Impact of fragmented care on retroperitoneal sarcomas.

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.