Nathaniel Deboever, Michael A. Eisenberg, Mara B. Antonoff, Wayne L. Hofstetter, Reza J. Mehran, David C. Rice, Jack A. Roth, Stephen G. Swisher, Ara A. Vaporciyan, Garrett L. Walsh, Ravi Rajaram
{"title":"Relationship of Surgical Approach With Financial Toxicity in Patients With Resected Lung Cancer","authors":"Nathaniel Deboever, Michael A. Eisenberg, Mara B. Antonoff, Wayne L. Hofstetter, Reza J. Mehran, David C. Rice, Jack A. Roth, Stephen G. Swisher, Ara A. Vaporciyan, Garrett L. Walsh, Ravi Rajaram","doi":"10.1002/jso.27870","DOIUrl":null,"url":null,"abstract":"IntroductionMinimally invasive surgery (MIS) reduces lengths of stay, complications, and potentially perioperative hospital costs. However, the impact of MIS on financial toxicity (FT), defined as the costs resulting from oncologic care and their negative effects on quality of life, in patients with lung cancer is unknown. Our objective was to investigate the association between surgical approach and FT in this population.MethodsA single‐institution study was performed evaluating resected lung cancer patients (2016–2021). FT was assessed using the Comprehensive Score for Financial Toxicity (COST) questionnaire. The relationship between surgical approach (MIS vs. thoracotomy) and FT was evaluated using propensity score‐matched (PSM) regression analysis. A sensitivity analysis involving the entire cohort was also performed using an inverse probability‐weighted generalized linear model.ResultsAs reported previously, of 1477 patients surveyed, 463 responded (31.3%) with FT reported in 196 patients (42.3%). Resection was performed by thoracotomy in 53.3% (<jats:italic>n</jats:italic> = 247), and by MIS in the remainder (<jats:italic>n</jats:italic> = 216, 46.7%; video‐assisted thoracoscopic surgery [VATS] = 115; robotic‐assisted = 101). There was no difference in FT in patients who underwent VATS and robotic‐assisted surgery (<jats:italic>p</jats:italic> = 0.515). In the PSM analysis, MIS was not associated with FT (odds ratio [OR]: 0.980, 95% confidence interval [CI]: 0.628–1.533, <jats:italic>p</jats:italic> = 0.929). Similar results were found on sensitivity analysis (OR: 1.488, CI: 0.931–2.378, <jats:italic>p</jats:italic> = 0.096).ConclusionsCompared to MIS, thoracotomy was not associated with FT in patients with resected lung cancer. Though there are several benefits from MIS, it does not appear to be a meaningful strategy to alleviate FT in this population.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.27870","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
IntroductionMinimally invasive surgery (MIS) reduces lengths of stay, complications, and potentially perioperative hospital costs. However, the impact of MIS on financial toxicity (FT), defined as the costs resulting from oncologic care and their negative effects on quality of life, in patients with lung cancer is unknown. Our objective was to investigate the association between surgical approach and FT in this population.MethodsA single‐institution study was performed evaluating resected lung cancer patients (2016–2021). FT was assessed using the Comprehensive Score for Financial Toxicity (COST) questionnaire. The relationship between surgical approach (MIS vs. thoracotomy) and FT was evaluated using propensity score‐matched (PSM) regression analysis. A sensitivity analysis involving the entire cohort was also performed using an inverse probability‐weighted generalized linear model.ResultsAs reported previously, of 1477 patients surveyed, 463 responded (31.3%) with FT reported in 196 patients (42.3%). Resection was performed by thoracotomy in 53.3% (n = 247), and by MIS in the remainder (n = 216, 46.7%; video‐assisted thoracoscopic surgery [VATS] = 115; robotic‐assisted = 101). There was no difference in FT in patients who underwent VATS and robotic‐assisted surgery (p = 0.515). In the PSM analysis, MIS was not associated with FT (odds ratio [OR]: 0.980, 95% confidence interval [CI]: 0.628–1.533, p = 0.929). Similar results were found on sensitivity analysis (OR: 1.488, CI: 0.931–2.378, p = 0.096).ConclusionsCompared to MIS, thoracotomy was not associated with FT in patients with resected lung cancer. Though there are several benefits from MIS, it does not appear to be a meaningful strategy to alleviate FT in this population.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.