Postoperative Fever and Survival in Patients after Open Resection for Colorectal Cancer: A Long-Term Follow-Up Study of 2,311 Prospectively Enrolled Patients

Purpose  Two reports on the impact of postoperative fever on survival after surgery in patients with colorectal cancer yielded contradictory results. Our study examined possible associations between postoperative fever and long-term survival of patients who underwent resection of colorectal cancer. Methods  We investigated 2,311 consecutive patients who underwent elective open colorectal resection for primary colorectal cancer at a single institution between 1995 and 1998. The primary end points were cancer-specific and overall survival. Multiple covariate impact of risk factors on survival rates was assessed by Cox regression analysis. Results  A total of 252 patients (12.2 percent) developed postoperative fever. The most important independent risk factor for postoperative fever was postoperative morbidity (odds ratio, 4.9; 95 percent confidence interval, 3.7–6.6) followed by blood transfusion (1.7; 1.2–2.2), Stage IV disease (1.6; 1.1–2.2), male gender (1.4; 1.0–1.9), and rectal cancer (1.4; 1.0–1.8). Cox regression modeling indicated that stage, histology, tumor location, and blood transfusion were statistically significant covariate predictors for cancer-specific survival. Postoperative fever was not independently associated with cancer-specific or overall survival. Conclusions  This study did not support the hypothesis that postoperative fever is an independent prognostic factor after colorectal resection for primary colorectal cancer.