Hospital costs of complications after esophagectomy for cancer

Goense, Lucas; Dijk, W.A. van; Govaert, Johannes A.; Rossum, Peter S.N. van; Ruurda, Jelle P.; Hillegersberg, Richard van

doi:10.1016/j.ejso.2016.11.013

Cited by 97 publications

(85 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, newer treatment modalities are being developed, such as MIE, which will provide patients with alternatives to open esophagectomy . As a result, the rates at which patients choose specific treatments will likely shift, causing changes in resource utilization, such as a potential reduction in hospitalizations for the postoperative complications associated with invasive surgery . A detailed understanding of recent costs associated with esophageal cancer treatment, based on studies such as ours, is necessary for researchers who hope to predict future cancer care costs.…”

Section: Discussionmentioning

confidence: 99%

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

et al. 2019

View full text Add to dashboard Cite

Background Detailed cost estimates are not widely available for esophageal cancer. Our study estimates phase‐specific costs for esophageal cancer by age, year, histology, stage, and treatment for older patients in the United States and compares these costs within stage and treatment modalities. Methods We identified 8061 esophageal cancer patients in the Surveillance, Epidemiology, and End Results‐Medicare database for years 1998‐2013. Total, cancer‐attributable, and patient‐liability costs were calculated based on separate phases of care—staging (or surgery), initial, continuing, and terminal. We estimated costs by treatment modality within stage and phase for esophageal adenocarcinoma and squamous cell carcinoma separately. We fit linear regression models using log transformation to determine cost by age and calendar year. All costs are reported in 2018 US dollars. Results Overall, mean (95% CI) monthly total cost estimates were high during the staging ($8953 [$8385‐$9485]) and initial phases ($7731 [$7492‐$7970]), decreased over the continuing phase ($2984 [$2814‐$3154]), and increased substantially during the 6‐month terminal phase ($18 150 [$17 211‐$19 089]). This pattern of high staging and initial phase costs, decreasing continuing phase costs, and increasing terminal phase costs was seen in all stages. The highest staging costs were in stages III ($9249, $8025‐$10 474) and II ($9171, $7642‐$10 699). The highest initial phase cost was in stage IV, $9263 ($8758‐49 768), the lowest continuing phase cost was in stage I, $2338 ($2160‐$2517), and the highest terminal phase costs were in stages II ($20 533, $17 772‐$23 293) and III ($20 599, $18 268‐$22 929). The linear regression models showed that cancer‐attributable costs remained stable over the study period and were unaffected by age for most histology, stage, and treatment modality subgroups. Conclusions Our estimates demonstrate that esophageal cancer costs can vary widely by histology, stage, and treatment. These cost estimates can be used to guide future resource allocation for esophageal cancer care and research.

show abstract

Section: Discussionmentioning

confidence: 99%

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Reported overall rates of complications after oesophagectomy range from 40 to 60 per cent, with pulmonary and anastomotic complications being the most common. These postoperative complications have a significant effect on morbidity, duration of hospital stay, mortality and healthcare costs. Although advances in surgical techniques and perioperative care have reduced the frequency of complications over the years, postoperative morbidity rates remain high.…”

Section: Introductionmentioning

confidence: 99%

Impact of postoperative complications on outcomes after oesophagectomy for cancer

Goense

Meziani

Ruurda

et al. 2019

Journal of British Surgery

View full text Add to dashboard Cite

Background To allocate healthcare resources optimally, complication‐related quality initiatives should target complications that have the greatest overall impact on outcomes after surgery. The aim of this study was to identify the most clinically relevant complications after oesophagectomy for cancer in a nationwide cohort study. Methods Consecutive patients who underwent oesophagectomy for cancer between January 2011 and December 2016 were identified from the Dutch Upper Gastrointestinal Cancer Audit. The adjusted population attributable fraction (PAF) was used to estimate the impact of specific postoperative complications on the clinical outcomes postoperative mortality, reoperation, prolonged hospital stay and readmission to hospital in the study population. The PAF represents the percentage reduction in the frequency of a given outcome (such as death) that would occur in a theoretical scenario where a specific complication (for example anastomotic leakage) was able to be prevented completely in the study population. Results Some 4096 patients were analysed. Pulmonary complications and anastomotic leakage had the greatest overall impact on postoperative mortality (risk‐adjusted PAF 44·1 and 30·4 per cent respectively), prolonged hospital stay (risk‐adjusted PAF 31·4 and 30·9 per cent) and readmission to hospital (risk‐adjusted PAF 7·3 and 14·7 per cent). Anastomotic leakage had the greatest impact on reoperation (risk‐adjusted PAF 47·1 per cent). In contrast, the impact of other complications on these outcomes was relatively small. Conclusion Reducing the incidence of pulmonary complications and anastomotic leakage may have the greatest clinical impact on outcomes after oesophagectomy.

show abstract

“…Not only safe anastomoses, but also timely identification of anastomotic or other surgical complications are essential to reduce morbidity, prolonged hospitalization, mortality, and, consequently, additional medical costs . Both surgical expertise and experience are key elements for limiting the leakage rate and managing its consequences after esophagectomy, and it is argued that centralizing surgical care may be a key determinant of lower leakage rates .…”

Section: Introductionmentioning

confidence: 99%

Diagnosis, assessment, and management of surgical complications following esophagectomy

Grimminger

Goense

Gockel

et al. 2018

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

show abstract

Hospital costs of complications after esophagectomy for cancer

Cited by 97 publications

References 35 publications

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

Esophageal cancer treatment costs by phase of care and treatment modality, 2000‐2013

Impact of postoperative complications on outcomes after oesophagectomy for cancer

Diagnosis, assessment, and management of surgical complications following esophagectomy

Contact Info

Product

Resources

About