The Relative Net Health Benefit of Liver Resection, Ablation, and Transplantation for Early XXXX .

@entity1 @entity157 @entity82 @entity5
BACKGROUND: There are no conclusive cost-effectiveness studies measuring the efficacy of salvage LT after liver resection (LR) and radiofrequency ablation (RFA) in @entity1 with @entity157 ( @entity157 ) and compensated @entity82 . The aim of the present study is to compare liver transplantation (LT) versus locoregional therapy plus salvage LT (to treat @entity5 recurrence) in @entity1 with early @entity157 and compensated @entity82 . METHODS: Reference case: 55-year old male with @entity157 within Milan criteria and @entity1 -Pugh A @entity82 . The analysis was performed in two geographical cost settings: USA and Italy. Survival benefit measured in quality-adjusted life years (QALYs), costs (C) in US , incremental cost-effectiveness, willingness to pay, and net health benefit (NHB). RESULTS: In the base-case analysis, NHB of LT vs. LR and RFA was -1.7 and -1.3  years for @entity5   <=3  cm, -1.2 and -0.7 for single nodules measuring 3.1-5  cm and -0.7 and -0.7 for @entity5   <=3  cm in Italy. In USA, NHB of LT versus LR and RFA were -1.2 and -0.8  years for @entity5   <=3  cm, -0.9 and -0.5 for single nodules measuring 3.1-5  cm, and -0.5 and -0.4 for @entity5   <=  3  cm. On the Monte Carlo simulation, only young @entity1 with multi-nodular @entity157 and short waiting list time had a positive NHB. Salvage LT proved to be an ineffective cost strategy after RFA or LR. CONCLUSION: In @entity1 with @entity157 within Milan criteria and @entity1 -Pugh A @entity82 , LR and RFA were more cost-effective than LT. Salvage LT was not cost-effective.
