journal of Roentgenology (AJR).

“Total and out-of-pocket costs for index procedures, as well as for 30-day and 90-day post-procedure periods, were lowest for ablation—followed by resection and then transplant,” noted Resmi A. Charalel, MD, MPH, from the interventional radiology department at Weill Cornell Medicine.

This US population study in AJR used the SEER-Medicare linked dataset to identify a sample of 1,067 Medicare beneficiaries (mean age, 73 years; 674 men, 393 women) diagnosed with early-stage HCC (size ≤ 5 cm) treated with ablation (n = 623), resection (n = 201), or transplant (n = 243) between January 2009 and December 2016. Total costs and patient out-of-pocket costs for the index procedure, as well as for any care within 30 days and 90 days post-procedure, were stratified via treatment modality. Additional comparisons were performed among propensity subgroups treated with ablation or resection (each n = 172).

Ultimately, for ablation, resection, and transplant, median 90-day total cost was $14,572; $34,984; and $88,103. The median 90-day patient out-of-pocket cost was $2,138; $2,462; and $3,876, respectively (p < .001). Adjusting for socioeconomic factors, comorbidities, and prognostic indicators with multivariable analysis, surgical treatment (i.e., resection or transplant) was associated with greater costs than ablation.