ASCO GU 2017: Characterizing the costs of complications after cystectomy: Can we target the primary drivers? - Session Highlights

Orlando, Florida USA ( Dr. Matthew Mossanen from Brigham and Women’s Hospital targeted the thromboembolic events, soft tissue and GI complications as primary cost drivers following radical cystectomy. Motivation for this study stemmed from recognising the high complication rate of cystectomy being as high as 64% at 90 days and that radical cystectomy and care for bladder cancer as a whole is one of the more expenisive diseases to care for. This study looked at financial cost of different categories of complication following radical cystectomy to identify primary forces driving expenditures.

Data from 600 hospitals across the US was conglomerated to bring data on 9,137 patients. The top four most costly complications were venous thromboembolism (17,547$), soft tissue complications (13,523$), gastrointestinal complications (8663$), and non-wound related infections (7,930$). A large factor was length of stay as this was increased in each complication. Factors associated with lower costs of complication following cystectomy included: being married, having fewer comorbidities, shorter operations, lack of transfusions, treatment at larger hospitals, high volume hospitals, and teaching hospitals, and being treated by high volume surgeons. This study further addresses importance of high volume centers in bladder cancer care as well as identifies quality potential quality initiatives for cost reduction.

Author: Matthew Mossanen, MD, Brigham and Women’s Hospital

Written By: Michael J Metcalfe, MD, Fellow of Urologic Oncology Urology, MD Anderson Cancer Center, Houston TX
Ashish M. Kamat, MD, MBBS, FACS, President, International Bladder Cancer Network Chair, Society of Immunotherapy for Cancer (SITC), BCTF, Director of Urologic Oncology Fellowship, Professor of Urology, Attending Surgeon, Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston TX

at the 2017 Genitourinary Cancers Symposium - February 16 - 18, 2017 – Orlando, Florida USA