Abstract
Objective: To investigate the pattern of palliative surgeries and associated costs in patients with metastatic melanoma in the USA. Methods: This was a retrospective claims-based study of patients identified using administrative claims from MarketScan® databases among patients with metastatic melanoma diagnosed between 2005 and 2011. Patient characteristics, patterns and cost of surgery, and length of hospital stay were evaluated. Results: Of the 2399 patients identified, 888 (37.0%) underwent at least one surgical procedure either in the outpatient or inpatient setting. The subgroup of patients who underwent surgery included significantly more patients with distant skin metastases compared to the subgroup who did not receive surgery; whereas significantly more patients in the non-surgery group had brain or bone metastases. Surgery performed in the outpatient setting was predominantly on the skin, whereas surgery on the brain was generally performed in the inpatient setting. The mean cost of the surgical procedures performed in the outpatient setting was $3393 (median: $1419) per procedure, which varied according to the location of the metastasis. For surgical procedures that were performed in the inpatient setting, the mean length of stay in hospital due to surgery was 4.4 (± 5.1) days, at a mean cost of $37,649 (median: $28,067) per hospitalization. Conclusions: Surgery is prevalent and costly in patients with metastatic melanoma.
Highlights
Metastatic melanoma (MM), defined as melanoma that has spread to distant sites such as the skin, subcutaneousHow to cite this paper: Zhao, Z.Y., Wang, S. and Barber, B.L. (2015) The Pattern and Cost of Palliative Surgeries in Patients with Metastatic Melanoma
Surgical procedures that were likely to be related to melanoma treatment and had been performed on skin, brain, liver, lung, lymph nodes or soft tissue were included in this study
The mean cost of the surgical procedures performed in the outpatient setting was $3393 per procedure, which varied according to the location of the metastasis
Summary
Metastatic melanoma (MM), defined as melanoma that has spread to distant sites such as the skin, subcutaneous. (2015) The Pattern and Cost of Palliative Surgeries in Patients with Metastatic Melanoma. Surgical intervention for MM is rarely curative since the majority of patients with distant metastases have widespread micrometastatic disease and circulating tumor cells. Palliative surgery for distant metastases can be considered in patients where some benefits may be expected [6], such as to reduce tumor burden before the use of adjuvant immunotherapies [7]. Few studies have examined the patterns and cost of surgical procedures in this patient population.
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