The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium
Background Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longe...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2017-12, Vol.21 (12), p.2016-2024 |
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| creator | O’Connor, Sean C. Mogal, Harveshp Russell, Gregory Ethun, Cecilia Fields, Ryan C. Jin, Linda Hatzaras, Ioannis Vitiello, Gerardo Idrees, Kamran Isom, Chelsea A. Martin, Robert Scoggins, Charles Pawlik, Timothy M. Schmidt, Carl Poultsides, George Tran, Thuy B. Weber, Sharon Salem, Ahmed Maithel, Shishir Shen, Perry |
| description | Background
Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longer travel distances are associated with worse outcomes for these patients as well.
Study Design
Data was analyzed from the US Extrahepatic Biliary Consortium database, which retrospectively reviewed patients who received resection of extrahepatic biliary malignancies at 10 high-volume centers. Driving distance to the patient’s treatment center was measured for 1025 patients. These were divided into four quartiles for analysis: |
| doi_str_mv | 10.1007/s11605-017-3537-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5909109</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1966805183</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-6cb1fe7df18ffa7c36ade9902896374485374c9faf6d729fd75a6f2f8c99551d3</originalsourceid><addsrcrecordid>eNp1kV1rFDEUhgdRbK3-AG8k4I03o8nM5MsLoV3WD6gUdAvehTRzspsyk2yTmaJ_o7-4Z9laquhVAuc573nPeavqJaNvGaXyXWFMUF5TJuuWt7LuHlWHTMm27kQjHuOfalY3nP84qJ6VckkRpEw9rQ4apZWQvDmsblYbIEvvwU2FJE9W2V7DQE7m3EMkKZKzeXJphEKO_QSZfIOCaMACwsufU7Yb2NopOHIShmDzL_LVDmEdbXQByvsdPw8o7XMayYSzzr__u22RYkl5CvP4vHri7VDgxd17VJ1_XK4Wn-vTs09fFsentesknWrhLpgH2XumvLfStcL2oDXF3UQru07hRTqnvfWil432veRW-MYrpzXnrG-Pqg973e18MULvIKKtwWxzGNGQSTaYPysxbMw6XRuu8a5Uo8CbO4GcrmYokxlDcTAMNkKai2G6U5KjjwbR13-hl2nOEddDSghFOVMtUmxPuZxKyeDvzTBqdombfeIGgzS7xE2HPa8ebnHf8TtiBJo9ULAU15AfjP6v6i0UArmF</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1966805183</pqid></control><display><type>article</type><title>The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>O’Connor, Sean C. ; Mogal, Harveshp ; Russell, Gregory ; Ethun, Cecilia ; Fields, Ryan C. ; Jin, Linda ; Hatzaras, Ioannis ; Vitiello, Gerardo ; Idrees, Kamran ; Isom, Chelsea A. ; Martin, Robert ; Scoggins, Charles ; Pawlik, Timothy M. ; Schmidt, Carl ; Poultsides, George ; Tran, Thuy B. ; Weber, Sharon ; Salem, Ahmed ; Maithel, Shishir ; Shen, Perry</creator><creatorcontrib>O’Connor, Sean C. ; Mogal, Harveshp ; Russell, Gregory ; Ethun, Cecilia ; Fields, Ryan C. ; Jin, Linda ; Hatzaras, Ioannis ; Vitiello, Gerardo ; Idrees, Kamran ; Isom, Chelsea A. ; Martin, Robert ; Scoggins, Charles ; Pawlik, Timothy M. ; Schmidt, Carl ; Poultsides, George ; Tran, Thuy B. ; Weber, Sharon ; Salem, Ahmed ; Maithel, Shishir ; Shen, Perry</creatorcontrib><description>Background
Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longer travel distances are associated with worse outcomes for these patients as well.
Study Design
Data was analyzed from the US Extrahepatic Biliary Consortium database, which retrospectively reviewed patients who received resection of extrahepatic biliary malignancies at 10 high-volume centers. Driving distance to the patient’s treatment center was measured for 1025 patients. These were divided into four quartiles for analysis: < 24.5, 24.5–57.2, 57.2–117, and < 117 mi. Cox proportional hazard models were then used to measure differences in overall survival.
