Original Title: Sistema guiado por imagen para cirugía hepática (CAScination)

Authors' objectives: To evaluate the efficacy, effectiveness, safety and efficiency of the CAS-One system in open liver surgery and in percutaneous interventions in patients with tumours located in the liver.

Authors' results and conclusions: CAS-One is still a relatively new technology that has only been available in Europe since 2010 and was approved for use in the USA in April 2015. The clinical experience with CAS-One is to a large extent based on the studies performed in Europe by its manufacturer; and basically involve validation, viability and system-testing studies. The evidence from the review, which is of low scientific quality given the low number of patients and limited follow-up thereof over time, suggests that the CAS-One system improves the precision of hepatic resection and ablation. There are no studies comparing CAS-One with other computer-assisted guided surgery systems, therefore it is not possible to determine whether operation of the system is better or worse in comparison with similar systems. In light of the above, new prospective, controlled and randomised studies need to be performed to allow the results published in the various articles found to be confirmed and to draw direct comparisons with other, similar techniques that will allow the relevance of image-guided surgery in the treatment of localised liver cancer to be determined. The introduction of emerging technologies, such as that analysed herein, implies a significant initial cost to the National Health System (NHS), and the ability to support such a cost depends on the funding ability thereof. As such, a correct definition of the scenario in which the CAS-One system will be used is essential. The economic analysis suggests the need to correctly define the hospital units in which this technology should be used, as well as the criteria for selecting patients in which it could be applied. A higher number of patients will result in a lower opportunity cost.

Authors' methods: To evaluate the efficacy, effectiveness, safety and efficiency of the CAS-One technology, a systematic review of the scientific evidence was performed in order to provide objective information that supports both healthcare and health policy decisions. The methodology was based on a structured search in pre-determined scientific literature databases, a critical reading of the literature located, a summary of the results and an evaluation thereof in the context of the Spanish National Health System. In addition, a description of the costs per patient and per treatment was prepared depending on whether the CAS-One system is purchased or paid for on a per use basis.

Project Status: Completed

Year Published: 2016

URL for published report: https://www.ogasun.ejgv.euskadi.eus/r51-catpub/es/k75aWebPublicacionesWar/k75aObtenerPublicacionDigitalServlet?R01HNoPortal=true&N_LIBR=051909&N_EDIC=0001&C_IDIOM=es&FORMATO=.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: Osteba (Basque Office for Health Technology Assessment) Health Department of the Basque Government