PMID- 31157367
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 57
IP  - 1
DP  - 2020 Jan 1
TI  - Cost and survival of video-assisted thoracoscopic lobectomy versus open lobectomy 
      in lung cancer patients: a propensity score-matched study.
PG  - 92-99
LID - 10.1093/ejcts/ezz157 [doi]
AB  - OBJECTIVES: A video-assisted thoracoscopic surgery (VATS) is an accepted 
      alternative to open thoracotomy (OT) in lung cancer patients undergoing 
      lobectomy, but evidence of the benefits of VATS remains inconsistent. The aim of 
      this study was to compare VATS and OT regarding survival, costs and length of 
      hospital stay (LOS). METHODS: We identified lung cancer patients (incident 2013) 
      undergoing VATS or OT from German insurance claims data and performed 1:2 
      propensity score matching. A 3-year survival was analysed using the Kaplan-Meier 
      curves and a univariable Cox model. Group differences in the 3-year lung 
      cancer-related costs and costs of hospital stay with lobectomy were compared via 
      univariable generalized linear gamma models. LOS was compared using the 
      Mann-Whitney-Wilcoxon test. RESULTS: After propensity score matching, we compared 
      294 patients undergoing VATS and 588 receiving OT. We found no differences in the 
      3-year survival (VATS: 73.8%, OT: 69.2%, P = 0.131) or costs for hospital stay 
      with lobectomy (VATS: euro11 921, OT: euro12 281, P = 0.573). However, VATS patients 
      had significantly lower lung cancer-related costs (VATS: euro20 828, OT: euro23 723, 
      P = 0.028) and median postoperative LOS (VATS: 9 days, OT: 11 days, P < 0.001). 
      CONCLUSIONS: From a payer's perspective, extending the use of VATS is beneficial, 
      as it shows economic benefits without affecting survival. However, for a more 
      comprehensive assessment of the benefits of VATS from a society's point of view, 
      further aspects such as patient-reported outcomes and provider-related standby 
      costs need to be investigated further.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Marijic, Pavo
AU  - Marijic P
AD  - Institute for Medical Information Processing, Biometry and Epidemiology (IBE), 
      Ludwig-Maximilians-Universitaat Munchen, Munich, Germany.
AD  - Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum 
      Munchen, Munich, Germany.
FAU - Walter, Julia
AU  - Walter J
AD  - Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum 
      Munchen, Munich, Germany.
AD  - Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research 
      (DZL), Munich, Germany.
FAU - Schneider, Christian
AU  - Schneider C
AD  - Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research 
      (DZL), Munich, Germany.
AD  - Department of Thoracic Surgery, Ludwig-Maximilians-Universitat Munchen, Munich, 
      Germany.
FAU - Schwarzkopf, Larissa
AU  - Schwarzkopf L
AD  - Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum 
      Munchen, Munich, Germany.
AD  - Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research 
      (DZL), Munich, Germany.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Humans
MH  - Length of Stay
MH  - *Lung Neoplasms/surgery
MH  - Pneumonectomy
MH  - Postoperative Complications
MH  - Propensity Score
MH  - Retrospective Studies
MH  - *Thoracic Surgery, Video-Assisted
MH  - Thoracotomy
OTO - NOTNLM
OT  - Length of stay
OT  - Lung cancer
OT  - Mortality
OT  - Open thoracotomy
OT  - Spending
OT  - Video-assisted thoracic surgery
EDAT- 2019/06/04 06:00
MHDA- 2021/06/22 06:00
CRDT- 2019/06/04 06:00
PHST- 2018/11/27 00:00 [received]
PHST- 2019/04/11 00:00 [revised]
PHST- 2019/04/28 00:00 [accepted]
PHST- 2019/06/04 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2019/06/04 06:00 [entrez]
AID - 5510143 [pii]
AID - 10.1093/ejcts/ezz157 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2020 Jan 1;57(1):92-99. doi: 10.1093/ejcts/ezz157.