@article{1f6a54f160d643779a50d0ef756129d1,
title = "Association between travel distance and overall survival among patients with adrenocortical carcinoma",
abstract = "Background and Objectives: Regionalization of care is associated with improved perioperative outcomes after adrenalectomy. However, the relationship between travel distance and treatment of adrenocortical carcinoma (ACC) is unknown. We investigated the association between travel distance, treatment, and overall survival (OS) among patients with ACC. Methods: Patients diagnosed with ACC between 2004 and 2017 were identified with the National Cancer Database. Long distance was defined as the highest quintile of travel (≥42.2 miles). The likelihood of surgical management and adjuvant chemotherapy (AC) were determined. The association between travel distance, treatment, and OS was evaluated. Results: Of 3492 patients with ACC included, 2337 (66.9%) received surgery. Rural residents were more likely to travel long distances for surgery than metropolitan residents (65.8% vs. 15.5%, p < 0.001), and surgery was associated with improved OS (HR 0.43, 95% CI 0.34–0.54). Overall, 807 (23.1%) patients received AC with rates decreasing approximately 1% per 4-mile travel distance increase. Also, long distance travel was associated with worse OS among surgically treated patients (HR 1.21, 95% CI 1.05–1.40). Conclusions: Surgery was associated with improved overall survival for patients with ACC. However, increased travel distance was associated with lower likelihood to receive adjuvant chemotherapy and decreased overall survival.",
keywords = "adrenalectomy, rural population, travel",
author = "Logan, {Charles D.} and Nunnally, {Sara E.A.} and Catherine Valukas and Samantha Warwar and Swinarska, {Joanna T.} and Lee, {Frances T.} and Bentrem, {David J.} and Odell, {David D.} and Elaraj, {Dina M.} and Cord Sturgeon",
note = "Funding Information: The data used are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number T37MD014248 (CDL), and the National Cancer Institute under Award Number K07 CA216330 (DDO). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The data used are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award Number T37MD014248 (CDL), and the National Cancer Institute under Award Number K07 CA216330 (DDO). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2023 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.",
year = "2023",
month = oct,
doi = "10.1002/jso.27387",
language = "English (US)",
volume = "128",
pages = "749--763",
journal = "Journal of surgical oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "5",
}
