Cost-effectiveness analysis of chemoradiotherapy compared to surgery in patients with stage I esophageal squamous cell carcinoma in Japan.

Authors

Takuro Ariga, Kensuke Moriwaki, Kousuke Morimoto, Katsuyuki Sakanaka, Yoshinori Ito, Tetsuo Saito, Atsuto Katano, Satoru Matsuda, Ken Kato, Hiroya Takeuchi, Hiroshi Onishi, Japanese Society for Radiation Oncology (JASTRO) Health Insurance Committee

Published in

International journal of clinical oncology. Jul 23, 2026. Epub Jul 23, 2026.

Abstract

We performed a model-based cost-effectiveness analysis of the use of surgical treatment (ST) versus chemoradiotherapy (CRT) for stage I esophageal cancer in Japan.
A model for partitioned survival analysis was developed to estimate the long-term medical costs and quality-adjusted life years (QALYs) for patients who had received either ST or CRT. Data on survival times were taken from the JCOG0502 trial. Utility values were estimated by applying a mapping algorithm based on Japanese data from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire. From the perspective of public healthcare, only direct medical costs were considered. A discount rate of 2% per year was applied to long-term costs and QALYs to estimate the incremental cost-effectiveness ratio (ICER) of CRT compared to ST.
The incremental cost of CRT versus ST was estimated to be $26,313 (USD), the incremental QALY was 0.630, and the ICER was $41,742/QALY. Sensitivity analysis showed that the parameter with a relatively large effect on the ICER was the utility weight of progressive disease with esophagus preserved patients in CRT. The variations in ICERs ranged from approximately $37,113/QALY to $47,690/QALY. With willingness-to-pay thresholds ranging from $50,000/QALY to $100,000/QALY, CRT was more cost-effective than ST, with the probability of being cost-effective estimated to range from 59.3% to 76.3%.
In Japan, CRT for stage I esophageal cancer may be more cost-effective than ST, if the acceptable ICER is $50,000/QALY.

PMID:
42490005
Bibliographic data and abstract were imported from PubMed on 23 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.