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

Eur Arch Otorhinolaryngol. 2013 Mar;270(4):1181-8. doi: 10.1007/s00405-012-2139-8. Epub 2012 Aug 8.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cost Savings / economics*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Laryngeal Neoplasms / economics*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery*
  • Laryngoscopy / economics*
  • Larynx / pathology
  • Larynx / radiation effects
  • Larynx / surgery*
  • Laser Therapy / economics*
  • Lasers, Gas / therapeutic use*
  • Male
  • Middle Aged
  • National Health Programs / economics*
  • Neoplasm Staging
  • Retrospective Studies
  • Spain
  • Vocal Cords / radiation effects*
  • Vocal Cords / surgery*