Results
No difference was found between the groups in severity of disease or post-operative complications. The median overall survival in each quartile was as follows: 1st = 1.91, 2nd = 1.60, 3rd = 1.30, and 4th = 1.39 years. Patients in the 3rd and 4th quartile had a significantly lower median household income (
p
= 0.0001) and a greater proportion Caucasian race (
p
= 0.0001). However, neither of these was independently associated with overall survival. The two furthest quartiles were found to have decreased overall survival (HR = 1.39, CI = 1.12–1.73 and HR = 1.3, CI = 1.04–1.62), with quartile 3 remaining significant after multivariate analysis (HR = 1.45, CI = 1.04–2.0,
p
= 0.028).
Conclusions
Longer travel distances were associated with decreased overall survival, especially in the 3rd quartile of our study. Patients traveling longer distances also had a lower household income, suggesting that these patients have significant barriers to care.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-017-3537-4</identifier><identifier>PMID: 28986752</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Biliary Tract Neoplasms - mortality ; Biliary Tract Neoplasms - surgery ; Cholangiocarcinoma ; Consortia ; Delivery of Health Care - organization & administration ; Female ; Gallbladder cancer ; Gastroenterology ; Gastrointestinal surgery ; Hospitals, High-Volume ; Humans ; Income - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Original Article ; Proportional Hazards Models ; Retrospective Studies ; Surgery ; Survival Rate ; Tertiary Care Centers ; Travel ; Travel - statistics & numerical data ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Journal of gastrointestinal surgery, 2017-12, Vol.21 (12), p.2016-2024</ispartof><rights>The Society for Surgery of the Alimentary Tract 2017</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-6cb1fe7df18ffa7c36ade9902896374485374c9faf6d729fd75a6f2f8c99551d3</citedby><cites>FETCH-LOGICAL-c470t-6cb1fe7df18ffa7c36ade9902896374485374c9faf6d729fd75a6f2f8c99551d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-017-3537-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-017-3537-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28986752$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Connor, Sean C.</creatorcontrib><creatorcontrib>Mogal, Harveshp</creatorcontrib><creatorcontrib>Russell, Gregory</creatorcontrib><creatorcontrib>Ethun, Cecilia</creatorcontrib><creatorcontrib>Fields, Ryan C.</creatorcontrib><creatorcontrib>Jin, Linda</creatorcontrib><creatorcontrib>Hatzaras, Ioannis</creatorcontrib><creatorcontrib>Vitiello, Gerardo</creatorcontrib><creatorcontrib>Idrees, Kamran</creatorcontrib><creatorcontrib>Isom, Chelsea A.</creatorcontrib><creatorcontrib>Martin, Robert</creatorcontrib><creatorcontrib>Scoggins, Charles</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><creatorcontrib>Schmidt, Carl</creatorcontrib><creatorcontrib>Poultsides, George</creatorcontrib><creatorcontrib>Tran, Thuy B.</creatorcontrib><creatorcontrib>Weber, Sharon</creatorcontrib><creatorcontrib>Salem, Ahmed</creatorcontrib><creatorcontrib>Maithel, Shishir</creatorcontrib><creatorcontrib>Shen, Perry</creatorcontrib><title>The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longer travel distances are associated with worse outcomes for these patients as well.
Study Design
Data was analyzed from the US Extrahepatic Biliary Consortium database, which retrospectively reviewed patients who received resection of extrahepatic biliary malignancies at 10 high-volume centers. Driving distance to the patient’s treatment center was measured for 1025 patients. These were divided into four quartiles for analysis: < 24.5, 24.5–57.2, 57.2–117, and < 117 mi. Cox proportional hazard models were then used to measure differences in overall survival.
Results
No difference was found between the groups in severity of disease or post-operative complications. The median overall survival in each quartile was as follows: 1st = 1.91, 2nd = 1.60, 3rd = 1.30, and 4th = 1.39 years. Patients in the 3rd and 4th quartile had a significantly lower median household income (
p
= 0.0001) and a greater proportion Caucasian race (
p
= 0.0001). However, neither of these was independently associated with overall survival. The two furthest quartiles were found to have decreased overall survival (HR = 1.39, CI = 1.12–1.73 and HR = 1.3, CI = 1.04–1.62), with quartile 3 remaining significant after multivariate analysis (HR = 1.45, CI = 1.04–2.0,
p
= 0.028).
