title: Initial operative time and metastatic disease recurrence.
abstract: Colon cancer metastases are a major source of morbidity and mortality for patients following oncologic resection. The purpose of this study was to identify whether operative time as a surrogate for resident involvement increased the risk of future liver metastases. We performed a retrospective review of patients undergoing curative colon resection from 2001 to 2010 at two military residency training hospitals. Intraoperative time as well as preoperative comorbidities and perioperative factors were gathered from electronic medical records. Liver metastases were identified from the tumor registry and inpatient records. A total of 106 patients underwent resection for colon cancer (Stage I-III) from 2001 to 2005 with 5-year follow-up through 2010. Operative times in patients who had recurrence was 205 +/- 60 minutes and those without recurrence was 187 +/- 73 minutes (p = 0.398). There was no correlation between operative time and time to recurrence (p = 0.452), and Cox regression demonstrated that case duration had no impact on time to metastatic recurrence (p = 0.461). Within our cohort, operative time had no impact on metastatic cancer recurrence. Surgeons should continue to focus on proper oncologic principles and tumor biology rather than the concern that increased operative time or resident training leads to increased metastatic recurrence.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Avenue, Tacoma, WA 98431, USA.
authors.forename: Marlin Wayne
authors.initials: MW
authors.lastname: Causey
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Burgess
authors.forename: Christopher Rees
authors.initials: CR
authors.lastname: Porta
authors.forename: Eric K
authors.initials: EK
authors.lastname: Johnson
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D061646:Operative Time; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014481:United States / Q000453:epidemiology