Cost-Effectiveness of Endoscopically Placed Stents in the Palliation of Locally Advanced Esophageal Carcinoma

Gabriel Dimofte1, Felicia Crumpei2, Liviu Trifina1, Simona Nicolescu1, Dan Leanca3

1) 1st Surgical Clinic.2) Department of Radiology. 3) Department of Statistics, University Hospital „St. Spiridon” Iasi

Abstract

The study assessed 50 consecutive patients presenting advanced esophageal carcinoma, in order to evaluate the cost-effectiveness of endoscopic palliation of dysphagia. Cases were divided into groups according to the type of therapy: Group A - surgical resections; Group B - gastrostomy, jejunostomy, surgical bypass or no palliation; Group C - endoscopic palliation. A retrospective study analysed early mortality, length of hospital stay and cost of therapy. Mean postoperative survival was within the expected limits in the endoscopically treated group (3-6 months), and in the non-resected group, while resected patients showed a very high early mortality and no long term survivals. Costs were significantly smaller in Group C as compared with Group A, with shorter hospital stay and better palliation. We conclude that endoscopically placed stents represent a cost effective palliation for advanced esophageal carcinoma and medical authorities should consider covering the expenses required by such procedures.

Keywords

Esophageal cancer - survival - stent - palliation