A Comparison of the Initial Cost Associated With Resection Versus Laparoscopic Radiofrequency Ablation of Small Solitary Colorectal Liver Metastasis


TAKAHASHI H., Akyuz M., KAHRAMANGIL B., KOSE E., Aucejo F., FUNG J., ...Daha Fazla

SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, cilt.28, sa.6, ss.371-374, 2018 (SCI-Expanded) identifier identifier identifier

Özet

Introduction: The aim of this report was to perform a cost-comparison between liver resection (LR) and radiofrequency ablation (RFA). Method: Patients with colorectal liver metastasis (CRLM)<= 3 cm, who underwent LR or laparoscopic RFA between 2006 and 2015 were included in the study. Using a prospectively maintained CRLM database, clinical, oncologic, and financial parameters were compared. Results: Sixty-three patients underwent open or laparoscopic LR, and 25 patients underwent laparoscopic RFA. No significant difference was noted in postoperative complications, readmission rate, and local recurrence rate. With a median follow-up of 40 months for RFA, and 36 months for LR (P=0.61), mean cancer-specific overall survival was 51 months for RFA and 63 months for LR (P=0.64). The median disease-free survival was 14 months for RFA, and 21 months for LR (P=0.59). The mean operating room and hospital costs were 51% and 55% higher in the LR (P<0.001, each). Conclusions: The results of the study suggest that in selected patients with small solitary CRLM, laparoscopic tumor ablation might offer opportunities for cost-savings compared with resection as the primary treatment. This model may suggest possible equivalent oncologic outcomes between the 2 modalities.