Effect Of Preoperative Preparation Time On Overall Survival And Disease-free Survival In Patients With Colorectal Cancer

Objective: The impact of the length of preoperative preparation time on the prognosis of colorectal cancer(CRC)patients is unclear.Immediate treatment is considered after the diagnosis,but recent studies showed better post-operative recovery and lower mortality in patients with an appropriately extended preoperative preparation time.This study aimed to investigate the impact of preoperative preparation time on 5-year overall survival(OS)and 5-year disease-free survival(DFS)among CRC patients.Methods: Details of patients with primary CRC who underwent radical resection at the Department of Gastrointestinal Surgery,Sichuan Provincial People’s Hospital,from January 2015 to February 2017 were retrospectively analyzed.Patients were divided into two groups according to the preoperative preparation time of 0-2 weeks or 2-4 weeks.Patients’ 5-year OS and 5-year DFS were compared in both groups.The Kaplan-Meier method was used to plot the survival curves,log-rank test to compare curves of the two groups,and Cox analysis to assess the factors affecting prognosis.Results: A total of 419 patients were included in the study,with a median preoperative preparation time of 13 d.The 5-year OS were 78.5% and 76.8% in the 0-2 week group and the 2-4 week group,respectively,with no statistically significant difference(P=0.683).The 5-year DFS were 78.5% and 80.8% in the two groups,respectively,also with no statistically significant difference(P=0.568).In the 2-4 week group,patients with TNM stage I was significantly more than that of the 0-2 week group,and the patients aged >64 years were also considerably more than that of the 2-4 week group.There was no significant difference in survival curves between the two groups.Cox multivariate analysis implied that preoperative preparation time was not an independent risk factor for OS or DFS in colorectal cancer patients.Results: Waiting time of up to 4 weeks from diagnosis to surgery could not influence the 5-year OS and 5-year DFS in CRC patients.This provides a safe time window for optimizing preoperative nutrition,improving anemia and hypoproteinemia,and implementing a prehabilitation program in CRC patients.