Citation
Farquhar, Douglas R.; Masood, Maheer M.; Lenze, Nicholas R.; Tasoulas, Jason; Sheth, Siddharth; Lumley, Catherine; Blumberg, Jeffrey; Yarbrough, Wendell G.; Zevallos, Jose P.; & Weissler, Mark C., et al. (2023). Effect of Distance of Treatment Center on Survival for HPV-Negative Head and Neck Cancer Patients. Head & Neck, 45(12), 2981-2989.Abstract
BACKGROUND: In rural states, travel burden for complex cancer care required for head and neck squamous cell carcinoma (HNSCC) may affect patient survival, but its impact is unknown.METHODS: Patients with HPV-negative HNSCC were retrospectively identified from a statewide, population-based study. Euclidian distance from the home address to the treatment center was calculated for radiation therapy, surgery, and chemotherapy. Multivariable Cox proportional hazards models were used to examine the risk of 5-year mortality with increasing travel quartiles.
RESULTS: There were 936 patients with HPV-negative HNSCC with a mean age of 60. Patients traveled a median distance of 10.2, 11.1, and 10.9 miles to receive radiation therapy, surgery, and chemotherapy, respectively. Patients in the fourth distance quartile were more likely to live in a rural location (p < 0.001) and receive treatment at an academic hospital (p < 0.001). Adjusted overall survival (OS) improved proportionally to distance traveled, with improved OS remaining significant for patients who traveled the furthest for care (third and fourth quartile by distance). Relative to patients in the first quartile, patients in the fourth had a reduced risk of mortality with radiation (HR 0.59, 95% CI 0.42-0.83; p = 0.002), surgery (HR 0.47, 95% CI 0.30-0.75; p = 0.001), and chemotherapy (HR 0.56, 95% CI 0.35-0.91; p = 0.020).
CONCLUSION: For patients in this population-based cohort, those traveling greater distances for treatment of HPV-negative HNSCC had improved OS. This analysis suggests that the benefits of coordinated, multidisciplinary care may outweigh the barriers of travel burden for these patients.
URL
http://dx.doi.org/10.1002/hed.27522Reference Type
Journal ArticleYear Published
2023Journal Title
Head & NeckAuthor(s)
Farquhar, Douglas R.Masood, Maheer M.
Lenze, Nicholas R.
Tasoulas, Jason
Sheth, Siddharth
Lumley, Catherine
Blumberg, Jeffrey
Yarbrough, Wendell G.
Zevallos, Jose P.
Weissler, Mark C.
Zanation, Adam M.
Hackman, Trevor G.
Olshan, Andrew F.
Article Type
RegularData Set/Study
Carolina Head and Neck Cancer Epidemiology (CHANCE) StudyContinent/Country
United StatesState
North CarolinaRace/Ethnicity
WhiteBlack