A recent study comparing perioperative chemotherapy with adjuvant chemoradiotherapy among patients with gastric cancer suggests that the most cost-effective treatment strategy may be PCT.

Perioperative chemotherapy and adjuvant chemoradiotherapy are the most commonly used treatment options for gastric cancer. This study aimed to identify the most optimal treatment strategy of the two.

Vishnu Prasath, MS, Rutgers-New Jersey Medical School, Newark, NJ, and colleagues built a decision tree model in order to analyze the survival and costs associated with perioperative chemotherapy and adjuvant chemoradiation therapy. Medicare reimbursement rates from a third-party perspective were used to estimate costs for this study. Quality-adjusted life years (QALYs) represented the model’s effectiveness. One-way, two-way, and probabilistic sensitivity analyses measures the robustness of conclusions.

The cost of perioperative chemotherapy was $54,326.10 with 4.08 QALYs, while the cost of adjuvant chemoradiotherapy was $77,987.52 with 4.28 QALYs. Adjuvant chemoradiotherapy surpassed the threshold of $100,000 per QALYs gained for this study, while perioperative chemotherapy did not. In over 100,000 simulations, 51.4% favored perioperative chemotherapy.

“In our simulated patients with diagnosed gastric cancer, the most cost-effective treatment strategy was PCT [perioperative chemotherapy]” wrote Dr Prasath and colleagues, concluding, “We see cost-effectiveness alternating to favor CRT [chemoradiotherapy] with changes in non-curative procedure rates and adjuvant therapy complication rates.”—Marta Rybczynski