Healthcare costs associated with renal cell carcinoma recurrence following curative surgery: a real-world national claims data analysis from Poland

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Abstract Introduction Renal cell carcinoma (RCC) carries a considerable recurrence risk, even after curative surgery. While early detection and treatment improve outcomes, recurrence remains a key clinical and economic challenge. Objectives To evaluate clinical outcomes, healthcare resource use, and costs from the payer’s perspective in patients with recurrent renal cell carcinoma following curative surgery. Patients and methods We performed a retrospective cohort analysis using two nationwide databases from the Polish National Health Fund (NHF) between 2016 and 2022. Patients with histologically confirmed RCC who underwent curative-intent surgery in 2016–2017 were followed for at least five years. Recurrence was defined based on treatment initiation (e.g. chemotherapy, radiotherapy, drug program for metastatic disease) or cancer-specific mortality. Healthcare resource utilization and costs were analyzed annually after recurrence and compared to recurrence-free patients. All costs were adjusted to 2022 values. Results Among the 4,472 patients, 488 (10.9%) developed a recurrence during follow-up. The average five-year cost for recurrence-free patient was €5,820.82 (Costs converted from Polish zloty (PLN) to euro (EUR) using the average 2022 exchange rate of 4.69 PLN/EUR (source: National Bank of Poland, https://www.nbp.pl )), while costs for patient with recurrence exceeded €50,381.67. The highest costs were observed in the first year following recurrence, driven primarily by hospital and drug program costs. Fatal recurrences were associated with over 40% higher costs compared to non-fatal cases. Scenario analysis using a shorter (3-month) window to identify early recurrence confirmed cost trends and revealed more severe cases with increased expenditures. Conclusions Recurrence after RCC surgery significantly increases healthcare costs, particularly within hospital-based drug programs. Early detection and recurrence prevention may reduce economic burden.

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