Residential Distance to the Cancer Center and Outcomes after Robotic-Assisted Pulmonary Lobectomy

IF 0.8 Q4 SURGERY Surgery in practice and science Pub Date : 2023-08-25 DOI:10.1016/j.sipas.2023.100210

Allison O. Dumitriu Carcoana , Jenna C. Marek , William J. West III , Cole R. Fiedler , William N. Doyle Jr. , Kristie M. Labib , Lauren C. Ladehoff , Jose A. Malavet , Gregory Fishberger , Carla C. Moodie , Joseph R. Garrett , Jenna R. Tew , Jobelle J.A.R. Baldonado , Jacques P. Fontaine , Eric M. Toloza

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Abstract

Background

Outcomes of lung cancer patients traveling greater distances for surgical oncology care are not well-described. We investigated the effects of increased travel burden after robotic-assisted pulmonary lobectomy (RAPL) for lung cancer.

Methods

Clinical characteristics and surgical outcomes of 711 consecutive patients who underwent RAPL from September 2010 to March 2022 were compared, stratified by primary residential ZIP code <160 km or ≥160 km from the cancer center.

Results

Of 711 study patients, 515 (72.4%) lived within 160 km and 196 (27.6%) lived ≥160 km away. There were no differences in Charlson Comorbidity Index scores or tumor characteristics. Those traveling ≥160 km experienced more unfavorable perioperative outcomes and postoperative complications, and had worse median survival time by 1.68 years, but this survival difference did not reach statistical significance.

Conclusions

With the growing centralization of cancer care, travel burden may emerge as a predictor of surgical oncology outcomes.

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机器人辅助肺叶切除术后到癌症中心的居住距离和预后

背景:肺癌患者长途跋涉接受外科肿瘤治疗的结果尚未得到很好的描述。我们研究了机器人辅助肺叶切除术(RAPL)治疗肺癌后旅行负担增加的影响。方法比较2010年9月至2022年3月连续711例接受RAPL的患者的临床特征和手术结果，按主要居住邮政编码距离癌症中心160公里或≥160公里进行分层。结果711例患者中，515例(72.4%)居住在160公里以内，196例(27.6%)居住在≥160公里。两组在Charlson合并症指数评分和肿瘤特征方面均无差异。行程≥160 km的患者围手术期预后及术后并发症较多，中位生存时间差1.68年，但差异无统计学意义。结论随着肿瘤治疗的日益集中，旅行负担可能成为肿瘤手术预后的预测指标。

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