TY - JOUR
T1 - The Financial burden of reexcising incompletely excised soft tissue sarcomas
T2 - A cost analysis
AU - Alamanda, Vignesh K.
AU - Delisca, Gadini O.
AU - Mathis, Shannon L.
AU - Archer, Kristin R.
AU - Ehrenfeld, Jesse M.
AU - Miller, Mark W.
AU - Homlar, Kelly Cornett
AU - Halpern, Jennifer L.
AU - Schwartz, Herbert S.
AU - Holt, Ginger E.
PY - 2013/9
Y1 - 2013/9
N2 - Background: Although survival outcomes have been evaluated between those undergoing a planned primary excision and those undergoing a reexcision following an unplanned resection, the financial implications associated with a reexcision have yet to be elucidated. Methods: A query for financial data (professional, technical, indirect charges) for soft tissue sarcoma excisions from 2005 to 2008 was performed. A total of 304 patients (200 primary excisions and 104 reexcisions) were identified. Wilcoxon rank sum tests and χ 2 or Fisher's exact tests were used to compare differences in demographics and tumor characteristics. Multivariable linear regression analyses were performed with bootstrapping techniques. Results: The average professional charge for a primary excision was $9,694 and $12,896 for a reexcision (p <.001). After adjusting for tumor size, American Society of Anesthesiologists status, grade, and site, patients undergoing reexcision saw an increase of $3,699 in professional charges more than those with a primary excision (p <.001). Although every 1-cm increase in size of the tumor results in an increase of $148 for a primary excision (p =.006), size was not an independent factor in affecting reexcision charges. The grade of the tumor was positively associated with professional charges of both groups such that higher-grade tumors resulted in higher charges compared to lower-grade tumors (p <.05). Conclusions: Reexcision of an incompletely excised sarcoma results in significantly higher professional charges when compared to a single, planned complete excision. Additionally, when the cost of the primary unplanned surgery is considered, the financial burden nearly doubles.
AB - Background: Although survival outcomes have been evaluated between those undergoing a planned primary excision and those undergoing a reexcision following an unplanned resection, the financial implications associated with a reexcision have yet to be elucidated. Methods: A query for financial data (professional, technical, indirect charges) for soft tissue sarcoma excisions from 2005 to 2008 was performed. A total of 304 patients (200 primary excisions and 104 reexcisions) were identified. Wilcoxon rank sum tests and χ 2 or Fisher's exact tests were used to compare differences in demographics and tumor characteristics. Multivariable linear regression analyses were performed with bootstrapping techniques. Results: The average professional charge for a primary excision was $9,694 and $12,896 for a reexcision (p <.001). After adjusting for tumor size, American Society of Anesthesiologists status, grade, and site, patients undergoing reexcision saw an increase of $3,699 in professional charges more than those with a primary excision (p <.001). Although every 1-cm increase in size of the tumor results in an increase of $148 for a primary excision (p =.006), size was not an independent factor in affecting reexcision charges. The grade of the tumor was positively associated with professional charges of both groups such that higher-grade tumors resulted in higher charges compared to lower-grade tumors (p <.05). Conclusions: Reexcision of an incompletely excised sarcoma results in significantly higher professional charges when compared to a single, planned complete excision. Additionally, when the cost of the primary unplanned surgery is considered, the financial burden nearly doubles.
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U2 - 10.1245/s10434-013-2995-5
DO - 10.1245/s10434-013-2995-5
M3 - Article
C2 - 23636515
AN - SCOPUS:84881476162
SN - 1068-9265
VL - 20
SP - 2808
EP - 2814
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 9
ER -