ArticlePloS one2021
Greater travel distance to specialized facilities is associated with higher survival for patients with soft-tissue sarcoma: US nationwide patterns.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers to care for musculoskeletal sarcoma patients: a public health perspective.Frontiers in public health · 2024Pooled it
- Validation of Updated Sarculator Nomogram for Primary Retroperitoneal Sarcoma in the United States.Annals of surgical oncology · 2026Article
- Article
- Review
- Article
- The impact of social determinants of health on textbook oncological outcomes and overall survival in locally advanced non-small cell lung cancer.JTCVS open · 2023Article
- Ten recommendations for sarcoma surgery: consensus of the surgical societies based on the German S3 guideline "Adult Soft Tissue Sarcomas".Langenbeck's archives of surgery · 2023Article
- Geographical and spatial disparities in the incidence and survival of rare cancers in Australia.International journal of cancer · 2023Article
- Disparities in Survival Due to Social Determinants of Health and Access to Treatment in US Patients With Operable Malignant Pleural Mesothelioma.JAMA network open · 2023Observational
- Prevalence of and Mortality Associated with Cross-State Inpatient Care Fragmentation Among Older Adults in a Nationally Representative Dataset.Journal of general internal medicine · 2022Article
- Article
- Impact of racial disparities and insurance status in patients with bone sarcomas in the USA : a population-based cohort study.Bone & joint research · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
purposeThe survival impact of geographic access to specialized care remains unknown in patients with soft-tissue sarcomas (STS). This study aimed to clarify the association between the patient travel distance and survival outcome and investigate the factors lying behind it.
methodsA total of 34 528 patients with STS registered in the National Cancer Data Base, diagnosed from 2004-2016, were investigated.
resultsTumor stage correlated with travel distance: patients with metastatic disease stayed closer to home. However, the type of facility showed greatest variation: 37.0%, 51.0%, 73.5%, and 75.9% of patients with ≤10 miles, 10.1-50 miles, 50.1-100 miles, and >100 miles, respectively (P<0.001), had a sarcoma care at academic/research centers. On a multivariable analysis, reduced mortality risk was associated with longer (versus short) travel distance (>100 miles: HR = 0.877; P = 0.001) and management at academic/research (versus non-academic/research) centers (HR = 0.857; P<0.001). The greatest divergence was seen in patients traveling very long distance (>100 miles) to an academic/research center, with a 26.9% survival benefit (HR = 0.731; P<0.001), compared with those traveling short distance (≤10 miles; 95.4% living in metropolitan area) to a non-academic/research center. There was no significant correlation between travel distance and survival in patients who had care at academic/research centers, whereas a survival benefit of management at academic/research centers was observed in every group of travel distance, regardless of tumor stage.
conclusionsThis national study demonstrated that increased travel distance was associated with superior survival, attributable to a higher proportion of patients receiving sarcoma care at distant academic/research centers. These data support centralized care for STS. Overcoming referral and travel barriers may enable more patients to be treated at specialized centers and may further improve survival rates for patients with STS, even when it imposes an increased travel burden.
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