Synapse - Financial toxicity in pediatric and adolescent neurosurgical oncology

Financial toxicity in pediatric and adolescent neurosurgical oncology Journal Article

Authors:	Giantini-Larsen, A. M.; Brown, S.; Reiner, A. S.; Doyle Giandalone, S.; Zappi, K.; Abou-Mrad, Z.; Khakoo, Y.; Dunkel, I. J.; Karajannis, M. A.; Sait, S. F.; Hoffman, C. E.; Greenfield, J. P.; Souweidane, M. M.; Newman, W. C.
Article Title:	Financial toxicity in pediatric and adolescent neurosurgical oncology
Abstract:	Background: Financial toxicity (FT) encompasses the negative impact of medical costs on patients. In-depth analysis of FT in pediatric and adolescent neurosurgical oncology has not been performed. The aim of this study was to determine the incidence of FT in this population. Design: A retrospective review of medical and financial services data was conducted at Memorial Sloan Kettering Cancer Center of patients under 21 years of age who underwent neurosurgery for a cancer-related diagnosis from 2016 to 2020. Results: 294 surgical procedures across 202 patients were analyzed. 16% (33/202) of patients experienced FT in the two years prior to the first neurosurgical procedure, and the most common toxicity identifier was utilization of the financial assistance program (45%). For all 202 patients, the 2-year cumulative incidence of FT following first neurosurgical procedure was 19% (CI:14%,24%). Among patients who survived for at least 2 years after surgery, 34% (29/86) experienced FT with the most common toxicity being having bills sent to collections (34%). Most patients who experienced FT had at least one commercial insurance policy. Presence of pre-operative FT was associated with a significantly higher cumulative incidence of post-operative FT (2-year estimates: pre-operative FT 61% (95%CI: [41%,75%]) vs. no pre-operative FT 11% (95%CI: [7%,16%]), p < 0.001). Conclusion: FT poses challenges in the pediatric neurosurgical oncology population. Pre-operative FT significantly influences post-operative FT. Most patients who experienced FT had at least one commercial insurance plan, providing evidence that even patients with insurance are not immune to FT. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.
Keywords:	neurosurgery; pediatric; financial toxicity
Journal Title:	Journal of Neuro-Oncology
Volume:	174
Issue:	2
ISSN:	0167-594X
Publisher:	Springer
Publication status:	Published
Date Published:	2025-09-01
Online Publication Date:	2025-05-12
Start Page:	349
End Page:	356
Language:	English
DOI:	10.1007/s11060-025-05056-3
PROVIDER:	scopus
PUBMED:	40355786
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-105004846932&doi=10.1007%2fs11060-025-05056-3&partnerID=40&md5=5302c17da3bccddf43139d19a155c422
Notes:	Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is W. Christopher Newman -- Source: Scopus