The Effect of the Presence of a Surgical Oncologist on Access to Surgery

Abstract

Background: Surgical oncology needs continue to grow as cancer prevalence increases. Recent research has highlighted the disparity in cancer care that can occur due to physical and resource-related barriers. Rural patients are less likely to receive care that is on par with current standards due to geographic distances that must be traveled to receive appropriate care. Methods: Chart review was conducted of patients newly diagnosed with a resectable stage I-III pancreatic, gastric, or hepatic cancer or sarcoma during the employment of a surgical oncologist at our community hospital with a period during which there was no such specialist. By comparing percentage of treatment completion, wait times, completion of adjuvant treatment, and patient outcomes, a link between access and outcomes can be identified. Results: From 12/23/16 to 3/31/18, when no surgical oncologist was employed (Group A), 66 of 123 eligible patients received surgery (53.66%). In contrast, from 4/1/18 to 4/1/20, when a surgical oncologist was employed (Group B), 119 of 192 eligible patients received surgery (61.98%). Chi squared analysis with respect to tumor stage, with non-staged patients classified into a unique stage, demonstrated no statistically significant difference with a p-value of 0.1178, suggesting that the demonstrated increase in surgery completion is not due to differences in tumor stage. Conclusion: Preliminary analysis demonstrates the presence of a surgical oncology specialist plays a significant role in cancer care outcomes. Further research will be performed to identify other factors such as surgery wait time, completion of neoadjuvant and adjuvant therapy, and overall patient outcomes.