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Article Abstract
Background: Studies of fragmented care (FC) in rectal cancer have not adjusted for indicators of hospital quality and may misrepresent the effects of FC.
Methods: We queried the National Cancer Database to identify patients undergoing care for clinical stage II and III rectal adenocarcinoma between 2006 and 2019. Those undergoing FC were sub-categorized based on whether (FC CoC) or not (FC non-CoC) they received systemic therapy at CoC accredited facilities.
Results: 44,339 patients met inclusion criteria; 23,921 (54 %) underwent FC, 16,929 (71 %) FC non-CoC. Differences in utilization of neoadjuvant therapy (92.3 % vs 89.7 % vs 89.5 %, p < 0.01) and 5-year overall survival (76.1 vs 75.5 vs 74.1 %, p < 0.01) between treatment cohorts were marginal.
Conclusion: In patients undergoing multimodality therapy for rectal cancer, care fragmentation is not associated with long-term clinical outcome. Decisions regarding where these patients go for systemic therapy may be safely made on the basis of ease of access.
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| http://dx.doi.org/10.1016/j.amjsurg.2023.12.024 | DOI Listing |
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