Adverse effects of prolonged postoperative hospital stay on long-term survival of pancreatic adenocarcinoma

Abstract

Objective: The relationship between the length of postoperative hospital stay, postoperative morbidity, and long-term sur- vival after pancreatectomy was investigated. Patients and methods: Data of 295 patients who underwent surgical resection for pancreatic adenocarcinoma between 2007 and 2014 were analyzed. Results: Pancreatoduodenectomy was performed in 228 patients, and portal vein resection was performed in 118 patients. Postoperative complications of any grade occurred in 165 patients, and median postoperative hospital stay was 20 days (7–189 days). No complications of any grade affected the postoperative survival. However, postoperative hospital stay was significantly correlated poor prognosis (median survival time: 14 months in patients with a hospital stay >6 weeks and 26 months in those with a hospital stay <6 weeks, p = 0.008). Multivariate analyses for the long-term prognosis identified 5 independent factors: lymph node metastases (odds ratio [OR]: 2.92, p < 0.001), absence of adjuvant chemotherapy (OR: 1.73, p = 0.002), elevated serum level of CA19-9 ≥300 U/ml (OR: 1.79, p < 0.001), age >70 (OR: 1.39, P = 0.038) and postopera- tive hospital stay ≥6 weeks (OR: 1.82, p = 0.005). The types of complication and severe complications with grade IIIb/IV of Clavien-Dindo classification were not found to be related to the survival. Conclusion: In the present study, Clavien-Dindo classification was not associated with long-term survival rates after pancreatectomy for pancreatic adenocarcinoma. The length of postoperative hospital stay is related to the long-term survival after pancreatectomy.