Conclusions
Longer travel distances were associated with decreased overall survival, especially in the 3rd quartile of our study. Patients traveling longer distances also had a lower household income, suggesting that these patients have significant barriers to care.</description><subject>Aged</subject><subject>Biliary Tract Neoplasms - mortality</subject><subject>Biliary Tract Neoplasms - surgery</subject><subject>Cholangiocarcinoma</subject><subject>Consortia</subject><subject>Delivery of Health Care - organization & administration</subject><subject>Female</subject><subject>Gallbladder cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Hospitals, High-Volume</subject><subject>Humans</subject><subject>Income - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Original Article</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Tertiary Care Centers</subject><subject>Travel</subject><subject>Travel - statistics & numerical data</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV1rFDEUhgdRbK3-AG8k4I03o8nM5MsLoV3WD6gUdAvehTRzspsyk2yTmaJ_o7-4Z9laquhVAuc573nPeavqJaNvGaXyXWFMUF5TJuuWt7LuHlWHTMm27kQjHuOfalY3nP84qJ6VckkRpEw9rQ4apZWQvDmsblYbIEvvwU2FJE9W2V7DQE7m3EMkKZKzeXJphEKO_QSZfIOCaMACwsufU7Yb2NopOHIShmDzL_LVDmEdbXQByvsdPw8o7XMayYSzzr__u22RYkl5CvP4vHri7VDgxd17VJ1_XK4Wn-vTs09fFsentesknWrhLpgH2XumvLfStcL2oDXF3UQru07hRTqnvfWil432veRW-MYrpzXnrG-Pqg973e18MULvIKKtwWxzGNGQSTaYPysxbMw6XRuu8a5Uo8CbO4GcrmYokxlDcTAMNkKai2G6U5KjjwbR13-hl2nOEddDSghFOVMtUmxPuZxKyeDvzTBqdombfeIGgzS7xE2HPa8ebnHf8TtiBJo9ULAU15AfjP6v6i0UArmF</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>O’Connor, Sean C.</creator><creator>Mogal, Harveshp</creator><creator>Russell, Gregory</creator><creator>Ethun, Cecilia</creator><creator>Fields, Ryan C.</creator><creator>Jin, Linda</creator><creator>Hatzaras, Ioannis</creator><creator>Vitiello, Gerardo</creator><creator>Idrees, Kamran</creator><creator>Isom, Chelsea A.</creator><creator>Martin, Robert</creator><creator>Scoggins, Charles</creator><creator>Pawlik, Timothy M.</creator><creator>Schmidt, Carl</creator><creator>Poultsides, George</creator><creator>Tran, Thuy B.</creator><creator>Weber, Sharon</creator><creator>Salem, Ahmed</creator><creator>Maithel, Shishir</creator><creator>Shen, Perry</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20171201</creationdate><title>The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium</title><author>O’Connor, Sean C. ; Mogal, Harveshp ; Russell, Gregory ; Ethun, Cecilia ; Fields, Ryan C. ; Jin, Linda ; Hatzaras, Ioannis ; Vitiello, Gerardo ; Idrees, Kamran ; Isom, Chelsea A. ; Martin, Robert ; Scoggins, Charles ; Pawlik, Timothy M. ; Schmidt, Carl ; Poultsides, George ; Tran, Thuy B. ; Weber, Sharon ; Salem, Ahmed ; Maithel, Shishir ; Shen, Perry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-6cb1fe7df18ffa7c36ade9902896374485374c9faf6d729fd75a6f2f8c99551d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Biliary Tract Neoplasms - mortality</topic><topic>Biliary Tract Neoplasms - surgery</topic><topic>Cholangiocarcinoma</topic><topic>Consortia</topic><topic>Delivery of Health Care - organization & administration</topic><topic>Female</topic><topic>Gallbladder cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Hospitals, High-Volume</topic><topic>Humans</topic><topic>Income - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Original Article</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Tertiary Care Centers</topic><topic>Travel</topic><topic>Travel - statistics & numerical data</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Connor, Sean C.</creatorcontrib><creatorcontrib>Mogal, Harveshp</creatorcontrib><creatorcontrib>Russell, Gregory</creatorcontrib><creatorcontrib>Ethun, Cecilia</creatorcontrib><creatorcontrib>Fields, Ryan C.