ArticleANZ journal of surgery
Total Neoadjuvant Therapy Versus Conventional Neoadjuvant Therapy for Rectal Cancer: Cost Analysis in a Public Healthcare System.
Article in ANZ journal of surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTotal neoadjuvant therapy (TNT) has become the standard of care in locally advanced rectal cancer, but its economic impact is unclear. This study compares the cost of TNT with conventional neoadjuvant therapy (CNT), consisting of either short-course radiotherapy or long-course chemoradiotherapy, within a universally funded public healthcare system. METHODOLOGY: A trial-based costing analysis was conducted from a third-party payer's perspective with a 2-year time horizon, following CHEERS guidelines. Consecutive patients with rectal cancer treated with neoadjuvant therapy from 2014 to 2023 were extracted from a multi-institutional database. Inpatient, outpatient, imaging and pathology resource costs were extracted and adjusted to 2024 AUD with a 5% discount rate. Primary outcomes were overall cost per cohort and mean per patient cost. Secondary outcomes were overall and mean cost per cost category. Sensitivity analysis explored the influence of discount rates and inflation methods.
resultsOf 115 eligible patients, 60 (52.2%) received CNT and 55 (47.8%) received TNT. Overall treatment costs for the cohorts were $8 429 710.66 (CNT) and $6 992 616.67 (TNT), with mean per patient costs of $140 495.18 (CNT) and $127 138.48 (TNT). Overall per patient costs were $13 356.70 (9.51%) lower for TNT patients, mainly driven by lower mean inpatient costs ($78 523.53 vs. $96 843.08, 18.9%). TNT increased outpatient ($43 001.18 vs. $39 376.12, 9.21%), imaging ($4179.13 vs. $2973.61, 40.5%) and pathology ($1434.65 vs. $1302.38, 10.1%) costs. The results were robust to sensitivity analysis.
conclusionTNT is less costly than CNT within a universally funded public healthcare system, primarily due to reduced inpatient costs associated with higher rates of organ preservation.
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