Association between delayed anesthesia recovery and prognosis in patients with Stage I-III colorectal cancer following radical surgery: a retrospective cohort study

Emerging evidence suggests that prolonged recovery from anesthesia may be linked to increased cancer metastasis. This study aimed to examine the correlation between delayed anesthesia recovery and recurrence/metastasis in Colorectal Cancer (CRC) patients undergoing radical resection. This retrospective study analyzed 2312 patients with stage I-III CRC who underwent radical resection between September 2012 and February 2019. The association between anesthesia recovery time and prognosis was evaluated using 30, 60, and 90 minutes as cutoff thresholds, with the >90 min group serving as the reference. The primary objective was to investigate the incidence of delayed emergence as the main outcome measure. Overall survival (OS) and Recurrence-Free Survival (RFS) rates were calculated via the Kaplan‒Meier method, and the correlation between anesthesia recovery time and patient prognosis was assessed via multivariable Cox regression analysis. Among the 2312 patients, 57.74% were male, with a median follow-up time of 65.38 months. Kaplan‒Meier analysis revealed that delayed anesthesia recovery, defined as recovery exceeding 90 min, was significantly associated with increased recurrence/metastasis rates (log rank p = 0.038). Multivariable Cox regression analysis confirmed that an anesthesia recovery time between 30 and 60 min is a favorable prognostic factor for improving patients' RFS (Model 3: HR = 0.76, 95% CI: 0.58–0.99, p = 0.045) compared with 90 min. Delayed emergence from anesthesia was identified as a risk factor for recurrence and metastasis in CRC patients, suggesting the need for careful monitoring of recovery time to potentially improve long-term outcomes.