The impact of travel distance to treatment centre on oral tongue squamous cell carcinoma survival and recurrence
Details
Publication Year 2022-07,Volume 51,Issue #7,Page 854-861
Journal Title
International Journal of Oral and Maxillofacial Surgery
Publication Type
Research article
Abstract
There have been no prior studies examining the effect of distance to the treatment centre on oral squamous cell carcinoma outcomes in Australia. The purpose of this study was to analyse the impact of travel distance on oral tongue squamous cell carcinoma (OTSCC) outcomes. This was a retrospective analysis of 243 patients who received surgical treatment +/- adjuvant therapy between 2007 and 2016. The overall survival (OS), disease-specific survival (DSS), and freedom from loco-regional failure (FFLRF) survival analyses were conducted using Kaplan-Meier curves and a multivariate Cox proportional hazards model. A competing risk (CR) analysis was conducted. Patients living >/=200 km from the treatment centre, when compared with those living within 40 km, had worse OS (hazard ratio (HR) 3.11, 95% confidence interval (CI) 1.74-5.54), DSS (HR 2.58, 95% CI 1.30-5.12), and FFLRF (HR 2.47, 95% CI 1.22-5.01). These discrepancies were significant when adjusted for socioeconomic status (OS P < 0.001, DSS P 0.004, FFLRF P = 0.005) and in the presence of CR (OTSCC-specific death with CR 'non-disease-related death' P =0.030, FFLRF with CR 'any cause death' P = 0.013, FFLRF with CR 'OTSCC-specific death' P = 0.004). Patients with OTSCC living >/=200 km from the treatment centre were found to have worse outcomes than those living within 40 km.
Keywords
*Carcinoma, Squamous Cell/pathology/surgery; *Head and Neck Neoplasms/pathology; *Health Services Accessibility; Humans; *Mouth Neoplasms/pathology; Neoplasm Staging; Prognosis; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; *Tongue Neoplasms/surgery; health services accessibility; medical geography; residence characteristics; rural health
Department(s)
Radiation Oncology; Surgical Oncology
PubMed ID
34551874
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