title: 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.
authors.affiliation: Otorhinolaryngology Department, San Pedro Hospital, Logroño, La Rioja, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Diaz-de-Cerio
authors.forename: Julian
authors.initials: J
authors.lastname: Preciado
authors.forename: Francisco
authors.initials: F
authors.lastname: Santaolalla
authors.forename: Ana
authors.initials: A
authors.lastname: Sanchez-Del-Rey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000191:economics* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007828:Laryngoscopy / Q000191:economics*; D007830:Larynx / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D053685:Laser Therapy / Q000191:economics*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013030:Spain; D014827:Vocal Cords / Q000528:radiation effects* / Q000601:surgery*