Comparison of patient outcomes following colon and rectal cancer surgery

Background: Length of stay (LOS), readmission rate, and mortality have a significant impact on the management of both colon and rectal cancer surgery. Colon and rectal cancer are two distinct entities, with different treatments and prognoses. An improved understanding of how different variables affect LOS, readmission, and mortality of both types of cancers can enable better treatment plans.

Materials and Methods: We analysed two datasets consisting of colon and rectal cancer patients including numerous pre- and post-operative variables. The colon and rectal datasets contain respectively 2858 and 1462 patients who underwent surgical procedures for colorectal cancer between 2003 and 2019 at the Portsmouth Hospitals University NHS Trust. Data analyses were conducted on different variables of both datasets to explore correlations with LOS, readmission, and mortality days.

Results: We found that robotic surgery is associated with a shorter LOS in both cancer groups, with a more enhanced effect in the colon group. BMI had a positive correlation with LOS for rectal cancer patients, but had no correlation for colon cancer patients. Our analyses also showed that a laparoscopic operation was associated with a shorter LOS for both colon and rectal cancer patients compared with open surgery.

We also found that rectal cancer patients with a higher BMI have an increased chance of being readmitted compared with colon cancer patients and that rectal cancer patients with previous abdominal surgery have a greater chance of being readmitted compared with colon cancer patients.

Patients with a better performance status (ASA grade) were found to live longer than those with a poor performance status for both colon and rectal cancer surgery. Operations with conversions are associated with a higher mortality rate in both groups, with a bigger effect in the rectum group. BMI did not show any negative correlation with mortality, and our analysis even showed that rectal cancer patients with a higher BMI lived longer than their counterparts.

Conclusions: When analysing data on colorectal cancer from a single expert centre, there are several associations of interest. They include shorter LOS with robotics compared with other approaches, longer LOS for rectal cancer patients compared with colon cancer, more readmission in patients with a higher BMI, and no correlation between BMI and mortality. Data analytics can bring new insights into cancer treatment planning and resource allocation.