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Publications

Journal Article Epublish

PubMed: 42776261 DOI: 10.1007/s00345-026-06783-6

Factors associated with long-distance travel among patients undergoing radical prostatectomy at a German high-volume tertiary prostate cancer centre.

World J Urol 44(1)

Authors: Sami-Ramzi Leyh-Bannurah, Lars Budäus, Armin Soave, Su Oh-Hohenhorst, Clemens Rosenbaum, Christian Wagner, Fabian Falkenbach, Theodoros Karagiotis, Nikolaos Liakos, Okyaz Eminaga, Mahmoud Farzat, Zhe Tian, Georg Salomon, Thomas Steuber, Felix Preisser, Alexander Haese, Tobias Maurer, Margit Fisch, Markus Graefen, Frank Schiemann, Mykyta Kachanov

Affiliations

  • Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
  • Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
  • Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany.
  • Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
  • Martini-Klinik Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
  • Asklepios Paulinen Klinik, Wiesbaden, Germany.
  • Prostate Center Northwest, Department of Urology, Pediatric Urology and Uro-Oncology, St. Antonius-Hospital, Gronau, Germany.
  • Department of Urology, Heidelberg University Hospital, Heidelberg, Germany.
  • Second Department of Urology, Medical School, Sismanoglio Hospital, National and Kapodistrian University of Athens, Sismanogliou 37, Athens, Greece.
  • Department of Urology, University of Freiburg, Freiburg im Breisgau, Germany.
  • AI Vobis, Palo Alto and Department of Anesthesia, Stanford University School of Medicine, Palo Alto, CA, USA.
  • Department of Urology, Pediatric Urology, and Andrology, Justus-Liebig University of Giessen, Giessen, Germany.
  • Department of Urology and Robotic Urology, Diakonie Klinikum Siegen, Siegen, Germany.
  • Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.
  • Faculty of Social Sciences, Economics and Business Administration, University of Bamberg, Bamberg, Germany.
  • Department of Socioeconomics, Faculty of Business, Economics and Social Sciences, University of Hamburg, Hamburg, Germany.

Abstract

PURPOSE

To evaluate determinants of long-distance travel for radical prostatectomy (RP) to a German high-volume tertiary centre.

METHODS

A total of 15,727 patients underwent RP at our high-volume tertiary centre (2019-2025). Distances from residential postal codes to our centre were computed using the Google Maps Directions API. Long-distance travel was defined a priori as > 300 km. Multivariable logistic regression analysis (MVA) was used to identify factors associated with this outcome and were complemented with sensitivity analyses that evaluated alternative distance thresholds (100-400 km), and a continuous log-transformed distance model.

RESULTS

In our cohort, 10,672 (68%) patients travelled ≤ 300 km. Those who travelled > 300 km were younger (median 64 vs.65 years), more often underwent RARP (80% vs.64%), and were more likely to have private insurance (66% vs.43%) (all p < 0.001). In MVA, younger age, private insurance, RARP, and residence in Towns and Villages (DEGURBA stratification) were independently associated with long-distance travel. These socio-demographic predictors remained highly consistent and significant across all alternative thresholds and the continuous model. Interestingly, greater distance to nearest certified PCa centre reduced the odds of travelling even farther to our centre. Disease-related variables such as EAU risk group and baseline erectile function did not achieve independent predictor status for long-distance travel.

CONCLUSIONS

Nearly one-third of patients bypassed nearby certified providers and travelled > 300 km for RP. Long-distance travel was associated primarily by non-disease-related factors, rather than disease-related, that might affect oncological or functional outcomes. Transparent outcome reporting and counselling are needed to align travel decisions with objective quality metrics.

MeSH

Travel, Urology, Neoplasms, Prostate, Insurance, Prostatic Neoplasms, Prostatectomy