Distance from Treatment Center as a Predictor of Outcome in Head and Neck Cancer

Introduction: Timely access to care and treatment is crucial for achieving optimal outcomes in patients with head and neck cancer (HNC). Barriers to care, such as travel distance to treatment centers, can play a critical role in potentially delaying treatment and diagnosis, negatively affecting prognosis. In this project, our aim was to assess the association between patients' travel distance to a tertiary treatment center and various outcomes in HNC.

Methods: A retrospective analysis of patients undergoing treatment for oral cavity cancers at a tertiary care center during the years 2000-2020 was conducted. Multivariable logistic regression and Cox proportional hazard models were employed for statistical analysis.

Results: In the preliminary stage of data extraction, 291 patients were identified. The majority of these patients were male (n=213, 73.2%) with an average age of 60.90 (SD=2.15). Of these, 64 patients were candidates for receiving post-operative radiation treatment (PORT), with 43 (67.18%) of these patients had delays in starting their adjuvant therapy in the ideal 6-week post operative window. A total of 62 patients were diagnosed with recurrent disease during surveillance and follow-up. Multivariate regression analysis looking at association of age, race, sex, insurance status, and distance on PORT-delay did not yield any statistically significant results. Similarly, when using recurrence as the outcome of interest, the same independent variables led to statistically insignificant results in logistic regression analysis. Finally, an ordinal regression analysis using AJCC staging data points did not yield statistically significant findings with these variables.

Conclusions: In the preliminary stages of our analysis, we did not find any association between the distance traveled by patients and various outcome endpoints. While awaiting further analysis with more data points, our preliminary results suggest that the distance to the treatment center might not play a significant role in outcomes as previously thought.