Original Title: Cirurgia de citorredução com hipertermoquimioterapia em pacientes com pseudomixoma peritoneal

Authors' objectives: Is treatment with cytoreductive surgery with hyperthermic chemotherapy more effective and cost-effective than systemic chemotherapy for survival of patients with pseudomyxoma peritonei?

Authors' results and conclusions: The Conitec’s members present at the 86th Ordinary Meeting, on March 4th and 5th, 2020, unanimously decided to recommend the incorporation of cytoreductive surgery with HIPEC for the treatment of pseudomyxoma peritonei, in the scope of SUS, in accordance with a protocol to be developed by the Ministry of Health.

Authors' recommendations: Scientific evidence: Clinical trials on cytoreductive surgery with HIPEC specifically for patients with pseudomyxoma peritonei were not found. Fifteen observational studies were selected, the number of patients evaluated ranged from 29 to 636, and the data collection period ranged from 3 to 26 years. The overall 5-year survival rate ranged from 42% to 94%. The studies with the largest number of patients reported an overall 5-year survival rate ranging from 73% to 84%. For the two most recently published studies, the 5-year survival rates were 87% and 82%. Although studies with a comparison group were not found, observational studies on older treatment methods (surgery and/or systemic chemotherapy) reported lower overall survival, indirectly suggesting the superiority of the cytoreduction with HIPEC procedure. Budget impact analysis: The incremental value per health centre was assessed considering it would perform 24 procedures per year. A dynamic microsimulation model was developed, over a 5-year time horizon. According to the Brazilian Society of Surgical Oncology (SBCO in Portuguese), 120-200 cases per year in Brazil of pseudomyxoma peritonei and peritoneal mesothelioma would be eligible for the procedure. The average annual budget impact for the 24 patients was estimated to be BRL 1,692,864.36. For the entire population, the values per year ranged from BRL 8,661,117.15 to BRL 14,657,044.06.

Project Status: Completed

URL for project: http://conitec.gov.br/images/Consultas/Relatorios/EN2020/20210106_Report518_CytoreductiveSurgery_HIPEC.pdf

Year Published: 2020

URL for published report: http://conitec.gov.br/images/Relatorios/2020/Relatorio_HIPEC_Pseudomixioma_FINAL_518_2020.pdf

URL for additional information: http://conitec.gov.br/recomendation-reports

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Brazil

Organisation Name: National Committee for Technology Incorporation (CONITEC)

Contact Address: Esplanada dos Ministérios, Bl. G, Ed. Sede, 8º andar, CEP: 70058-900

Contact Name: Clarice Moreira Portugal

Contact Email: clarice.portugal@saude.gov.br

Copyright: 2021 Conitec