Impact of fragmented care on retroperitoneal sarcomas.

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-03-26 DOI:10.1016/j.amjsurg.2025.116319

Denise L Wong, Jordan Fredette, Jill Hasler, Andrea S Porpiglia, Stephanie H Greco, Sanjay S Reddy, Jeffrey M Farma, Anthony M Villano

{"title":"Impact of fragmented care on retroperitoneal sarcomas.","authors":"Denise L Wong, Jordan Fredette, Jill Hasler, Andrea S Porpiglia, Stephanie H Greco, Sanjay S Reddy, Jeffrey M Farma, Anthony M Villano","doi":"10.1016/j.amjsurg.2025.116319","DOIUrl":null,"url":null,"abstract":"Background: Fragmented care (FC) is associated with mixed outcomes. This analysis examines FC's impact on retroperitoneal sarcoma (RPS) treatment.Methods: The National Cancer Database was queried for adult patients with non-metastatic, surgically-resected RPS. FC was defined as diagnosis/treatment at >1 facility. Univariable and multivariable analyses examined factors associated with FC and its impact on overall survival.Results: 4976 patients were included; 45.6 % experienced FC. Non-FC and FC cohorts were similar. Dedifferentiated liposarcoma were more common in FC cohort, as were poorly differentiated and undifferentiated tumors (p < 0.05). FC cohort had greater travel distance and time-to-treatment (both p < 0.001). Variables independently associated with FC included urban and rural setting and histology (poorly differentiated and undifferentiated) (all p < 0.05). After controlling for other variables, FC was not associated with survival.Conclusion: FC patients experienced longer distance travelled and time-to-treatment without survival impact. National emphasis must be placed on broadening access to equitable, high-quality sarcoma care.","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116319"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjsurg.2025.116319","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Fragmented care (FC) is associated with mixed outcomes. This analysis examines FC's impact on retroperitoneal sarcoma (RPS) treatment.

Methods: The National Cancer Database was queried for adult patients with non-metastatic, surgically-resected RPS. FC was defined as diagnosis/treatment at >1 facility. Univariable and multivariable analyses examined factors associated with FC and its impact on overall survival.

Results: 4976 patients were included; 45.6 % experienced FC. Non-FC and FC cohorts were similar. Dedifferentiated liposarcoma were more common in FC cohort, as were poorly differentiated and undifferentiated tumors (p < 0.05). FC cohort had greater travel distance and time-to-treatment (both p < 0.001). Variables independently associated with FC included urban and rural setting and histology (poorly differentiated and undifferentiated) (all p < 0.05). After controlling for other variables, FC was not associated with survival.

Conclusion: FC patients experienced longer distance travelled and time-to-treatment without survival impact. National emphasis must be placed on broadening access to equitable, high-quality sarcoma care.

查看原文本刊更多论文

碎片化护理对腹膜后肉瘤的影响。

背景：分散治疗（FC）的结果好坏参半。本研究分析了FC对腹膜后肉瘤（RPS）治疗的影响：方法：对全国癌症数据库中的非转移性、手术切除的腹膜后肉瘤成年患者进行查询。FC的定义是在>1家机构进行诊断/治疗。单变量和多变量分析检验了与FC相关的因素及其对总生存率的影响：共纳入 4976 例患者，其中 45.6% 的患者经历过 FC。非 FC 和 FC 组群相似。在 FC 组中，分化不良和未分化的脂肪肉瘤更常见（p 结论：FC 患者的旅行距离更长，总生存期也更长：FC患者的治疗距离和时间更长，但对生存没有影响。国家必须重视扩大公平、高质量的肉瘤治疗机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.