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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2015

01-08-2015 | Head and Neck Oncology

Analysis of Charges Associated with Definitive Nonsurgical Therapy for Early-Stage Lateralized Tonsil Cancer

Authors: Carol M. Lewis, MD, Gregory M. Chronowski, MD, Wenli Dong, MS, G. Brandon Gunn, MD, David I. Rosenthal, MD, Randal S. Weber, MD

Published in: Annals of Surgical Oncology | Issue 8/2015

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Abstract

Objective

The cost of treatment as it affects comparative effectiveness is becoming increasingly more important. Because cost data are not readily available, we evaluated the charges associated with definitive nonsurgical therapy for early-stage lateralized tonsil cancers.

Methods

Patients treated with unilateral radiation therapy (RT) for T1 or T2 tonsil cancer between 1995 and 2007 were retrospectively reviewed. Total and radiation-specific charges, from 3 months before to 4 months after radiation, were adjusted for inflation. All facets of treatment were evaluated for significant associations with total billing.

Results

Eighty-four patients were identified. Three-year overall survival, disease-specific survival, and recurrence-free survival were 97 % [95 % confidence interval (CI) 0.88–0.99], 98 % (95 % CI 0.89–1), and 96 % (95 % CI 0.88–0.99), respectively. The median for radiation-specific charges was $60,412 (range $16,811–$84,792). The median for total charges associated with treatment was $109,917 (range $36,680–$231,895). Total billing for treatment was significantly associated with the year of diagnosis (p = 0.008), intensity-modulated radiation therapy versus wedge pair RT (p = 0.005), preradiation direct laryngoscopy (p < 0.0001), chemotherapy (p < 0.0001), gastrostomy tube placement (p = 0.004), and postradiation neck dissection (p = 0.005).

Conclusions

Although cost data for treatment are not readily available, historically, the recovery rate is approximately 30 %. The charges associated with definitive nonsurgical therapy for early-stage lateralized tonsil cancer have a wide range likely due to treatment-related procedures, the use of chemotherapy, and evolving RT technologies. These benchmark data are important given renewed interested in primary surgery for tonsil cancer. Cost of care, disease control, and functional outcomes will be critical for comparisons of effectiveness when selecting treatment modalities.
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Metadata
Title
Analysis of Charges Associated with Definitive Nonsurgical Therapy for Early-Stage Lateralized Tonsil Cancer
Authors
Carol M. Lewis, MD
Gregory M. Chronowski, MD
Wenli Dong, MS
G. Brandon Gunn, MD
David I. Rosenthal, MD
Randal S. Weber, MD
Publication date
01-08-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 8/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4298-x

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