How much does it cost to preserve a larynx? An economic study

Various studies report an increase in costs when induction chemotherapy is included in the treatment of advanced laryngeal cancer, but to our knowledge no studies have yet compared the economic costs of total laryngectomy versus induction chemotherapy in the treatment of advanced laryngeal cancer. We have conducted a retrospective study comparing the costs of treatment and survival in 96 patients with a T3N0-1 glottic carcinoma. Findings showed that the average cost per patient in the group of patients treated by total laryngectomy with or without postoperative radiotherapy was 5853 Eur, while that for the group of patients who began treatment with induction chemotherapy was 6452 Eur. The adjusted 5-year survival for patients treated with total laryngectomy with or without postoperative radiotherapy was 80%, and 72% for patients who began treatment with induction chemotherapy. Sixteen of the 35 patients (46%) receiving induction chemotherapy were spared laryngectomy. The use of induction chemotherapy in the treatment of patients with advanced laryngeal carcinomas involved an increase in cost of 600 Eur in relation to treatment with total laryngectomy and postoperative radiotherapy. However, from an economic point of view, we consider induction chemotherapy to be an important consideration in an organ-preservation strategy.