ArticleJournal of the American College of Surgeons2017
Why Do Long-Distance Travelers Have Improved Pancreatectomy Outcomes?
Article in Journal of the American College of Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04893408 (Postoperative and Long-term Survival in Relation to Life-expectancy After Pancreatic Surgery in Elderly Patients), which is not on this map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Postoperative and Long-term Survival in Relation to Life-expectancy After Pancreatic Surgery in Elderly Patients
Who cites it
20 citing papers in PubMed.
- Effect of travel distance on utilization of ancillary services among patients with pancreatic ductal adenocarcinoma: A single institution study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Travel burden and bypassing closest site for surgical cancer treatment for urban and rural oncology patients.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Accessibility to ERCP-performing hospitals among patients with pancreatic cancer living in SEER regions.Cancer medicine · 2024Article
- Transportation considerations in underserved patient populations receiving multidisciplinary head and neck cancer care.AIMS public health · 2024Article
- Lymph node yield as a measure of pancreatic cancer surgery quality.Surgery in practice and science · 2022Article
- Evaluating Distance Bias in Chronic Rhinosinusitis Outcomes.JAMA otolaryngology-- head & neck surgery · 2022Article
- Equity of travel required to access first definitive surgery for liver or stomach cancer in New Zealand.PloS one · 2022Article
- Postoperative and long-term survival in relation to life-expectancy after pancreatic surgery in elderly patients (cohort study).Annals of medicine and surgery (2012) · 2021Article
- Traveling to Receive Treatment for Extremity Soft Tissue Sarcomas: Is it worth the drive?World journal of surgery · 2021Article
- Article
- Hospital Surgical Volume and 3-Year Mortality in Severe Prognosis Cancers: A Population-Based Study Using Cancer Registry Data.Journal of epidemiology · 2021Article
- Ovarian cancer in California: Guideline adherence, survival, and the impact of geographic location, 1996-2014.Cancer epidemiology · 2020Article
- Evaluating Dissemination of Adequate Lymphadenectomy for Gastric Cancer in the USA.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Contribution of Geographic Location to Disparities in Ovarian Cancer Treatment.Journal of the National Comprehensive Cancer Network : JNCCN · 2019Article
- Travel distance and regional access to cardiac valve surgery.Journal of cardiac surgery · 2019Article
- Outcomes After Resection of Hepatocellular Carcinoma: Intersection of Travel Distance and Hospital Volume.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Association Between Travel Distance, Hospital Volume, and Outcomes Following Resection of Cholangiocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Surgical Delay Is Associated with Improved Survival in Hepatocellular Carcinoma: Results of the National Cancer Database.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Article
- Treatment strategies and clinical outcomes of locally advanced pancreatic cancer patients treated at high-volume facilities and academic centers.Advances in radiation oncologyArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundCentralization of complex surgical care has led patients to travel longer distances. Emerging evidence suggested a negative association between increased travel distance and mortality after pancreatectomy. However, the reason for this association remains largely unknown. We sought to unravel the relationships among travel distance, receiving pancreatectomy at high-volume hospitals, delayed surgery, and operative outcomes. STUDY
designWe identified 44,476 patients who underwent pancreatectomy for neoplasms between 2004 and 2013 at the reporting facility from the National Cancer Database. Multivariable analyses were performed to examine the independent relationships between increments in travel distance mortality (30-day and long-term survival) after adjusting for patient demographics, comorbidity, cancer stage, and time trend. We then examined how additional adjustment of procedure volume affected this relationship overall and among rural patients.
resultsMedian travel distance to undergo pancreatectomy increased from 16.5 to 18.7 miles (p for trend < 0.001). Although longer travel distance was associated with delayed pancreatectomy, it was also related to higher odds of receiving pancreatectomy at a high-volume hospital and lower postoperative mortality. In multivariable analysis, difference in mortality among patients with varying travel distance was attenuated by adjustment for procedure volume. However, longest travel distance was still associated with a 77% lower 30-day mortality rate than shortest travel among rural patients, even when accounting for procedure volume.
conclusionsOur large national study found that the beneficial effect of longer travel distance on mortality after pancreatectomy is mainly attributable to increase in procedure volume. However, it can have additional benefits on rural patients that are not explained by volume. Distance can represent a surrogate for rural populations.
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