Traveling Long Distances for Rectal Cancer Care: Institutional Outcomes and Patient Experiences

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Health Services Research

Background:

• Evidence suggests complex procedures like proctectomy benefit from high-volume centers.
• The impact of long-distance travel on patient outcomes and burdens remains unclear.

Purpose of the Study:

• To evaluate oncologic outcomes, quality of life, and travel burdens for rectal cancer patients undergoing proctectomy.
• To compare outcomes between patients with long travel distance (LTD) and short travel distance (STD) to a tertiary care center.

Main Methods:

• Retrospective study of 102 patients with locally advanced rectal cancer undergoing proctectomy.
• Comparison of LTD (mean 57.8 miles) and STD (mean 12.8 miles) cohorts.
• Analysis of oncologic outcomes, quality of life, and out-of-pocket expenses; Kaplan-Meier survival analysis.

Main Results:

• No significant differences in 5-year mortality (4% vs 4%), disease recurrence (26% vs 18%), or quality of life (0.85 vs 0.87) between LTD and STD cohorts.
• LTD cohort showed lower postresection surveillance compliance (84% vs 96%).
• LTD cohort incurred significantly higher lodging ($77.1 vs $0) and transportation ($133.6 vs $92.6) expenses.

Conclusions:

• Long-distance travel for rectal cancer proctectomy is associated with comparable oncologic outcomes and quality of life to local care.
• Increased travel costs and decreased surveillance compliance are key barriers for LTD patients.
• Strategies are needed to mitigate travel-related burdens and improve adherence to surveillance for LTD populations.