How much does it cost to preserve a larynx?

Abstract

Various studies report an increase in costs when induction chemotherapy is included in the treatment of advanced laryngeal cancer, but to our knowledge no studies have yet compared the economic costs of total laryngectomy versus induction chemotherapy in the treatment of advanced laryngeal cancer. We have conducted a retrospective study comparing the costs of treatment and survival in 96 patients with a T3N0-1 glottic carcinoma. Findings showed that the average cost per patient in the group of patients treated by total laryngectomy with or without postoperative radiotherapy was 5,853 Eur, while that for the group of patients who began treatment with induction chemotherapy was 6,452 Eur. The adjusted 5-year survival for patients treated with total laryngectomy with or without postoperative radiotherapy was 80%, and 72% for patients who began treatment with induction chemotherapy. Sixteen of the 35 patients (46%) receiving induction chemotherapy were spared laryngectomy. The use of induction chemotherapy in the treatment of patients with advanced laryngeal carcinomas involved an increase in cost of 600 Eur in relation to treatment with total laryngectomy and postoperative radiotherapy. However, from an economic point of view, we consider induction chemotherapy to be an important consideration in an organ-preservation strategy.

Cost Comparison of Surgery vs Organ Preservation for Laryngeal Cancer

“…According to the decision-analysis model in this study, total laryngectomy with postoperative radiotherapy yields lower direct medical costs by $2914 per patient com-(REPRINTED) ARCH OTOLARYNGOL HEAD NECK SURG/ VOL 131, JAN 2005 pared with an organ preservation protocol in the management of advanced laryngeal cancer. This finding agrees with that reported by Leon and colleagues, 33 who retrospectively reviewed medical records from 96 patients from Spain with stage III glottic tumors and found surgery to be less expensive than organ preservation by €600.…”

Organ Preservation With Concurrent Chemoradiation for Advanced Laryngeal Cancer: Are We Succeeding?

“…Although some trials have shown an improvement in some components of quality of life (8, 30) many others have described equivalent results (31)(32)(33)(34). Furthermore, cost consideration may be an important factor in decision making for the treatment of advanced laryngeal cancer (35,36).…”

Economic burden of head and neck cancer

“…Leon et al [34] compared the costs of total laryngectomy to induction chemotherapy.The average cost per laryngectomized patient with or without radiotherapy was €5,853 (2001 €6,002) while the average cost for those patients treated with induction chemotherapy was €6,452 (€6,616). Among patients who received induction chemotherapy 46% (16 of 35) did not have a laryngectomy.…”