TABLE 1.
Demographic and clinicopathologic factors of the entire cohort and univariate comparison of factors by presence of minor versus major postoperative complications
| All patients | Postoperative complications | None vs. minor or major p value | Minor vs. major p value | |||
|---|---|---|---|---|---|---|
| [N = 1136] | None [N = 529] | Minor [N = 330] | Major [N = 170] | |||
| Preoperative factors | ||||||
| Age at diagnosis [median (IQR)] | 59 (51–67) | 58 (50–66) | 61 (53–69) | 60 (52–69) | < 0.01 | 0.99 |
| Sex | ||||||
| Female | 443 (39) | 202 (39) | 134 (41) | 53 (31) | 0.70 | 0.10 |
| Male | 693 (61) | 316 (61) | 196 (59) | 117 (69) | ||
| Race | ||||||
| White | 1012 (89) | 417 (91) | 292 (88) | 145 (85) | 0.02 | 0.03 |
| Black | 95 (8) | 30 (6) | 34 (10) | 22 (13) | ||
| Other | 29 (3) | 71 (14) | 4 (1) | 3 (2) | ||
| Number of comorbidities | ||||||
| 0 | 262 (23) | 113 (22) | 76 (23) | 34 (20) | 0.30 | 0.21 |
| 1 | 373 (33) | 165 (32) | 113 (34) | 64 (38) | ||
| 2 | 203 (18) | 83 (16) | 62 (19) | 41 (24) | ||
| 3 | 79 (7) | 30 (6) | 25 (8) | 17 (10) | ||
| ≥ 4 | 44 (4) | 16(3) | 21 (6) | 5 (3) | ||
| BMI [median (IQR)] | 28 (24–32) | 28 (24–31) | 28 (24–33) | 27 (24–32) | 0.95 | 0.33 |
| Preoperative serum albumin | 4 (3.7–4.3) | 4 (3.7–4.3) | 4 (3.6–4.2) | 4 (3.6–4.2) | 0.03 | 0.95 |
| Intraoperative factors | ||||||
| Type of resection | ||||||
| LAR | 799 (70) | 406 (78) | 213 (64) | 95 (56) | < 0.01 | < 0.01 |
| APR | 337 (30) | 112 (22) | 117 (35) | 75 (44) | ||
| Operative approach | ||||||
| Open | 420 (37) | 150 (29) | 144 (44) | 77 (45) | < 0.01 | < 0.01 |
| Hand-assist | 221 (19) | 114 (22) | 55 (17) | 31 (18) | ||
| Laparoscopic | 153 (13) | 60 (12) | 58 (18) | 28 (16) | ||
| Robotic | 151 (13) | 74 (14) | 37 (11) | 21 (12) | ||
| Hybrid (laparoscopic + robotic) | 160 (14) | 104 (20) | 35 (11) | 12 (7) | ||
| Drain placement | 755 (66) | 350 (68) | 226 (68) | 123 (72) | 0.26 | 0.44 |
| Diverting loop ileostomy | 621 (55) | 316 (61) | 178 (54) | 71 (42) | < 0.01 | < 0.01 |
| Intraoperative complication | 54 (5) | 10 (2) | 24 (7) | 19 (11) | < 0.01 | < 0.01 |
| Estimated blood loss, mL [median (IQR)] | 200 (100–400) | 200 (100–300) | 200 (150–425) | 300 (104–500) | < 0.01 | < 0.01 |
| Intraoperative blood transfusion | 65 (6) | 12 (2) | 31 (9) | 19 (11) | < 0.01 | < 0.01 |
| Histopathology | ||||||
| Tumor grade | ||||||
| Well-differentiated | 35 (3) | 15 (3) | 9 (3) | 8 (5) | 0.65 | 0.83 |
| Moderately differentiated | 664 (58) | 275 (53) | 222 (67) | 115 (67) | ||
| Poorly differentiated | 60 (5) | 23 (4) | 22 (7) | 12 (7) | ||
| Undifferentiated | 8 (1) | 5 (1) | 2 (1) | 1 (1) | ||
| Pathologic stage (AJCC 8th edition) | ||||||
| Stage I | 358 (32) | 168 (32) | 96 (29) | 59 (35) | 0.10 | 0.17 |
| Stage II | 267 (24) | 105 (20) | 95 (29) | 42 (35) | ||
| Stage III | 340 (30) | 147 (28) | 94 (28) | 53 (31) | ||
| Final resection status | ||||||
| R0 | 1080 (95) | 495 (96) | 312 (95) | 162 (95) | 0.84 | 0.88 |
| R1 | 56 (5) | 23 (4) | 18 (5) | 8 (5) | ||
| Multimodality therapy | ||||||
| Neoadjuvant chemotherapy | 251 (22) | 123 (24) | 76 (23) | 37 (22) | 0.90 | 0.93 |
| Neoadjuvant chemoradiation | 867 (76) | 390 (75) | 261 (79) | 139 (82) | 0.06 | 0.11 |
| Adjuvant chemotherapy | 659 (58) | 320 (62) | 195 (59) | 94 (55) | 0.11 | 0.16 |
| Delay in adjuvant chemotherapy | 43 (7) | 9 (2) | 14 (7) | 17 (18) | 0.07 | < 0.01 |
| Postoperative outcomes | ||||||
| ERP utilization | 326 (29) | 199 (38) | 90 (27) | 33 (19) | < 0.01 | < 0.01 |
| Any POC | 523 (46) | – | – | |||
| Infectious POCs | 104 (20) | – | 38 (12) | 60 (35) | – | < 0.01 |
| Cardiopulmonary POCs | 14 (3) | – | 2 (1) | 12 (7) | – | < 0.01 |
| Thromboembolic POCs | 25 (5) | – | 13 (4) | 12 (7) | – | < 0.01 |
| Renal POCs | 46 (9) | – | 28 (8) | 17 (10) | – | < 0.01 |
| Intestinal dysmotility POCs | 100 (19) | – | 56 (17) | 38 (22) | – | < 0.01 |
| Discharge destination | ||||||
| Home | 1023 (9) | 496 (96) | 323 (98) | 159 (93) | < 0.01 | < 0.01 |
| Non-home | 12 (1) | 14 (3) | 3 (1) | 5 (3) | ||
Data are expressed as n (%) unless otherwise specified
Bold data indicates statistical significance
LAR low-anterior resection, APR abdominoperineal resection, ERP enhanced recovery pathway, POCs postoperative complications, BMI body mass index, IQR interquartile range, AJCC American Joint Committee on Cancer