Distance to the pediatric oncology center does not affect survival in children with acute lymphoblastic leukemia: a report from CYP-C

Abstract

Remoteness is associated with worse survival in adults with cancer. We aimed to determine whether remoteness is associated with cancer outcomes in pediatric acute lymphoblastic leukemia (ALL). Canadian children with ALL entered in the CYP-C registry were included. The predictive impact of remoteness on overall survival (OS), relapse, and treatment-related complications (infections, thrombosis, bleeding, and osteonecrosis) was estimated using multivariate regression models. We included 1383 children, of whom 277 (20.0%) lived remotely (>200 km from the pediatric oncology center). The median latency to see a pediatric oncologist was longer in children living remotely. The 5-year OS (95% CI) was similar for both groups (remote: 95.2% [93.7–96.3%] vs close: 94.1% [90.5–95.2%]). No difference was found in the relapse rate between both groups and in treatment-related complications. Remoteness did not affect survival in pediatric ALL. Further research is needed to determine which models of healthcare organization optimize cancer outcomes and patients’ satisfaction.

Keywords:

• Leukemia;
• children;
• epidemiology;
• survival

Acknowledgements

The authors gratefully acknowledge the contributions of study participants, participating pediatric oncology centres, members of the Cancer in Young People in Canada (CYP-C) Management and Advisory Committees, and the Pediatric Oncology Group of Ontario (POGO). The CYP-C is funded by the Public Health Agency of Canada. The authors thank M. Randy Barber for his help.

Disclosure statement

The authors report no conflict of interest.

Data used in this publication are from the Cancer in Young People in Canada Surveillance Program and are used with the permission of the Public Health Agency of Canada. The analyses and interpretation presented in this work do not necessarily reflect the opinions of the federal government of Canada.

Marie-Claude Pelland-Marcotte received support from a Canadian Institutes of Health Research (CIHR) Doctoral Research Award, under the grant HMD − 164883.