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. 2022 Sep 2;6(5):zrac109.
doi: 10.1093/bjsopen/zrac109.

Impact of cumulative complications on 1-year treatment-related healthcare costs in patients with colorectal peritoneal metastases undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Femke A van der Zant  1 , Bob J L Kooijman  1 , Judith E K R Hentzen  2 , Wijnand Helfrich  3 , Emily M Ploeg  3 , Robert J van Ginkel  1 , Barbara L van Leeuwen  1 , Lukas B Been  1 , Joost M Klaase  4 , Patrick H J Hemmer  1 , Christian S van der Hilst  4 , Schelto Kruijff  1
Affiliations

Impact of cumulative complications on 1-year treatment-related healthcare costs in patients with colorectal peritoneal metastases undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Femke A van der Zant et al. BJS Open. .

Abstract

Background: The aim of this study was to evaluate the impact of all minor and major complications on treatment-related healthcare costs in patients who undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of colorectal peritoneal metastases (PMs).

Method: Patients with histologically proven colorectal PMs who underwent CRS + HIPEC from March 2006 to October 2019 in a tertiary referral centre were retrospectively identified from a prospectively maintained database. Patients were divided into six subgroups according to the severity of the complications, which were scored using the comprehensive complication index (CCI) (CCI 0-9.9, CCI 10-19.9, CCI 20-29.9, CCI 30-39.9, CCI 40-49.9, and CCI 50 or higher). Treatment-related healthcare costs up to 1 year after CRS + HIPEC were obtained from the financial department. Differences in costs and survival outcomes were compared using the chi-squared test and Kruskal-Wallis H test.

Results: A total of 142 patients were included (CCI 0-9.9, 53 patients; CCI 10-19.9, 0 patients; CCI 20-29.9, 45 patients; CCI 30-39.9, 14 patients; CCI 40-49, 9 patients; and CCI 50 or higher, 21 patients). Median (interquartile range) treatment-related healthcare costs increased significantly and exponentially for the CCI 30-39, CCI 40-49, and CCI 50 or higher groups (€48 993 (€44 262-€84 805); €57 167 (€43 047-€67 591); and €82 219 (€55 487-€145 314) respectively) compared with those for the CCI 0-9.9 and CCI 20-29.9 groups (€33 856 (€24 433-€40 779) and €40 621 (€31 501-€58 761) respectively, P < 0.010).

Conclusion: Treatment-related healthcare costs increase exponentially as more complications develop among patients who undergo CRS + HIPEC for the treatment of colorectal PMs. Anastomotic leakages after CRS + HIPEC lead to an increase of 295 per cent of treatment-related healthcare costs.

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Figures

Fig. 1
Fig. 1
Subgroups of patients with colorectal peritoneal metastases who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, according to the comprehensive complication index
Fig. 2
Fig. 2
Correlation between total median treatment-related healthcare costs and the comprehensive complication index score CCI, comprehensive complication index.
See this image and copyright information in PMC

References

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