Abstract Details

Title Impact of Travel Distance to Care Facility on Survival in Patients with Glioblastoma: A Retrospective Study Using the National Cancer Database

Topic Neuro-oncology

Presentation(s) S30 - Brain Cancer: From Epidemiology to Quality of Life (4:58 PM-5:09 PM)

Poster/Presentation
Number 009

Background

Prior studies demonstrated that longer travel distance is associated with superior outcomes in cancers of prostate, bladder and pancreas. However, there is no study of the impact of travel distance on the receipt of treatment, post-operative outcomes, and survival of GBM patients.

Objective To investigate if there is a relationship between overall survival (OS) and travel distance to hospital for glioblastoma (GBM) patients. Other parameters studied are the receipts of tumor resection, radiation therapy (XRT), and chemotherapy, length of stay (LOS), rates of 30-day readmission and 90-day mortality

Design/Methods

A total of 20424 eligible GBM patients underwent surgery, XRT, and chemotherapy at the same facility (2004-2014) were derived from the National Cancer Database (NCDB). Patients were classified by the travel distance between residence and care facility into four groups (<10, 10-19.99, 20-49.99, ≥50 miles). Outcomes include the receipt of tumor resection, XRT, chemotherapy, length of stay (LOS), 30-day readmission, 90-day mortality, and overall survival (OS). Kaplan-Meier method and Cox proportional hazards model were applied for survival analysis. Multivariate logistic regression was performed to compare differences in treatments received and post-operative outcomes by travel distance.

Results

Compared to patients traveled less than 10 miles, patients traveled 50 miles and more experienced 14% reduced risk of death regardless of adjustment of all covariates (Hazard ratio: 0.86, 95% confidence interval: 0.82-0.91, P<0.001). For patients traveled more than 50 miles, tumor resection and chemotherapy were more frequently utilized at 18% and 26%, respectively. Prolonged length of stay (>4 days), 30-day readmission, and 90-day mortality were significantly decreased by 25%, 29%, and 21% in the group of long-distance travelers (≥50 miles), respectively.

Conclusions

This study provides evidence of superior outcomes among GBM patients who travel ≥50 miles after adjusting socio-demographics, facility type/volume, and treatment strategy. Further investigations are needed to explore the determinants of survival advantage among this population.

Authors/Disclosures
Jay-Jiguang Zhu, MD, PhD, FAAN (Univ of Texas Health Science Center in Houston) PRESENTER	Dr. Zhu has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novocure, INC, Japan. An immediate family member of Dr. Zhu has stock in Abbott lab. The institution of Dr. Zhu has received research support from NRG NIH. The institution of Dr. Zhu has received research support from Novocure, Inc. The institution of Dr. Zhu has received research support from Five Prime pharmaceutical. The institution of Dr. Zhu has received research support from Denovo, inc. The institution of Dr. Zhu has received research support from Boston Biomedical Sumitomo Dainippon Pharma Global Oncology. The institution of Dr. Zhu has received research support from CNS pharmaceutical. The institution of Dr. Zhu has received research support from ABM Therapeutics Corporation . The institution of Dr. Zhu has received research support from Chimerix Inc.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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