The Pattern and Cost of Palliative Surgeries in Patients with Metastatic Melanoma

Zhongyun Zhao^*, Song Wang, Beth L. Barber

Amgen Inc, Thousand Oaks, CA, USA.

DOI: 10.4236/jct.2015.63027                

Abstract

Objective: To investigate the pattern of palliative surgeries and associated costs in patients with metastatic melanoma in the USA. Methods: This was a retrospective claims-based study of patients identified using administrative claims from MarketScan^® databases among patients with metastatic melanoma diagnosed between 2005 and 2011. Patient characteristics, patterns and cost of surgery, and length of hospital stay were evaluated. Results: Of the 2399 patients identified, 888 (37.0%) underwent at least one surgical procedure either in the outpatient or inpatient setting. The subgroup of patients who underwent surgery included significantly more patients with distant skin metastases compared to the subgroup who did not receive surgery; whereas significantly more patients in the non-surgery group had brain or bone metastases. Surgery performed in the outpatient setting was predominantly on the skin, whereas surgery on the brain was generally performed in the inpatient setting. The mean cost of the surgical procedures performed in the outpatient setting was $3393 (median: $1419) per procedure, which varied according to the location of the metastasis. For surgical procedures that were performed in the inpatient setting, the mean length of stay in hospital due to surgery was 4.4 (± 5.1) days, at a mean cost of $37,649 (median: $28,067) per hospitalization. Conclusions: Surgery is prevalent and costly in patients with metastatic melanoma.

Keywords

Metastatic Melanoma, Surgery Cost, Healthcare Costs, Claims Analysis

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Menaa, F. (2013) Latest Approved Therapies for Metastatic Melanoma: What Comes Next? Journal of Skin Cancer, 2013, Article ID: 735282. http://dx.doi.org/10.1155/2013/735282
[2]	Balch, C.M., Buzaid, A.C., Soong, SJ., Atkins, M.B., Cascinelli, N., Coit, D.G., Fleming, I.D., Gershenwald, J.E., Houghton Jr., A., Kirkwood, J.M., McMasters, K.M., Mihm, M.F., Morton, D.L., Reintgen, D.S., Ross, M.I., Sober, A., Thompson, J.A. and Thompson, J.F. (2001) Final Version of the American Joint Committee on Cancer Staging System for Cutaneous Melanoma. Journal of Clinical Oncology, 19, 3635-3648.
[3]	Korn, E.L., Liu, P.Y., Lee, S.J., Chapman, J.A., Niedzwiecki, D., Suman, V.J., Moon, J., Sondak, V.K., Atkins, M.B., Eisenhauer, E.A., Parulekar, W., Markovic, S.N. and Kirkwood, J.M. (2008) Meta-Analysis of Phase II Cooperative Group Trials in Metastatic Stage IV Melanoma to Determine Progression-Free and Overall Survival Benchmarks for Future Phase II Trials. Journal of Clinical Oncology, 26, 527-534. http://dx.doi.org/10.1200/JCO.2007.12.7837
[4]	Leung, A.M., Hari, D.M. and Morton, D.L. (2012) Surgery for Distant Melanoma Metastasis. Cancer Journal, 18, 176-184. http://dx.doi.org/10.1097/PPO.0b013e31824bc981
[5]	Gogas, H.J., Kirkwood, J.M. and Sondak, V.K. (2007) Chemotherapy for Metastatic Melanoma: Time for a Change? Cancer, 109, 455-464. http://dx.doi.org/10.1002/cncr.22427
[6]	Bhatia, S., Tykodi, S.S. and Thompson, J.A. (2009) Treatment of Metastatic Melanoma: An Overview. Oncology (Williston Park), 23, 488-496.
[7]	Morton, D.L., Ollila, D.W., Hsueh, E.C., Essner, R. and Gupta, R.K. (1999) Cytoreductive Surgery and Adjuvant Immunotherapy: A New Management Paradigm for Metastatic Melanoma. CA: A Cancer Journal for Clinicians, 49, 101-116. http://dx.doi.org/10.3322/canjclin.49.2.101