American journal of surgery · 2025
Impact of fragmented care on retroperitoneal sarcomas.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Wong Denise L, Fredette Jordan, Hasler Jill, Porpiglia Andrea S, Greco Stephanie H, Reddy Sanjay S, Farma Jeffrey M, Villano Anthony M
Аннотация
BACKGROUND: Fragmented care (FC) is associated with mixed outcomes. This analysis examines FC's impact on retroperitoneal sarcoma (RPS) treatment.
METHODS: The National Cancer Database was queried for adult patients with non-metastatic, surgically-resected RPS. FC was defined as diagnosis/treatment at >1 facility. Univariable and multivariable analyses examined factors associated with FC and its impact on overall survival.
RESULTS: 4976 patients were included; 45.6 % experienced FC. Non-FC and FC cohorts were similar. Dedifferentiated liposarcoma were more common in FC cohort, as were poorly differentiated and undifferentiated tumors (p < 0.05). FC cohort had greater travel distance and time-to-treatment (both p < 0.001). Variables independently associated with FC included urban and rural setting and histology (poorly differentiated and undifferentiated) (all p < 0.05). After controlling for other variables, FC was not associated with survival.
CONCLUSION: FC patients experienced longer distance travelled and time-to-treatment without survival impact. National emphasis must be placed on broadening access to equitable, high-quality sarcoma care.
METHODS: The National Cancer Database was queried for adult patients with non-metastatic, surgically-resected RPS. FC was defined as diagnosis/treatment at >1 facility. Univariable and multivariable analyses examined factors associated with FC and its impact on overall survival.
RESULTS: 4976 patients were included; 45.6 % experienced FC. Non-FC and FC cohorts were similar. Dedifferentiated liposarcoma were more common in FC cohort, as were poorly differentiated and undifferentiated tumors (p < 0.05). FC cohort had greater travel distance and time-to-treatment (both p < 0.001). Variables independently associated with FC included urban and rural setting and histology (poorly differentiated and undifferentiated) (all p < 0.05). After controlling for other variables, FC was not associated with survival.
CONCLUSION: FC patients experienced longer distance travelled and time-to-treatment without survival impact. National emphasis must be placed on broadening access to equitable, high-quality sarcoma care.