Postoperative Stay Associated with Prognosis of Patients with Colorectal Cancer

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Abstract
The author's objective was to determine whether the length of postoperative stay for patients after colorectal cancer surgery is associated with prognosis. Financial pressure to reduce hospital costs has caused physicians to reduce hospital stays by changes in patient care, which reduce hospital stay but may compromise long-term results. Using multivariate analysis, the author examined the relationship between postoperative stay and prognosis in a consecutive series of 341 prospectively studied patients with colorectal cancer undergoing potentially curative surgery. In multivariate analysis, patients staying beyond the median of 11 days had more complications (p = 0.000), more left hemicolectomies and procedures with colostomies (p = 0.000), were older (p = 0.002), and lost more blood (p = 0.012) than patients staying less than the median. Disease-free survival was significantly and independently related to Dukes' stage (p = 0.000), postoperative stay (p = 0.001), and blood transfusion (p = 0.011). The mean postoperative stay for the 98 patients who later developed recurrence was 15 days compared to 12 days for the 243 patients who remained disease free (p = 0.0008). Cumulative disease-free survival of the 142 patients who stayed more than the median of 11 days was 60% compared to 77% for the 199 patients with shorter stays (p = 0.000). These data indicate that shorter hospital stays do not compromise disease-free survival of patients with colorectal cancer.