In-hospital costs of malignant brain tumor surgery: A systematic review and quality assessment

The increasing financial burden of therapies for brain tumor patients necessitates strategies that preserve equitable access and optimize resource allocation. The aim of this systematic review was to evaluate the in-hospital costs for malignant brain tumor surgery. A systematic review was carried out according to PRISMA guidelines on January 10, 2025, using the following databases: PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, CENTRAL, CINAHL, PsycINFO, and Academic Search Premier. Articles published after January 1, 2000, describing perioperative hospital costs for malignant brain tumor surgery patients were included. Study quality assessment was performed based on the 2022 CHEERS statement. Nine studies were included, encompassing a total of 140 813 patients. Total in-hospital costs were highly variable and ranged between $2382.47 and $30 836.98 per patient. Mean length of stay (LOS) was 5.24 days, ranging from 3 to 7.12 days. LOS and in-hospital costs were positively correlated. Study quality was low due to missing data on health economic analysis plans, and lack of reporting of uncertainty in the findings. In-hospital costs for malignant brain tumors are high, rising over time, and were significantly impacted by LOS. Study outcomes showed high variability, poor methodological quality due to inconsistent methods and inadequate cost data. Future research needs standardized, comprehensive cost analyses to support informed healthcare policy and resource allocation decisions.