title: Free tissue transfer versus pedicled flap cost in head and neck cancer.
abstract: OBJECTIVE
  We sought to compare the overall 1-year management costs for patients receiving a free tissue transfer with those of patients receiving a pedicled flap reconstruction as a component of their primary head and neck cancer treatment.
  
  
  METHODS
  Case-control, cost identification analysis of 21 matched pairs of patients and multivariate analysis of variables associated with treatment costs was conducted in a tertiary referral academic institution.
  
  
  RESULTS
  No significant difference in total 1-year charges between the pedicled and free tissue transfer groups was found. A structured measure of patient comorbidity was the only variable significantly associated with total 1-year charges.
  
  
  CONCLUSIONS
  Total 1-year treatment costs of primary upper aerodigestive tract cancers are similar for patients reconstructed with free tissue transfer or a pedicled flap.
  
  
  CONCLUSIONS
  Within the context of overall 1-year management costs, the primary determinants of health care expense for these patients are comorbidity and extent of disease, not reconstructive technique.
authors.affiliation: Department of Otolaryngology and Division of Radiation Oncology, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Funk
authors.forename: Lucy Hynds
authors.initials: LH
authors.lastname: Karnell
authors.forename: Stacey
authors.initials: S
authors.lastname: Whitehead
authors.forename: Arnold
authors.initials: A
authors.lastname: Paulino
authors.forename: Joan
authors.initials: J
authors.lastname: Ricks
authors.forename: Russell B
authors.initials: RB
authors.lastname: Smith
mesh_terms: D000437:Alcoholism / Q000150:complications; D016022:Case-Control Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003362:Cost-Benefit Analysis; D017050:Episode of Care; D005251:Fees, Medical / Q000706:statistics & numerical data*; D006258:Head and Neck Neoplasms / Q000145:classification / Q000191:economics* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps / Q000191:economics*; D016019:Survival Analysis; D019737:Transplants / Q000191:economics*