Cost-effectiveness of endoscopically placed stents in the palliation of locally advanced esophageal carcinoma

Abstract

The study assessed 50 consecutive patients presenting advanced esophageal carcinoma, in order to evaluate the cost-effectiveness of endoscopic palliation of dysphagia. Cases were divided into groups according to the type of therapy: Group A - surgical resections; Group B - gastrostomy, jejunostomy, surgical bypass or no palliation; Group C - endoscopic palliation. A retrospective study analysed early mortality, length of hospital stay and cost of therapy. Mean postoperative survival was within the expected limits in the endoscopically treated group (3-6 months), and in the non-resected group, while resected patients showed a very high early mortality and no long term survivals. Costs were significantly smaller in Group C as compared with Group A, with shorter hospital stay and better palliation. We conclude that endoscopically placed stents represent a cost effective palliation for advanced esophageal carcinoma and medical authorities should consider covering the expenses required by such procedures.