Travel distance and overall survival in hepatocellular cancer care.

Journal Article (Journal Article)

BACKGROUND: Our objective was to assess the relationship between overall survival (OS) and distance travelled to the treating facility for patients undergoing liver resection for hepatocellular carcinoma and to determine whether this relationship was dependent upon the structural factors of the treating facility. METHODS: Using National Cancer Database, we focused on extremes of travel: Local (<12.5 miles to treating facility) and Travel (≥50 miles). We analyzed OS with Cox models; we estimated stratified models to assess interaction between distance and facility characteristics (volume, academic status). RESULTS: We included 6860 patients. After correction for confounding, distance travelled was not associated with OS (p = 0.444). However, Travel patients treated at high-volume, academic centers had worse OS compared to Local patients (HR 1.54, 95%CI 1.07-2.21); this association was not seen for patients treated at low volume, academic centers (p = 0.708) high volume non-academic centers (p = 0.174) or low volume non-academic centers (p = 515). CONCLUSION: For those patients treated at high-volume, academic centers, living far from the facility was associated with worse OS. The reasons for this association should be investigated further.

Full Text

Duke Authors

Cited Authors

  • Siegel, JB; Allen, S; Engelhardt, KE; Morgan, KA; Lancaster, WP

Published Date

  • September 2021

Published In

Volume / Issue

  • 222 / 3

Start / End Page

  • 584 - 593

PubMed ID

  • 33413878

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2020.12.052


  • eng

Conference Location

  • United States