Relative incremental costs of complications of lobectomy for stage I non–small cell lung cancer

Geller, Abraham D.; Mathisen, Douglas J.; Wright, Cameron D.; Lanuti, Michael

doi:10.1016/j.jtcvs.2017.11.025

Cited by 20 publications

(17 citation statements)

References 29 publications

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“…Consistent with previous reports [8,15], major complications have substantially increased the incremental healthcare expenditure. Huo et al's study, using claims data, did not require every individual to undergo non-contrast chest CT within one month before the procedure [8], which in turn might have captured more procedures unrelated to screening.…”

Section: Discussionsupporting

confidence: 90%

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Yang

Lai

Kuo

et al. 2021

IJERPH

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This study aimed to estimate the downstream complications and healthcare expenditure after invasive procedures for lung lesions, which in turn could be used for future cost-effectiveness analyses of lung cancer screening in Taiwan. We interlinked the Taiwan National Beneficiary Registry with the National Health Insurance Reimbursement databases to identify non-lung cancer individuals aged 50–80 years who underwent invasive lung procedures within one month after non-contrast chest computed tomography between 2014 and 2016. We directly matched one individual with 10 controls by age, gender, calendar year, residence area, comorbidities, and the past one-year healthcare expenditure to calculate incremental one-month complication rates and attributable costs. A total of 5805 individuals who underwent invasive lung procedures were identified and matched with 58,050 controls. The incremental one-month complication rates were 13.4% (95% CI: 10.9% to 15.8%), 10.7% (95% CI: 9.2% to 12.1%), and 4.4% (95% CI: 2.0% to 6.7%) for thoracic surgery, bronchoscopy, and needle biopsy, respectively. The incremental one-month healthcare expenditure for minor, intermediate, and major complications were NT$1493 (95% CI: NT$-3107 to NT$6092), NT$18,422 (95% CI: NT$13,755 to NT$23,089), and NT$58,021 (95% CI: NT$46,114 to NT$69,929), respectively. Individuals aged 60–64 years incurred the highest incremental costs. Downstream complications and the healthcare expenditure after invasive procedures for lung lesions would be substantial for non-lung cancer individuals 50–80 years of age. These estimates could be used in modeling the cost-effectiveness of the national lung screening program in Taiwan.

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Section: Discussionsupporting

confidence: 90%

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Yang

Lai

Kuo

et al. 2021

IJERPH

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“…15 A previous analysis of factors associated with cost of lobectomy showed that the additive cost of postoperative events had a substantial impact on overall hospital cost following lobectomy, which increased by 23%, 53%, and 185% with 1, 2, and 3 complications, respectively. 23 Improvements of postoperative outcomes therefore have a notable impact on overall cost-effectiveness. 20 In one of the first cost-effectiveness studies, Burfeind and colleagues 24 also reported on cost savings and at a single center with high volume of VATS.…”

Section: Discussionmentioning

confidence: 99%

Hospital cost and clinical effectiveness of robotic-assisted versus video-assisted thoracoscopic and open lobectomy: A propensity score–weighted comparison

Kneuertz

Singer

D’Souza

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: To compare cost and perioperative outcomes of robotic, videoassisted thoracoscopic surgery (VATS), and open surgical approaches to pulmonary lobectomy.Methods: Patients who underwent pulmonary lobectomy between 2012 and 2017 at a single tertiary referral center were reviewed. Propensity score adjustment by inverse probability of treatment weighting (IPTW) was used to balance baseline patient characteristics. The primary outcomes of the study were direct hospital cost and perioperative outcomes, including operative time, complications rates, and length of stay. Indirect cost and charges were secondary financial outcomes.From the

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“…In the present study, we sought to describe the postoperative risk profiles of patients undergoing TIL harvest, characterizing commonly observed postoperative complications inherent to patients undergoing pulmonary resection. We identified that, indeed, cardiac, pulmonary, infectious, and other complications were uncommon, occurring less frequently than commonly cited literature evaluating pulmonary resection for other indications 10,11 . Furthermore, among the three patients who were either discharged with a chest tube or home oxygen, extensive pulmonary metastatic disease and/or limitations with pulmonary reserve may have contributed to these events.…”

Section: Discussionmentioning

confidence: 84%

Pulmonary resection for tissue harvest in adoptive tumor‐infiltrating lymphocyte therapy: Safety and feasibility

Corsini

Mitchell

Zhou

et al. 2021

Journal of Surgical Oncology

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Background and Objectives Adoptive T‐cell therapies (ACTs) using expansion of tumor‐infiltrating lymphocyte (TIL) populations are of great interest for advanced malignancies, with promising response rates in trial settings. However, postoperative outcomes following pulmonary TIL harvest have not been widely documented, and surgeons may be hesitant to operate in the setting of widespread disease. Methods Patients who underwent pulmonary TIL harvest were identified, and postoperative outcomes were studied, including pulmonary, cardiovascular, infectious, and wound complications. Results 83 patients met inclusion criteria. Pulmonary TIL harvest was undertaken primarily via a thoracoscopy with a median operative blood loss and duration of 30 ml and 65 min, respectively. The median length of stay was 2 days. Postoperative events were rare, occurring in only five (6%) patients, including two discharged with a chest tube, one discharged with oxygen, one episode of urinary retention, and one blood transfusion. No reoperations occurred. The median time from TIL harvest to ACT infusion was 37 days. Conclusions Pulmonary TIL harvest is safe and feasible, without major postoperative events in our cohort. All patients were able to receive intended ACT infusion without delays. Therefore, thoracic surgeons should actively participate in ongoing ACT trials and aggressively seek to enroll patients on these protocols.

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Relative incremental costs of complications of lobectomy for stage I non–small cell lung cancer

Cited by 20 publications

References 29 publications

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Downstream Complications and Healthcare Expenditure after Invasive Procedures for Lung Lesions in Taiwan

Hospital cost and clinical effectiveness of robotic-assisted versus video-assisted thoracoscopic and open lobectomy: A propensity score–weighted comparison

Pulmonary resection for tissue harvest in adoptive tumor‐infiltrating lymphocyte therapy: Safety and feasibility

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