OBJECTIVE: We sought to compare the overall 1-year management costs for patients receiving a free tissue transfer with those of patients receiving a pedicled flap reconstruction as a component of their primary head and neck cancer treatment. STUDY DESIGN AND SETTING: Case-control, cost identification analysis of 21 matched pairs of patients and multivariate analysis of variables associated with treatment costs was conducted in a tertiary referral academic institution. RESULTS: No significant difference in total 1-year charges between the pedicled and free tissue transfer groups was found. A structured measure of patient comorbidity was the only variable significantly associated with total 1-year charges. CONCLUSIONS: Total 1-year treatment costs of primary upper aerodigestive tract cancers are similar for patients reconstructed with free tissue transfer or a pedicled flap. SIGNIFICANCE: Within the context of overall 1-year management costs, the primary determinants of health care expense for these patients are comorbidity and extent of disease, not reconstructive technique.
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