Endoscopy 2021; 53(S 01): S253-S254
DOI: 10.1055/s-0041-1724964
Abstracts | ESGE Days
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Cost Comparisons Of Endoscopic And Surgical Resection Of T1 Rectal Cancer

V Arthursson
1   Lund University, Department of Clinical Sciences, Section of Surgery, Skåne University Hospital, Malmö, Sweden
,
R Rosén
1   Lund University, Department of Clinical Sciences, Section of Surgery, Skåne University Hospital, Malmö, Sweden
,
JM Norlin
2   The Swedish Institute for Health Economics, Lund, Sweden
,
K Gralén
2   The Swedish Institute for Health Economics, Lund, Sweden
,
E Toth
3   Lund University, Department of Clinical Sciences, Section of Gastroenterology, Skåne University Hospital, Malmö, Sweden
,
I Syk
1   Lund University, Department of Clinical Sciences, Section of Surgery, Skåne University Hospital, Malmö, Sweden
,
H Thorlacius
1   Lund University, Department of Clinical Sciences, Section of Surgery, Skåne University Hospital, Malmö, Sweden
,
CF Rönnow
1   Lund University, Department of Clinical Sciences, Section of Surgery, Skåne University Hospital, Malmö, Sweden
› Author Affiliations
 

Aims The aim of this study was to compare costs of endoscopic and surgical resection and to investigate hypothetical cost scenarios for the treatment of T1 rectal cancer (RC).

Methods Population-based cohort study on prospectively collected data on T1 RC patients treated using endoscopic submucosal dissection (ESD), transanal endoscopic microsurgery (TEM), open (OR), laparoscopic (LR) or robotic (RR) resection in Sweden (2011-2017). Cost-minimisation analysis were calculated on direct costs for procedural and 1-year follow-up periods and included in hypothetical cost scenarios based on the distribution of high risk features of lymph node metastases (LNM).

Results 85 patients with T1 RC undergoing, ESD (n = 16), TEM (n = 17), OR (n = 35), LR (n = 9), and RR (n = 8) were included. ESD had a total 1-year cost of 5 165€ and was significantly less expensive compared to TEM (14871€), OR (21453€), LR (22488€) and RR (26562€). 68 % of 779 cases of T1 RC included in the national cohort had high risk features of LNM. The hypothetical scenario of performing ESD on all T1 RC had the lowest total 1-year per patient cost compared to all other alternatives.

Conclusions This is the first study analysing total 1-year costs of endoscopic and surgical methods to resect T1 RC showing that the cost of ESD was significantly lower compared to TEM and surgical resection. In fact, based on hypothetical cost scenarios, ESD is still justifiable from a cost perspective even when all high risk cases are followed by surgery in accordance to guidelines.

Citation Arthursson V, Rosén R, Norlin JM et al. eP475 COST COMPARISONS OF ENDOSCOPIC AND SURGICAL RESECTION OF T1 RECTAL CANCER. Endoscopy 2021; 53: S253.



Publication History

Article published online:
19 March 2021

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