Travel distance to tertiary sarcoma centres does not influence oncological presentation or outcomes.

IF 4.9 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2025-03-01 DOI:10.1302/0301-620X.107B3.BJJ-2024-0488.R1

Aaron Gazendam, Liuzhe Zhang, David Clever, Anthony Griffin, Jay Wunder, Peter Ferguson, Kim M Tsoi

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引用次数: 0

Abstract

Aims: Soft-tissue sarcomas (STSs) are rare cancers with centralized care advocated to consolidate resources and expertise. However, geographical challenges, particularly in countries like Canada, can increase travel distances for patients. The impact of travel distance on sarcoma presentation and outcomes remains unclear, particularly in single-payer healthcare systems with centralized care.

Methods: A retrospective cohort analysis was conducted on 1,570 patients with STS who underwent surgical resection at a Canadian tertiary referral centre between January 2010 and January 2021. Patients were divided into those living ≤ 50 km and > 50 km from the centre. Demographics, tumour characteristics, treatment methods, and survival outcomes were analyzed. A Cox regression model was constructed to evaluate predictors of overall survival.

Results: Patients living > 50 km from the centre (n = 700) travelled a mean of 176 km (SD 250), while those ≤ 50 km (n = 870) travelled a mean of 24.8 km (SD 13.8). There were no significant differences in disease presentation, time to definitive treatment, use of systemic therapies, or functional outcomes between the two groups. The two-year and five-year overall survival rates were similar between the groups (83.1% (95% CI 80.1% to 86.1%) vs 83.8% (95% CI 81.8% to 85.8%) and 72.1% (95% CI 69.1% to 75.1%) vs 72.5% (95% CI 69.5% to 75.5%), respectively). The regression model demonstrated that age, higher tumour grade, depth, and lower income were predictive of worse overall survival, while distance travelled was not an independent predictor of survival.

Conclusion: Contrary to previous studies, our findings suggest that travel distance did not influence disease presentation or survival outcomes in STS patients treated at a centralized sarcoma centre. This challenges previous notions regarding the impact of travel distance on cancer outcomes, and supports the effectiveness of centralized care models, even in geographically vast regions.

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到三级肉瘤中心的距离不影响肿瘤表现或结果。

目的：软组织肉瘤（STSs）是一种罕见的癌症，提倡集中治疗，以巩固资源和专业知识。然而，地理上的挑战，特别是在加拿大等国家，可能会增加患者的旅行距离。旅行距离对肉瘤表现和预后的影响尚不清楚，特别是在集中护理的单一付款人医疗保健系统中。方法：对2010年1月至2021年1月期间在加拿大三级转诊中心接受手术切除的1570例STS患者进行回顾性队列分析。患者分为距离中心≤50 km和距离中心50 km的患者。分析了人口统计学、肿瘤特征、治疗方法和生存结果。建立Cox回归模型评价总生存期的预测因子。结果：生活在距离中心bbb50 km的患者（n = 700）平均行走176 km (SD 250)，而距离中心≤50 km的患者（n = 870）平均行走24.8 km （SD 13.8）。两组在疾病表现、最终治疗时间、全身治疗的使用或功能结局方面没有显著差异。两组的2年和5年总生存率相似(分别为83.1% (95% CI 80.1%至86.1%)vs 83.8% （95% CI 81.8%至85.8%）和72.1% (95% CI 69.1%至75.1%)vs 72.5% （95% CI 69.5%至75.5%）。回归模型表明，年龄、较高的肿瘤分级、肿瘤深度和较低的收入可预测较差的总生存率，而旅行距离并不是独立的生存率预测因子。结论：与之前的研究相反，我们的研究结果表明，在集中的肉瘤中心治疗的STS患者，旅行距离并不影响疾病的表现或生存结果。这挑战了以前关于出行距离对癌症结果影响的观念，并支持了集中护理模式的有效性，即使在地理上广阔的地区也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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