高癌症死亡率的一个关键原因是因为癌细胞转移，而治疗癌转移的医疗费用则产生了巨大的经济负担。转移病例的人口规模较小，全面的推理和预后很难开展。由于转移和财务状况可以随时间发展动态过渡，因此本研究提出了一个半马尔可夫模型，以针对主要癌转移（即肺癌、脑癌、肝癌和淋巴瘤癌）进行风险和经济评估，与罕见病例进行对照。台湾全国医疗数据库被用来得出基准研究人群和成本数据。通过基于半马尔可夫蒙特卡罗模拟估计转移发展和转移存活时间以及医疗费用。在转移癌患者的存活能力和风险方面，80%的肺癌和肝癌病例倾向于转移到身体其他部位。最高费用由脑癌-肝转移患者产生。幸存者组的平均费用约为非幸存者组的5倍。该提出的模型为评估主要癌转移的存活能力和支出提供了医疗卫生决策支持工具。版权所有©2023 Elsevier B.V.

A key reason of high mortality of cancers is attributed to the metastasized cancer, whereas, the medical expense for the treatment of cancer metastases generates heavily financial burden. The population size of metastases cases is small and comprehensive inferencing and prognosis is hard to conduct.Because metastases and finance state can develop dynamic transitions over time, this study proposes a semi-Markov model to perform risk and economic evaluation associated to major cancer metastasis (i.e., lung, brain, liver and lymphoma cancer) against rare cases. A nationwide medical database in Taiwan was employed to derive a baseline study population and costs data. The time until development of metastasis and survivability from metastasis, as well as the medical costs were estimated through a semi-Markov based Monte Carlo simulation.In terms of the survivability and risk associated to metastatic cancer patients, 80% lung and liver cancer cases are tended to metastasize to other part of the body. The highest cost is generated by brain cancer-liver metastasis patients. The survivors group generated approximately 5 times more costs, in average, than the non-survivors group.The proposed model provides a healthcare decision-support tool to evaluate the survivability and expenditure of major cancer metastases.Copyright © 2023 Elsevier B.V. All rights reserved.