Travel distance is associated with stage at presentation and laryngectomy rates among patients with laryngeal cancer Journal Article
| Authors: | Morse, E.; Lohia, S.; Dooley, L. M.; Gupta, P.; Roman, B. R. |
| Article Title: | Travel distance is associated with stage at presentation and laryngectomy rates among patients with laryngeal cancer |
| Abstract: | Background: The impact of travel distance on stage at presentation and management strategies of laryngeal squamous cell carcinoma (SCC) is unknown. We investigated this relationship. Methods: Retrospective review of patients with laryngeal SCC in the National Cancer Data Base from 2004 to 2016. Multivariate analysis determined relationships between travel distance, sociodemographic, geographic, and hospital factors. Logistic regression determined the influence of travel distance on T-stage and overall stage at presentation, and receipt of total laryngectomy. Results: Sixty thousand four hundred and thirty-nine patients were divided into groups based on distance to treatment: short (<12.5 miles); intermediate (12.5–49.9 miles); and long (>50 miles). Increased travel was associated with T4-stage (intermediate vs. short OR 1.11, CI 1.04–1.18, p = 0.001; long vs. short OR 1.5, CI 1.36–1.65, p < 0.001), and total laryngectomy (intermediate vs. short OR 1.40, CI 1.3–1.5, p ≤ 0.001; long vs. short OR 2.52, CI 2.28–2.79, p ≤ 0.001). In T4 disease, total laryngectomy was associated with improved survival compared to nonsurgical treatment (HR 0.75, CI 0.70–0.80, p < 0.001) regardless of travel distance. Conclusion: Longer travel distance to care is associated with increased stage at presentation, rate of laryngectomy, and improved survival in advanced laryngeal SCC. Health policy efforts should be directed towards improving early access to diagnosis and care. © 2021 Wiley Periodicals LLC |
| Keywords: | adult; cancer survival; aged; middle aged; survival analysis; major clinical study; overall survival; laryngectomy; advanced cancer; cancer patient; comparative study; cancer staging; cohort analysis; retrospective study; patient care; health care access; travel; disparities; laryngeal cancer; very elderly; human; male; female; article; larynx squamous cell carcinoma; travel distance; healthcare outcomes |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 124 |
| Issue: | 8 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2021-12-15 |
| Start Page: | 1272 |
| End Page: | 1283 |
| Language: | English |
| DOI: | 10.1002/jso.26643 |
| PUBMED: | 34390494 |
| PROVIDER: | scopus |
| PMCID: | PMC9473446 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus |
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