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Cost-minimisation and cost-effectiveness analysis comparing transoral CO₂ laser cordectomy, laryngofissure cordectomy and radiotherapy for the treatment of T1-2, N0, M0 glottic carcinoma.

Abstract
The financial costs of laryngeal cancer treatment are a notable burden on healthcare budgets. In this study, we assess whether CO2 laser surgery is cheaper than radiotherapy or laryngofissure and cordectomy in the treatment of T1-2, N0, M0 glottic squamous cell carcinoma. 56 patients with a mean age of 65.88 years (SD = 10.04), 53 men and 3 women, with T1-2, N0, M0 glottic squamous cell carcinoma were retrospectively analysed. We conducted a comparative analysis of costs associated with three treatments: carbon dioxide laser cordectomy (n = 21), radiotherapy (n = 20), and laryngofissure cordectomy (n = 15). Complications of the radiotherapy and surgical treatments, need for tracheotomy and its permanence, length of hospital stay, occupation and ability to work and economic costs of treatments were recorded. Cost-minimisation and cost-effectiveness analysis were obtained. The cost of transoral laser cordectomy (2,289.79 euro) is statistically significantly lower than that of radiotherapy (4,804.72 euro) or laryngofissure cordectomy (13,229.75 euro) (p < 0.001). Transoral carbon dioxide laser surgery is the best option in terms of cost-effectiveness for the treatment of T1-2, N0, M0 glottic cancer.
AuthorsPedro Diaz-de-Cerio, Julian Preciado, Francisco Santaolalla, Ana Sanchez-Del-Rey
JournalEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 270 Issue 4 Pg. 1181-8 (Mar 2013) ISSN: 1434-4726 [Electronic] Germany
PMID22872061 (Publication Type: Comparative Study, Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Cost Savings (economics)
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Laryngeal Neoplasms (economics, pathology, radiotherapy, surgery)
  • Laryngoscopy (economics)
  • Larynx (pathology, radiation effects, surgery)
  • Laser Therapy (economics)
  • Lasers, Gas (therapeutic use)
  • Male
  • Middle Aged
  • National Health Programs (economics)
  • Neoplasm Staging
  • Retrospective Studies
  • Spain
  • Vocal Cords (radiation effects, surgery)

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