Travel distance to tertiary sarcoma centres does not influence oncological presentation or outcomes

Area of Science:

• Oncology
• Surgical Oncology
• Public Health

Background:

• Soft-tissue sarcomas (STSs) are rare cancers necessitating specialized, centralized care.
• Geographical barriers in countries like Canada can significantly increase patient travel distances to these centers.
• The impact of travel distance on cancer presentation and outcomes in centralized models is not well understood, especially within single-payer systems.

Purpose of the Study:

• To investigate the association between travel distance and clinical outcomes for soft-tissue sarcoma patients treated at a Canadian tertiary referral center.
• To determine if increased travel distance affects disease presentation, treatment timelines, or survival rates in a centralized care setting.

Main Methods:

• A retrospective cohort analysis of 1,570 soft-tissue sarcoma patients undergoing surgical resection between 2010 and 2021.
• Patients were stratified based on proximity to the referral center (≤ 50 km vs. > 50 km).
• Cox regression analysis was used to identify predictors of overall survival, including travel distance.

Main Results:

• Patients living further (> 50 km) travelled significantly more (mean 176 km) than those closer (mean 24.8 km).
• No significant differences were observed in disease presentation, time to treatment, systemic therapy use, or functional outcomes between groups.
• Two-year and five-year overall survival rates were comparable across distance groups, and travel distance was not an independent predictor of survival.

Conclusions:

• Travel distance did not negatively impact disease presentation or survival outcomes for soft-tissue sarcoma patients at this centralized Canadian center.
• These findings challenge prior assumptions about travel distance affecting cancer outcomes.
• The study supports the efficacy of centralized cancer care models, even in geographically expansive nations.