دورية أكاديمية
أعرض في EDS

Travel Time to a High Volume Center Negatively Impacts Timing of Care in Rectal Cancer.

التفاصيل البيبلوغرافية
العنوان: Travel Time to a High Volume Center Negatively Impacts Timing of Care in Rectal Cancer.
المؤلفون: Abelson JS; Division of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts. Electronic address: jonathan.s.abelson@lahey.org., Barron J; Saint Louis University School of Medicine, Saint Louis, Missouri., Bauer PS; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Chapman WC Jr; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Schad C; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Ohman K; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Glasgow S; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Hunt S; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Mutch M; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Smith RK; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Wise PE; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri., Silviera M; Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, Saint Louis, Missouri.
المصدر: The Journal of surgical research [J Surg Res] 2021 Oct; Vol. 266, pp. 96-103. Date of Electronic Publication: 2021 May 11.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Hospitals, High-Volume*/standards , Hospitals, High-Volume*/statistics & numerical data , Travel*, Health Services Accessibility/*statistics & numerical data , Rectal Neoplasms/*therapy , Time-to-Treatment/*statistics & numerical data, Adult ; Aged ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Follow-Up Studies ; Health Services Accessibility/standards ; Humans ; Logistic Models ; Male ; Middle Aged ; Quality of Health Care/statistics & numerical data ; Rectal Neoplasms/mortality ; Retrospective Studies ; Time Factors ; Time-to-Treatment/standards
مستخلص: Background: Regionalization of rectal cancer surgery may lead to worse disease free survival owing to longer travel time to reach a high volume center yet no study has evaluated this relationship at a single high volume center volume center.
Materials and Methods: This was a retrospective review of rectal cancer patients undergoing surgery from 2009 to 2019 at a single high volume center. Patients were divided into two groups based on travel time. The primary outcome was disease-free survival (DFS). Additional outcomes included treatment within 60 d of diagnosis, completeness of preoperative staging, and evaluation by a colorectal surgeon prior to initiation of treatment.
Results: A lower proportion of patients with long travel time began definitive treatment within 60 d of diagnosis (74.0% versus 84.0%, P= 0.01) or were seen by the treating colorectal surgeon before beginning definitive treatment (74.8% versus 85.4%, P < 0.01). On multivariable logistic regression analysis, patients with long travel time were significantly less likely to begin definitive treatment within 60 d of diagnosis (OR = 0.54; 95% CI = 0.31-0.93) or to be evaluated by a colorectal surgeon prior to initiating treatment (OR = 0.45; 95% CI = 0.25-0.80). There were no significant differences in DFS based on travel time.
Conclusions: Although patients with long travel times may be vulnerable to delayed, lower quality rectal cancer care, there is no difference in DFS when definitive surgery is performed at a high volume canter. Ongoing research is needed to identify explanations for delays in treatment to ensure all patients receive the highest quality care.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: High volume center; Outcomes; Rectal cancer; Regionalization; Surgery; Survival
تواريخ الأحداث: Date Created: 20210514 Date Completed: 20210927 Latest Revision: 20210927
رمز التحديث: 20231215
DOI: 10.1016/j.jss.2021.02.056
PMID: 33989893
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2021.02.056