Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Ann Surg Oncol. 2024 Jul;31(7):4361-4370. doi: 10.1245/s10434-024-15236-6. Epub 2024 Mar 27.
Financial toxicity (FT) refers to the adverse impact of cancer treatment costs on patients' experiences, potentially leading to poor adherence to treatment and outcomes. However, the prevalence of FT among patients undergoing major upper gastrointestinal cancer operations, as well as factors associated with FT, remain unclear.
We conducted a cross-sectional study by sending the Comprehensive Score for financial Toxicity (COST) survey and Surgery-Q (a survey specifically developed for this study) to patients who underwent gastrectomy or pancreatectomy for malignant disease at our institution in 2019-2021.
We sent the surveys to 627 patients and received responses from 101 (16%) patients. The FT prevalence (COST score <26) was 48 (48%). Patients likely to experience FT were younger than 50 years of age, of non-White race, earned an annual income <$75,000, and had credit scores <740 (all p < 0.05). Additionally, longer hospital stay (p = 0.041), extended time off work for surgery (p = 0.011), and extended time off work for caregivers (p = 0.005) were associated with FT. Procedure type was not associated with FT; however, patients who underwent minimally invasive surgery (MIS) had a lower FT probability (p = 0.042). In a multivariable analysis, age <50 years (p = 0.031) and credit score <740 (p < 0.001) were associated with high FT risk, while MIS was associated with low FT risk (p = 0.024).
Patients with upper gastrointestinal cancer have a major risk of FT. In addition to predicting the FT risk before surgery, facilitating quicker functional recovery with the appropriate use of MIS is considered important to reducing the FT risk.
财务毒性（FT）是指癌症治疗费用对患者体验的不利影响，可能导致治疗依从性差和治疗效果不佳。然而，在上消化道癌症大手术患者中，FT 的流行程度以及与 FT 相关的因素尚不清楚。
我们通过向 2019 年至 2021 年在我们机构接受胃切除术或胰切除术治疗恶性疾病的患者发送综合财务毒性评分（COST）调查和专门为此研究开发的 Surgery-Q 调查，进行了一项横断面研究。
我们向 627 名患者发送了调查，收到了 101 名（16%）患者的回复。FT 患病率（COST 评分<26）为 48 例（48%）。可能经历 FT 的患者年龄小于 50 岁，非白人种族，年收入<75000 美元，信用评分<740（均 p<0.05）。此外，住院时间延长（p=0.041）、因手术而休假时间延长（p=0.011）和照顾者休假时间延长（p=0.005）与 FT 相关。手术类型与 FT 无关；然而，接受微创手术（MIS）的患者 FT 可能性较低（p=0.042）。在多变量分析中，年龄<50 岁（p=0.031）和信用评分<740（p<0.001）与高 FT 风险相关，而 MIS 与低 FT 风险相关（p=0.024）。
上消化道癌症患者有很大的 FT 风险。除了在手术前预测 FT 风险外，还需要考虑通过适当使用 MIS 促进更快的功能恢复，以降低 FT 风险。
