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J Neurol Surg B Skull Base 2024; 85(06): 659-665
DOI: 10.1055/a-2162-1134
Original Article

Cost of Vestibular Schwannoma Treatment: A Systematic Review and Meta-Analysis

Stefan W. Koester 
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Robert J. Dambrino IV
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Akshay Bhamidipati
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Gunther Wong
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Campbell Liles
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Michael Feldman
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Lola B. Chambless
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
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Abstract

Introduction Research furthering treatment efficacy for microsurgical resection and stereotactic radiosurgery for vestibular schwannoma (VS) is ever-growing; however, there remains a paucity of research addressing treatment costs. Our aim is to define the reported costs of different treatment modalities used for VS.

Methods A systematic review of the literature for VS treatment cost was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed and Web of Science databases. Literature that presented cost of VS treatment specific to the modality was included. Articles from 1990 to present day in English were considered. Cost was corrected for inflation to April 2022 dollars using the US Bureau of Labor Statistics Inflation Calculator.

Results A total of 407 articles were included in the analysis. After review, eight articles provided data on cost of treatment. In total, 687 patients were included across seven studies, with study dates ranging from 1997 to 2020. The average cost of resection was $54,321.99 (range = $10,243–95,590, n = 8), radiosurgery $27,837.92 (range = $6,281–51,676, n = 6), and observation $6,304.88 (range = $2,149–11,886, n = 3).

Conclusion Our findings describe the limited and significant variability of data on published costs for the treatment of VS. Given the relative clinical equipoise between treatment modalities in some scenarios, better understanding of this end-point will help physicians make more responsible recommendations in the resource-constrained environment of modern healthcare and this analysis should serve as a starting point for more robust analysis into cost-effectiveness of treatment for VS.

Keywords

vestibular schwannoma - acoustic neuromas - treatment cost - literature review - surgery vs stereotactic radiosurgery


Publication History

Received: 14 April 2023

Accepted: 27 August 2023

Accepted Manuscript online:
29 August 2023

Article published online:
18 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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