Bercez C, Lebrun T, Bonneterre M E, Selke B, Lenne X, Bonneterre J
Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille Cedex.
Bull Cancer. 1999 Jun;86(6):585-90.
In the context of a medicoeconomic study of the adjuvant treatment of breast cancer, we evaluated the cost of the recurrence. This cost was assessed from the medical records of 146 patients having presented either distant metastases, or a local recurrence followed or not by metastases between 1983 and 1990. We checked according to published data that the frequency of the metastatic risk is negligible if beyond 5 years after the local recurrence. Costs are expressed in 1995 French Francs (FF), with the French Social Security point of view. From the medical records, we calculated the mean cost of each type of recurrence using medical costs (visits, drugs and treatments, assessments, tests, hospital care, outpatient services.) and non medical costs (patient transportation). The costs are 175,168 FF (standard deviation or SD: 127,972) for metastatic recurrence, and respectively 287,582 FF (SD: 142,280) and 115,705 FF (SD: 78,677) for local recurrence followed or not by metastases. There is a significant difference between these figures (p < 0.001). The hospitalization costs are around 66% of the total cost of each type of recurrences and they are significantly higher (p < 0.005) when metastatic disease occurs after a local recurrence. The mean cost of isolated local recurrence added to metastatic recurrence, 290,873 FF, is not different from that of local recurrence followed by metastases, 287,582 FF (p = 0.15). These results will be integrated in a model in order to evaluate the long-term economic consequences of an adjuvant strategy in the treatment of breast cancer and presented in other publications.
在一项关于乳腺癌辅助治疗的药物经济学研究中，我们评估了复发的成本。该成本是根据1983年至1990年间出现远处转移或局部复发（无论是否伴有转移）的146例患者的病历进行评估的。我们根据已发表的数据核实，如果在局部复发后超过5年，转移风险的频率可忽略不计。成本以1995年法国法郎（FF）表示，从法国社会保障的角度来看。从病历中，我们使用医疗成本（就诊、药物和治疗、评估、检查、住院护理、门诊服务）和非医疗成本（患者交通）计算了每种复发类型的平均成本。转移性复发的成本为175,168法郎（标准差或SD：127,972），局部复发伴有或不伴有转移的成本分别为287,582法郎（SD：142,280）和115,705法郎（SD：78,677）。这些数字之间存在显著差异（p < 0.001）。住院成本约占每种复发类型总成本的66%，当局部复发后出现转移性疾病时，住院成本显著更高（p < 0.005）。孤立局部复发加上转移性复发的平均成本为290,873法郎，与局部复发后伴有转移的成本287,582法郎没有差异（p = 0.15）。这些结果将被纳入一个模型，以评估乳腺癌辅助治疗策略的长期经济后果，并在其他出版物中呈现。
