Surveillance vs Standard Surgery and Cost-Effectiveness After Neoadjuvant Chemoradiotherapy for Esophageal Cancer

Is active surveillance cost-effective compared with standard surgery among patients with esophageal cancer who achieved a complete clinical response after neoadjuvant chemoradiotherapy? In this prespecified cost-effectiveness secondary analysis of a cluster randomized clinical trial including 309 patients, active surveillance resulted in slightly higher quality-adjusted life-years and lower health care costs over 5 years compared with standard surgery, with 97% of bootstrap replications indicating cost-effectiveness. Active surveillance is a cost-effective alternative to standard surgery after neoadjuvant chemoradiotherapy and may reduce health care costs without compromising patient outcomes.

Corresponding Author: Sanjiv S. G. Gangaram Panday, MD, Department of Surgery, Erasmus MC Cancer Institute, University Medical Center, Dr. Molewaterplein 40, 3015GD, PO Box 2040, Ste Na-2119, Rotterdam, the Netherlands (s.gangaram-panday@erasmusmc.nl).

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