</creatorcontrib><creatorcontrib>Jin, Linda</creatorcontrib><creatorcontrib>Hatzaras, Ioannis</creatorcontrib><creatorcontrib>Vitiello, Gerardo</creatorcontrib><creatorcontrib>Idrees, Kamran</creatorcontrib><creatorcontrib>Isom, Chelsea A.</creatorcontrib><creatorcontrib>Martin, Robert</creatorcontrib><creatorcontrib>Scoggins, Charles</creatorcontrib><creatorcontrib>Pawlik, Timothy M.</creatorcontrib><creatorcontrib>Schmidt, Carl</creatorcontrib><creatorcontrib>Poultsides, George</creatorcontrib><creatorcontrib>Tran, Thuy B.</creatorcontrib><creatorcontrib>Weber, Sharon</creatorcontrib><creatorcontrib>Salem, Ahmed</creatorcontrib><creatorcontrib>Maithel, Shishir</creatorcontrib><creatorcontrib>Shen, Perry</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Connor, Sean C.</au><au>Mogal, Harveshp</au><au>Russell, Gregory</au><au>Ethun, Cecilia</au><au>Fields, Ryan C.</au><au>Jin, Linda</au><au>Hatzaras, Ioannis</au><au>Vitiello, Gerardo</au><au>Idrees, Kamran</au><au>Isom, Chelsea A.</au><au>Martin, Robert</au><au>Scoggins, Charles</au><au>Pawlik, Timothy M.</au><au>Schmidt, Carl</au><au>Poultsides, George</au><au>Tran, Thuy B.</au><au>Weber, Sharon</au><au>Salem, Ahmed</au><au>Maithel, Shishir</au><au>Shen, Perry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>21</volume><issue>12</issue><spage>2016</spage><epage>2024</epage><pages>2016-2024</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longer travel distances are associated with worse outcomes for these patients as well.
Study Design
Data was analyzed from the US Extrahepatic Biliary Consortium database, which retrospectively reviewed patients who received resection of extrahepatic biliary malignancies at 10 high-volume centers. Driving distance to the patient’s treatment center was measured for 1025 patients. These were divided into four quartiles for analysis: < 24.5, 24.5–57.2, 57.2–117, and < 117 mi. Cox proportional hazard models were then used to measure differences in overall survival.
Results
No difference was found between the groups in severity of disease or post-operative complications. The median overall survival in each quartile was as follows: 1st = 1.91, 2nd = 1.60, 3rd = 1.30, and 4th = 1.39 years. Patients in the 3rd and 4th quartile had a significantly lower median household income (
p
= 0.0001) and a greater proportion Caucasian race (
p
= 0.0001). However, neither of these was independently associated with overall survival. The two furthest quartiles were found to have decreased overall survival (HR = 1.39, CI = 1.12–1.73 and HR = 1.3, CI = 1.04–1.62), with quartile 3 remaining significant after multivariate analysis (HR = 1.45, CI = 1.04–2.0,
p
= 0.028).
Conclusions
Longer travel distances were associated with decreased overall survival, especially in the 3rd quartile of our study. Patients traveling longer distances also had a lower household income, suggesting that these patients have significant barriers to care.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28986752</pmid><doi>10.1007/s11605-017-3537-4</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2017-12, Vol.21 (12), p.2016-2024 |
| issn | 1091-255X 1873-4626 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5909109 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Biliary Tract Neoplasms - mortality Biliary Tract Neoplasms - surgery Cholangiocarcinoma Consortia Delivery of Health Care - organization & administration Female Gallbladder cancer Gastroenterology Gastrointestinal surgery Hospitals, High-Volume Humans Income - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Original Article Proportional Hazards Models Retrospective Studies Surgery Survival Rate Tertiary Care Centers Travel Travel - statistics & numerical data Treatment Outcome United States - epidemiology |
| title | The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium |
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