{"title":"Does distance to the hospital affect the course of treatment and follow-up for children with Acute Lymphoblastic Leukemia?","authors":"Cecilie Bjerregaard Brix, Mette Bitsch Linck Hansen, Rikke Io Jessen, Cecilie Møller Høymark, Regitze Gyldenholm Skals, Søren Hagstrøm, Ninna Brix","doi":"10.1007/s00432-025-06127-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Centralization of specialized healthcare including treatment of children with acute lymphoblastic leukemia (ALL) has increased in high-income countries. We aimed to clarify whether the distance to the hospital for children with ALL affects the course of treatment regarding the number and duration of hospitalizations, outpatient clinic visits, missed appointments in the outpatient clinic, the duration of follow-up, or survival.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of children diagnosed with ALL aged 0-14 at Aalborg University Hospital from 1996 to 2018. Data was collected through registries and medical records. Comparisons of cancer- and sociodemographic characteristics in children with long versus short distance were made, divided at 42 km. Outcome variables were assessed by correlation and regression analyses. We compared overall survival using Kaplan-Meier.</p><p><strong>Results: </strong>The cohort consisted of 95 children. Cancer- and sociodemographic characteristics of the children with long versus short distance were similar, though the children with long distance were older and had less infections during treatment. There was no significant difference between the two groups regarding the number of hospitalizations, outpatient clinic visits, missed appointments, the duration of follow-up, or survival. Though, the summarized length of hospitalization was shorter for the group with long distance, when adjusting for age (-23 days (95% CI -45;-1)).</p><p><strong>Conclusion: </strong>No significant differences between the course of treatment and follow-up for children with long and short distance to the hospital was revealed, except for a shorter summarized length of hospitalization for children with long distance.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 2","pages":"76"},"PeriodicalIF":2.7000,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814040/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Research and Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00432-025-06127-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Centralization of specialized healthcare including treatment of children with acute lymphoblastic leukemia (ALL) has increased in high-income countries. We aimed to clarify whether the distance to the hospital for children with ALL affects the course of treatment regarding the number and duration of hospitalizations, outpatient clinic visits, missed appointments in the outpatient clinic, the duration of follow-up, or survival.
Methods: We performed a retrospective cohort study of children diagnosed with ALL aged 0-14 at Aalborg University Hospital from 1996 to 2018. Data was collected through registries and medical records. Comparisons of cancer- and sociodemographic characteristics in children with long versus short distance were made, divided at 42 km. Outcome variables were assessed by correlation and regression analyses. We compared overall survival using Kaplan-Meier.
Results: The cohort consisted of 95 children. Cancer- and sociodemographic characteristics of the children with long versus short distance were similar, though the children with long distance were older and had less infections during treatment. There was no significant difference between the two groups regarding the number of hospitalizations, outpatient clinic visits, missed appointments, the duration of follow-up, or survival. Though, the summarized length of hospitalization was shorter for the group with long distance, when adjusting for age (-23 days (95% CI -45;-1)).
Conclusion: No significant differences between the course of treatment and follow-up for children with long and short distance to the hospital was revealed, except for a shorter summarized length of hospitalization for children with long distance.
目的：在高收入国家，包括急性淋巴细胞白血病（ALL）儿童治疗在内的专科医疗保健的集中化程度有所提高。我们的目的是阐明到医院的距离是否会影响ALL儿童的治疗过程，包括住院次数和持续时间、门诊就诊次数、门诊错过预约、随访时间或生存率。方法：我们对1996年至2018年在奥尔堡大学医院诊断为ALL的0-14岁儿童进行了回顾性队列研究。数据是通过登记处和医疗记录收集的。对距离较远和距离较近的儿童的癌症和社会人口学特征进行了比较，每隔42公里。结果变量通过相关分析和回归分析进行评估。我们用Kaplan-Meier法比较总生存率。结果：该队列包括95名儿童。距离远的儿童与距离近的儿童的癌症和社会人口学特征相似，尽管距离远的儿童年龄较大，在治疗期间感染较少。两组在住院次数、门诊就诊次数、错过预约、随访时间或生存率方面没有显著差异。然而，当调整年龄时，距离较远的组的总住院时间较短（-23天（95% CI -45;-1））。结论：距离较远和较近患儿的疗程和随访无显著差异，只是距离较远患儿的住院总时间较短。
期刊介绍：
The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses.
The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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