Synapse - Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State

Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State Journal Article

Authors:	Kahn, R. M.; Ma, X.; Gordhandas, S.; Yeoshoua, E.; Ellis, R. J.; Zhang, X.; Aviki, E. M.; Abu-Rustum, N. R.; Gardner, G. J.; Sonoda, Y.; Zivanovic, O.; Long Roche, K.; Jewell, E.; Boerner, T.; Chi, D. S.
Article Title:	Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State
Abstract:	Objective: To evaluate the theoretical impact of regionalizing cytoreductive surgery for ovarian cancer (OC) to high-volume facilities on patient travel. Methods: We retrospectively identified patients with OC who underwent cytoreduction between 1/1/2004–12/31/2018 from the New York State Cancer Registry and Statewide Planning and Research Cooperative System. Hospitals were stratified by low-volume (<21 cytoreductive surgical procedures for OC annually) and high-volume centers (≥21 procedures annually). A simulation was performed; outcomes of interest were driving distance and time between the centroid of the patient's residence zip code and the treating facility zip code. Results: Overall, 60,493 patients met inclusion criteria. Between 2004 and 2018, 210 facilities were performing cytoreductive surgery for OC in New York; 159 facilities (75.7%) met low-volume and 51 (24.3%) met high-volume criteria. Overall, 10,514 patients (17.4%) were treated at low-volume and 49,979 (82.6%) at high-volume facilities. In 2004, 78.2% of patients were treated at high-volume facilities, which increased to 84.6% in 2018 (P <.0001). Median travel distance and time for patients treated at high-volume centers was 12.2 miles (IQR, 5.6–25.5) and 23.0 min (IQR, 15.2–37.0), and 8.2 miles (IQR, 3.7–15.9) and 16.8 min (IQR, 12.4–26.0) for patients treated at low-volume centers. If cytoreductive surgery was centralized to high-volume centers, median distance and time traveled for patients originally treated at low-volume centers would be 11.2 miles (IQR, 3.8–32.3; P <.001) and 20.2 min (IQR, 13.6–43.0; P <.001). Conclusions: Centralizing cytoreductive surgery for OC to high-volume centers in New York would increase patient travel burden by negligible amounts of distance and time for most patients. © 2024 Elsevier Inc.
Keywords:	adult; aged; major clinical study; ovarian cancer; cytoreductive surgery; ovary cancer; cohort analysis; retrospective study; simulation; cancer registry; cytoreduction; new york; patient transport; human; female; article; high volume hospital; high-volume centers; patient travel
Journal Title:	Gynecologic Oncology
Volume:	182
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2024-03-01
Start Page:	141
End Page:	147
Language:	English
DOI:	10.1016/j.ygyno.2024.01.004
PUBMED:	38262237
PROVIDER:	scopus
PMCID:	PMC10960664
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85185159222&doi=10.1016%2fj.ygyno.2024.01.004&partnerID=40&md5=a39a7e4a7adff6e3ad1406a761106615
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Dennis S. Chi -- Source: Scopus