Predictors of Length of Hospital Stay Following Surgical Resection of Spinal Chondrosarcoma: A Retrospective Analysis of 1,392 Patients from the National Cancer Database

Introduction: Chondrosarcoma of the spine is an uncommon and aggressive malignant tumor with limited treatment options beyond surgical resection. This study aims to identify factors influencing length of hospital stay (LOS) after surgical resection using the National Cancer Database (NCDB).

Methods: We conducted a retrospective analysis of adult patients with spinal chondrosarcoma who underwent surgical resection between 2004 and 2017 using NCDB data. Patients were categorized based on whether they experienced prolonged LOS, defined as greater than the 75th percentile of the cohort. Demographic, clinical, and treatment variables were collected and analyzed. Multivariate logistic regression was conducted to identify predictors of prolonged LOS.

Results: Among 1,392 patients, 341 experienced prolonged LOS. Patients with prolonged LOS had higher 90-day mortality (4.4%) and overall mortality (38.4%) rates compared to those without prolonged LOS (1.3% and 24.6%, respectively). Age (OR 1.015; 95%CI 1.006-1.024; p< 0.001), male sex (OR 1.440; 95%CI 1.076-1.926; p=0.014), tumor volume (OR 1.001; 95%CI 1.000-1.002; p=0.018), sacral/coccygeal tumor location (OR 1.831; 95%CI 1.162-2.844; p=0.009), and gross total resection (OR 1.699; 95%CI 1.068-2.146; p=0.020) were significant risk factors for prolonged LOS.

Conclusion : Prolonged LOS after surgical resection for spinal chondrosarcoma is associated with increased mortality rates. Recognizing factors that predict prolonged LOS can aid in preoperative planning and improve patient outcomes.