San Diego, CA USA (UroToday.com) A very interesting poster was presented in today’s epidemiology and evaluation session at the AUA 2016 evaluating the Association of Distance to Treatment Facility with Survival and Quality Outcomes Following Radical Cystectomy. Dr Ahmed Haddad reminded all that Regionalization of cancer care has led to increased travel distances for many patients.
It is well known that the greater the distance to the hospital, the higher the 90 days mortality is. The authors sought to evaluate the association of travel distance on survival outcome and quality outcome measures following radical cystectomy in a large multi-institutional cohort. The authors examined all cystectomies performed in 6 north American institutes. The authors used straight line distance to calculate the distance from the hospital. Logistic regression was used to examine the association of the distance with 90 days mortality. Furthermore, point of care parameters (e.g. neoadjuvnt chemotherapy) were also examined. Finally, long term survival was examined by the cox regression methods. More neoadjuvant chemotherapy was used when the distance was more than 266 miles (OR 1.92). Interestingly, distance from the patient’s home to the hospital was not associated with 90 days mortality. overall mortality was improved for patients who live more than 21 miles from the hospital (OR = 0.84-0.89). The authors conclude that despite the fact that patients living far from the hospital may have less access to postoperative care, their mortality is not adversely affected.
Dr. Ahmed Haddad
at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA