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

Surg Laparosc Endosc Percutan Tech. 2018 Dec;28(6):371-374. doi: 10.1097/SLE.0000000000000577.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Blood Loss, Surgical / statistics & numerical data
  • Colorectal Neoplasms / economics*
  • Colorectal Neoplasms / mortality
  • Costs and Cost Analysis
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hepatectomy / economics
  • Hepatectomy / methods
  • Hepatectomy / mortality
  • Hospital Costs
  • Humans
  • Laparoscopy / economics*
  • Laparoscopy / mortality
  • Length of Stay / statistics & numerical data
  • Liver Neoplasms / economics*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / economics
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery
  • Operating Rooms / economics
  • Operative Time
  • Prospective Studies
  • Radiofrequency Ablation / economics*
  • Radiofrequency Ablation / mortality
  • Reoperation / economics
  • Reoperation / statistics & numerical data