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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P458
FACTORS ASSOCIATED WITH 90-DAY MORTALITY IN PATIENTS WITH RECTAL ADENOCARCINOMA UNDERGOING ABDOMINOPERINEAL RESECTION: AN NCDB-BASED ANALYSIS
Poster Presenter
Part of Topic
Colorectal
•Rectal adenocarcinoma is a common malignancy and abdominoperineal resection (APR) is the standard surgical treatment for tumors in the distal rectum invading the sphincter complex.
•APR is associated with significant postoperative morbidity and mortality, particularly among elderly patients and those with comorbidities.
•Ninety-day mortality is an emerging quality metric in colorectal surgery that captures both surgical complications and systemic oncologic factors, but predictors of 90-day mortality after APR are not well defined.
The goal of this study was to identify patient, tumor, and treatment factors associated with 90-day mortality after abdominoperineal resection for rectal adenocarcinoma.
Methods:
•Study Design & Reporting:Retrospective case–control study of patients with rectal adenocarcinoma undergoing APR from 2010–2021
•Data Source:Data were obtained from the National Cancer Database.
•Study Population:Adult patients with rectal adenocarcinoma who underwent APR; non-adenocarcinoma histology, unknown procedures, or missing 90-day mortality data were excluded.
•Variables & Outcomes: Demographic, tumor, treatment, and facility variables were analyzed. Primary outcome was 90-day postoperative mortality, with length of stay as a secondary outcome.
•Statistical Analysis:Univariable comparisons were performed using Mann–Whitney U and χ²/Fisher exact tests; multivariable logistic regression identified independent predictors of 90-day mortality.
Results:
•Cohort & Mortality: 21,957 APR patients; 90-day mortality 2.2% (n=477).
•Patient Factors: Mortality was associated with older age, higher comorbidity burden, Medicare insurance, and treatment at comprehensive community programs.
•Tumor Factors: Mortality cases had larger, higher-grade tumors, more advanced stage disease, signet-ring histology, and elevated CEA.
••Treatment Factors: Mortality was associated with less neoadjuvant therapy, open or converted surgery, and longer hospital stay.
Conclusion:
Older age, higher comorbidity burden, high tumor grade, and prolonged hospital stay independently predicted 90-day mortality after APR, highlighting the importance of risk stratification and tailored perioperative care.