The following is a summary of “Traveling Long Distances for Rectal Cancer Care: Institutional Outcomes and Patient Experiences,” published in the October 2024 issue of Surgery by Peterson et al.

Growing evidence shows that patients benefit from undergoing complex surgical procedures, such as proctectomy, at high-volume centers. However, the impact of long-distance travel on patient outcomes, quality of life, and financial burden remains unclear. This study aimed to evaluate oncologic outcomes, quality of life, and travel-related burdens among patients with rectal cancer treated at a single tertiary-care institution, comparing those who traveled long distances to those living closer to the center.

A retrospective analysis was conducted on patients treated with proctectomy for locally advanced rectal cancer, divided into two cohorts based on travel distance: long travel distance (LTD) and short travel distance (STD). Primary outcomes included overall mortality, disease recurrence, and quality of life, while secondary outcomes assessed out-of-pocket travel expenses. Statistical comparisons between the two groups were made using Wilcoxon rank-sum tests for continuous variables and Chi-square tests for categorical data. Kaplan-Meier survival analyses were used to evaluate overall and disease-free survival rates.

Out of 102 patients included in the study, 51 (50%) were categorized as LTD, with a mean travel distance of 57.8 miles, and 51 (50%) as STD, with a mean travel distance of 12.8 miles. No significant differences were found between the LTD and STD groups in 5-year mortality (4% vs. 4%, P = 1.000), disease recurrence rates (26% vs. 18%, P = 0.336), or quality of life scores (0.85 vs. 0.87, P = 0.690). However, patients in the LTD group exhibited significantly lower compliance with postoperative surveillance (84% vs. 96%, P = 0.046). They faced higher lodging expenses ($77.1 vs. $0, P = 0.025) and transportation costs ($133.6 vs. $92.6, P = 0.010) compared to the STD group.

In conclusion, patients traveling long distances for rectal cancer surgery at a high-volume center received comparable oncologic care. They achieved similar survival and quality of life outcomes as those living closer. However, the additional financial burden and reduced surveillance compliance among long-distance patients highlight barriers to optimal postoperative care. Addressing these issues through targeted interventions, such as enhanced patient education, remote monitoring, and financial support, may improve this population’s long-term outcomes and patient satisfaction.

Source: sciencedirect.com/science/article/abs/pii/S0022480424005110