Early Return to Intended Oncologic Therapy after implementation of an Enhanced Recovery After Surgery pathway for gastric cancer surgery

Purpose Time to initiation and completion of adjuvant therapy are critical to improve postoperative oncologic outcomes. This study aims to determine whether an Enhanced Recovery After Surgery (ERAS) pathway for gastric cancer surgery promotes early Return to Intended Oncologic Therapy (RIOT). Method...

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Published in:Langenbeck's archives of surgery 2022-09, Vol.407 (6), p.2293-2300
Main Authors: Garcia-Nebreda, Maria, Zorrilla-Vaca, Andrés, Ripollés-Melchor, Javier, Abad-Motos, Ane, Alvaro Cifuentes, Edurne, Abad-Gurumeta, Alfredo, Mena, Gabriel E., Grant, Michael C., Paseiro-Crespo, Gloria
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
General Surgery
Medicine
Medicine & Public Health
Original Article
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
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Summary:Purpose Time to initiation and completion of adjuvant therapy are critical to improve postoperative oncologic outcomes. This study aims to determine whether an Enhanced Recovery After Surgery (ERAS) pathway for gastric cancer surgery promotes early Return to Intended Oncologic Therapy (RIOT). Methods This is a before-after intervention study including patients with gastric adenocarcinoma who underwent surgery from January 2016 to January 2021. Two periods were denoted based upon the implementation date of our institutional ERAS pathway (June 2018). Our primary outcome was time to RIOT after surgery. Hodges-Lehmann analysis was used to estimate median differences of non-parametric outcomes. Results Seventy patients with gastric adenocarcinoma were included (35 in pre-ERAS period and 35 in post-ERAS period). Fourteen of the pre-ERAS and twenty-two patients of the post-ERAS period received adjuvant therapy. Time to RIOT was reduced in the post-ERAS period (median 39 days, IQR 31–49) by 12 days (95% CI 3–14 days, p  = 0.01) compared to the pre-ERAS period (median 51 days, IQR 42–62). Length of hospital stay (LOS) was lower in the ERAS group (6 days, IQR 5–11 vs 10 days, IQR 8–13, p  
ISSN:1435-2451
1435-2451
DOI:10.1007/s00423-022-02515-7