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Updated: Aug 30, 2025
03:55
Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
599
Care Fragmentation in Patients with Differentiated Thyroid Cancer
Jacques A Greenberg1, Jessica W Thiesmeyer1, Caitlin E Egan1
1Department of Surgery, Weill Cornell Medicine, 525 East 68th Street, F-838, 1300 York Avenue, New York, NY, 10065, USA.
World Journal of Surgery
|August 29, 2022
Summary
Care fragmentation (CF) in differentiated thyroid cancer (DTC) surgery, while linked to higher volume centers, is associated with improved overall survival (OS) despite minor delays. This suggests a complex relationship between centralized care and patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Health Services Research
Background:
- Care fragmentation (CF) is linked to poorer outcomes in surgical patients.
- High surgical volume centers improve outcomes but can increase CF for cancer patients.
- The study focuses on differentiated thyroid cancer (DTC) to explore CF's impact.
Purpose of the Study:
- Identify factors associated with CF in DTC patients.
- Determine if CF impacts overall survival (OS) in DTC.
- Compare OS between patients with CF and unified care (UC).
Main Methods:
- Utilized the National Cancer Database (2009-2017) for DTC patients.
- Defined CF as treatment outside the reporting facility or associated office.
- Employed multivariable logistic and Cox regression, and Kaplan-Meier analysis.
Main Results:
- Over 131,000 patients analyzed; 53.3% experienced CF.
- Younger age, high-income areas, and advanced stages (3-4) were linked to CF.
- CF was associated with treatment at high-volume centers and longer travel distances.
- Despite minor delays, 5-year OS improved with CF for Stages 1-3 disease.
Conclusions:
- CF in DTC is linked to high-volume cancer surgery centers.
- CF in DTC patients is associated with improved OS, even with slight treatment delays.
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