My summer vacation includes a road trip to da U.P., and I try to visit as many caches on the way as possible. If I have all the caches in the state listed, then it's easy to pick ones to stop for.
Also, I use a homegrown program to compare the new list with the previous list and generate a lists of what's changed (adds, delete, moves). The adds are imported into the map software, the drops are done manually, the moves are added or ignored.
I know I'll never get to every cache in the state. Looking at a map for a cluster of caches is an easy way to decide which direction to go on Saturday (especially if the map includes roads). Keeping the map up-to-date is the tedious part.