Table 4.

Preliminary cost-effectiveness estimates. Cost-effectiveness estimates for BSC and six established therapies (6–9) for widespread mCRC are noted in conjunction with liberal estimates of cost for MCA. Our proposed adjunctive cost-effectiveness ratio, or ACER, was used to calculate the estimated cost of MCA when paired with systemic regimens.

	BSC	5-FU	5-FU with LV	FOLFOX	FOLFIRI	FOLFIRI + BV	CX and IR	MCA
LYG	0.52	0.71	1.57	1.65	1.66	1.69	0.81	1.97
Total cost ($)**	$4,233	$12,344	$55,793	$94,693	$61,781	$78,245	$37,723	$73,900*
$/LYG	$8,140	$17,386	$35,537	$57,390	$37,217	$46,299	$46,572	$37,513
ACER (Cost/LYG)***	$39,661	$43,779	$65,834	$85,580	$68,874	$77,231	$56,661	Mean: $62,517

^*Assumes 1.9 cryoablation procedures per patient and more image intensive followup.

^**A conversion factor of 1.67 from pounds to dollars was used to allow easier comparison and conforms to the difference between established definitions of cost efficacy of $100,000 [28].

^***ACER: adjunctive role for, MCA: assumes costs are additive and divided by a total LYG of 1.97 for MCA.

MCA: multisite cryoablation.

5-FU: 5-fluorouracil.

LV: leucovorin.

FOLFOX: 5-FU, leucovorin, and oxaliplatin.

FOLFIRI: 5-FU, leucovorin, and irinotecan.

BV: bevacizumab.

IR: irinotecan.

CX: cetuximab.