Abstract
Aim The aim of the study was to evaluate costs associated with colonic endoscopic submucosal dissection (ESD) for treatment of colorectal cancer. Methods The study is a retrospective analysis of data on 395 patients treated by colonic ESD. Results The operation, consumable items, and medication accounted for 71% of the total costs for colonic ESD treatment. Medication and consumable items' costs were higher if lesions occurred in the transverse colon and right hemicolon compared to the left hemicolon. Medication, consumable items, and total costs were higher for larger lesions. Lesion numbers and carcinoma were associated with higher medication, consumable items, operation, and total costs. Positive surgical margins and complications of hemorrhage or perforation were positively correlated with higher costs for medication, consumable items, and total costs. Conclusion Labor costs for doctors and nurses remain low in China. Costs for medication and consumable items were higher for treatment involving the transverse colon or right hemicolon (vs. the left hemicolon), larger lesions, carcinoma, and a positive surgical margin. A benchmark cost estimate for ESD treatment including 4 days of postoperative hospitalization was determined to be approximately 5400 USD.
Highlights
Colorectal cancer is among the top three causes of cancer mortality and is commonly diagnosed in both Western and Eastern nations, including China [1]
Compared to conventional endoscopic procedures such as endoscopic mucosal resection, endoscopic submucosal dissection (ESD) exhibits higher en bloc resection rates and lower recurrence rates for early stage gastric and colorectal cancer [5, 6]
Invasive ESD is a promising technique for treatment of digestive tract diseases, especially polyps, adenoma, and early stage carcinoma [7]
Summary
Colorectal cancer is among the top three causes of cancer mortality and is commonly diagnosed in both Western and Eastern nations, including China [1]. Stage colorectal cancer can be effectively treated using advanced endoscopic procedures, including endoscopic submucosal dissection (ESD) [3]. Compared to conventional endoscopic procedures such as endoscopic mucosal resection, ESD exhibits higher en bloc resection rates and lower recurrence rates for early stage gastric and colorectal cancer [5, 6]. At the present time, optimized cost-benefit ratios for hospitalization time with respect to pre-ESD preparation and post-ESD complications remain undefined. To fill this knowledge gap, we performed a retrospective analysis of data collected on nearly 400 patients in order to examine the costeffectiveness of colonic ESD
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