Economic burden of complications and readmission following oesophageal cancer surgery

Abstract

Background: Oesophageal cancer is the seventh most prevalent malignancy globally, and the sixth most common cause of cancer-related death. Oesophageal cancer is also one of the most costly cancers to treat. The aim of this study was to assess the financial impact of post-operative morbidity and hospital readmissions following oesophagectomy for oesophageal cancer. Methods: A retrospective analysis was performed on a prospectively maintained database of patients with oesophageal cancer who underwent an oesophagectomy at a single centre between July 2014 and June 2019 (N = 56). Readmission costs were also assessed in this cohort for 12 months post-operatively.

Right gastroepiploic artery length determined anastomotic leakage after minimally invasive esophagectomy for esophageal cancer: a prospective cohort study

“…Among thoracic surgeons, minimally invasive McKeown esophagectomy has emerged as the preferred technique and gained widespread acceptance as the standard approach for esophageal resection 1 , 2 . Anastomotic leakage (AL), a complication that heightens postoperative morbidity and mortality, increases healthcare costs and prolongs hospital stays, is recognized as a significant challenge 3 – 5 . The reported incidence of AL ranges from 12.8 to 19%, with an associated mortality rate of 3.8% 2 , 6 , 7 .…”

Real cost of surgery: what are we missing?

“…In this issue, Browning et al . provide the hospital‐level cost associated with the different outcomes following oesophagectomy (with and without complications) 1 . This cost analysis is but one component of a full cost‐effectiveness/utility analysis.…”

“…In this issue, Browning et al report the cost of surgery for oesophageal cancer, confirm its high cost, and show that complications increase cost. 1 Their conclusion that minimizing complications will reduce cost is sound. However, the cost of oesophagectomy is not limited to inpatient costs.…”

“…In this issue, Browning et al provide the hospital-level cost associated with the different outcomes following oesophagectomy (with and without complications). 1 This cost analysis is but one component of a full cost-effectiveness/utility analysis. In a previous Australian study that determined health care resource use for oesophageal cancer, Gordon et al demonstrated that for patients undergoing oesophagectomy for cancer, surgery contributed 66.4% of the treatment cost, with neoadjuvant therapies and workup accounting for the other third.…”

“…Browning et al's assessment of hospital cost for patients undergoing oesophagectomy is an initial step towards determining the cost-effectiveness of surgery for oesophageal cancer and identifying strategies that might deliver a better outcome. 1 To adequately determine cost-effectiveness, all treatment strategies need to be identified and differences in incremental costs and outcomes between strategies should be compared by calculating the ICER. Costs that are outside the hospital admission for surgery also need to be included.…”