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March 14, 2026Journal of Cardiothoracic SurgeryOpen Access

Prolonged length of stay after esophagectomy is linked to a ~213% increase in 5-year mortality odds.

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Why the study?

Postoperative length of stay after esophagectomy varies substantially, but whether prolonged length of stay is associated with long-term oncologic outcomes remains unclear.

Does prolonged length of stay affect long-term survival in patients undergoing esophagectomy?

Population

84 patients who underwent esophagectomy between 2017 and 2018

Comparison

Prolonged length of stay vs normal length of stay

Design

Retrospective single-center cohort study

Key result

Prolonged postoperative length of stay (≥17 days) after esophagectomy was associated with a 5-year overall survival rate of 30.4%, compared to 43.9% in the normal LOS group, p = 0.008.

Authors

YDYan-yan DaiYYYu-ping YuanYZYuan-Liang Zheng

Discussion

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Overview

Prompts closer long-term monitoring after prolonged LOS post-esophagectomy; extends evidence linking perioperative vulnerability to oncologic outcomes.

Key Points

  • To investigate the association between postoperative length of stay and long-term survival outcomes after esophagectomy.
  • Retrospective analysis of 84 patients who underwent esophagectomy from 2017 to 2018.
  • Receiver operating characteristic (ROC) analysis defined prolonged length of stay.
  • Kaplan–Meier methods analyzed overall survival (OS) and disease-free survival (DFS).
  • Multivariable Cox regression models adjusted for clinically relevant covariates were used.
  • An optimal cutoff of 17 days for prolonged length of stay was identified.
  • Patients with prolonged length of stay had worse 5-year overall survival and disease-free survival rates.
  • Prolonged length of stay was linked to higher postoperative complication rates, especially anastomotic fistula and pulmonary infection.

Study Design

Type

Cohort (n=84)

Multicenter

No

Structured PICO

Does prolonged length of stay affect long-term survival in patients undergoing esophagectomy?

P
Population
84 patients who underwent esophagectomy for esophageal squamous cell carcinoma or adenocarcinoma between 2017 and 2018, age 18-80 years, ECOG performance status 0-1, and ASA classification <4.
I
Intervention
Prolonged postoperative length of stay (LOS ≥ 17 days)
C
Comparator
Normal postoperative length of stay (LOS < 17 days)
O
Outcome
5-year overall survival (OS) and disease-free survival (DFS)hard clinical

Main Result

Effect estimate: OR 3.125 (95% CI 1.073-9.104)

Absolute Event Rate: 30.4% vs 43.9%

p-value: p=0.008

Prolonged length of stay after esophagectomy serves as a surrogate marker for perioperative vulnerability and is independently associated with worse long-term overall and disease-free survival.

Limitations

  • Retrospective design limits causal inference
  • Small sample size restricts generalizability
  • Did not evaluate interventions for reducing postoperative complications or LOS
  • Retrospective design limits causal inference and may be subject to residual confounding
  • Single-center study with a limited sample size
  • Did not specifically evaluate interventions aimed at reducing postoperative complications or shortening LOS

Cite This Study

Dai et al. (2026) conducted a cohort in esophageal cancer (n=84). Prolonged postoperative length of stay (≥17 days) after esophagectomy was associated with a 5-year overall survival rate of 30.4%, compared to 43.9% in the normal LOS group, p = 0.008.

synapsesocial.com/papers/69b4fa6fb39f7826a300b357https://doi.org/10.1186/s13019-026-03909-0
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