Comparison of survival of stage I–III colon cancer by travel distance and hospital volume

Background Previous studies have demonstrated improved outcomes at high-volume colorectal surgery centers; however, the benefit for patients who live far from such centers has not been assessed relative to local, low-volume facilities. Methods The 2010–2015 National Cancer Database (NCDB) was queried for patients with stage I–III colon adenocarcinoma undergoing treatment at a single center. A ‘local, low-volume’ cohort was constructed of 12,768 patients in the bottom quartile of travel distance at the bottom quartile of institution surgical volume and a ‘travel, high-volume’ cohort of 11,349 patients in the top quartile of travel distance at the top quartile of institution surgical volume. Results In unadjusted analysis, patients in the travel cohort had improved rates of positive resection margins (3.7% vs. 5.5%, p