Longfei Ma1, Jingpei Li1, Longlong Shao1, Dong Lin1, Jiaqing Xiang1. 1. 1 Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China ; 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China ; 3 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Abstract
BACKGROUND: To investigate the impact of prolonged length of stay (LoS) on long-term mortality in patients who have undergone curative resection for esophageal cancer (EC). METHODS: Between January 2001 and December 2009, patients who underwent an esophagectomy for EC at Fudan University Shanghai Cancer Center were enrolled in this study. We retrospectively analyzed the medical charts of all of the enrolled patients. To determine the effect of postoperative LoS on long-term survival, we separated the patients into three groups based on the lengths of their postoperative LoS, including an LoS of less than 2 weeks (Group 1, ≤2 W), an LoS between 2 and 3 weeks (Group 2, ≤3 W) and an LoS of more than 3 weeks (Group 3, >3 W). Perioperative and long-term outcomes were compared between the groups. RESULTS: In total, 348 patients were included in this study. All of the patients underwent an esophagectomy with 3-field lymph node dissection (3FLND). The median postoperative hospital stay was 14 days (range: 8-153 days). Complications were observed in 123 patients (15.9% in Group 1 vs. 73.2% in Group 2 vs. 96.6% in Group 3, P<0.001). The median duration of follow-up was 39 months (range: 3-120 months). There were significant reductions in preventive adjuvant therapy (P=0.003) and postoperative salvage therapy (P<0.001) among the three groups. The 5-year survival rate was significantly different among the groups (43% vs. 36% vs. 29%, respectively, P=0.006). There was no difference in the 5-year disease-free survival rate among the three groups (23% vs. 21% vs. 19%, P=0.238). CONCLUSIONS: Prolonged LoS was significantly associated with reduced rates of overall survival (OS). The insufficient administration of adjuvant therapy may partly account for these findings.
BACKGROUND: To investigate the impact of prolonged length of stay (LoS) on long-term mortality in patients who have undergone curative resection for esophageal cancer (EC). METHODS: Between January 2001 and December 2009, patients who underwent an esophagectomy for EC at Fudan University Shanghai Cancer Center were enrolled in this study. We retrospectively analyzed the medical charts of all of the enrolled patients. To determine the effect of postoperative LoS on long-term survival, we separated the patients into three groups based on the lengths of their postoperative LoS, including an LoS of less than 2 weeks (Group 1, ≤2 W), an LoS between 2 and 3 weeks (Group 2, ≤3 W) and an LoS of more than 3 weeks (Group 3, >3 W). Perioperative and long-term outcomes were compared between the groups. RESULTS: In total, 348 patients were included in this study. All of the patients underwent an esophagectomy with 3-field lymph node dissection (3FLND). The median postoperative hospital stay was 14 days (range: 8-153 days). Complications were observed in 123 patients (15.9% in Group 1 vs. 73.2% in Group 2 vs. 96.6% in Group 3, P<0.001). The median duration of follow-up was 39 months (range: 3-120 months). There were significant reductions in preventive adjuvant therapy (P=0.003) and postoperative salvage therapy (P<0.001) among the three groups. The 5-year survival rate was significantly different among the groups (43% vs. 36% vs. 29%, respectively, P=0.006). There was no difference in the 5-year disease-free survival rate among the three groups (23% vs. 21% vs. 19%, P=0.238). CONCLUSIONS: Prolonged LoS was significantly associated with reduced rates of overall survival (OS). The insufficient administration of adjuvant therapy may partly account for these findings.
Entities:
Keywords:
Esophageal cancer (EC); length of stay (LoS); overall survival (OS); surgery
Authors: James D Luketich; Arjun Pennathur; Omar Awais; Ryan M Levy; Samuel Keeley; Manisha Shende; Neil A Christie; Benny Weksler; Rodney J Landreneau; Ghulam Abbas; Matthew J Schuchert; Katie S Nason Journal: Ann Surg Date: 2012-07 Impact factor: 12.969
Authors: Sjoerd M Lagarde; Johannes D de Boer; Fiebo J W ten Kate; Olivier R C Busch; Huug Obertop; Jan J B van Lanschot Journal: Ann Surg Date: 2008-01 Impact factor: 12.969
Authors: Felix G Fernandez; Onkar Khullar; Seth D Force; Renjian Jiang; Allan Pickens; David Howard; Kevin Ward; Theresa Gillespie Journal: Ann Thorac Surg Date: 2014-11-11 Impact factor: 4.330
Authors: Toni Lerut; Johnny Moons; Willy Coosemans; Dirk Van Raemdonck; Paul De Leyn; Herbert Decaluwé; Georges Decker; Philippe Nafteux Journal: Ann Surg Date: 2009-11 Impact factor: 12.969
Authors: Nabil P Rizk; Peter B Bach; Deborah Schrag; Manjit S Bains; Alan D Turnbull; Martin Karpeh; Murray F Brennan; Valerie W Rusch Journal: J Am Coll Surg Date: 2004-01 Impact factor: 6.113
Authors: Jonathan J Hue; Katelynn C Bachman; Stephanie G Worrell; Kelsey E Gray; Philip A Linden; Christopher W Towe Journal: Surg Endosc Date: 2020-08-12 Impact factor: 4.584
Authors: Kevin X Liu; Kailan Sierra-Davidson; Kevin Tyan; Lawrence T Orlina; J Paul Marcoux; Benjamin H Kann; David E Kozono; Raymond H Mak; Abby White; Lisa Singer Journal: Radiother Oncol Date: 2021-10-22 Impact factor: 6.280