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21-02-2024 | Rectal Cancer | Colorectal Cancer

The Impact of Enhanced Recovery on Long-Term Survival in Rectal Cancer

Authors: Ibrahim Gomaa, MD, Sara Aboelmaaty, MD, Avantika Lakshmi Narasimhan, MD, Himani Bhatt, MD, Courtney N. Day, MS, William S. Harmsen, MS, Kristen K. Rumer, MD, William R. Perry, MD, Kellie L. Mathis, MD, David W. Larson, MD, MBA

Published in: Annals of Surgical Oncology | Issue 5/2024

Abstract

Introduction

Implementing perioperative interventions such as enhanced recovery pathways (ERPs) has improved short-term outcomes and minimized length of stay. Preliminary evidence suggests that adherence to the enhanced recovery after surgery protocol may also enhance 5-year cancer-specific survival (CSS) in colorectal cancer surgery. This retrospective study presents long-term survival outcomes and disease recurrence from a high-volume, single-center practice.

Methods

All patients over 18 years of age diagnosed with rectal adenocarcinoma and undergoing elective minimally invasive surgery (MIS) were retrospectively reviewed between February 2005 and April 2018. Relevant data were extracted from Mayo electronic records and securely stored in a database. Short-term morbidity and long-term oncological outcomes were compared between patients enrolled in ERP and those who received non-enhanced care.

Results

Overall, 600 rectal cancer patients underwent MIS, of whom 320 (53.3%) were treated according to the ERP and 280 (46.7%) received non-enhanced care. ERP was associated with a decrease in length of stay (3 vs. 5 days; p < 0.001) and less overall complications (34.7 vs. 54.3%; p < 0.001). The ERP group did not show an improvement in overall survival (OS) or disease-free survival (DFS) compared with non-enhanced care on multivariable (non-ERP vs. ERP OS: hazard ratio [HR] 1.268, 95% confidence interval [CI] 0.852–1.887; DFS: HR 1.050, 95% CI 0.674–1.635) analysis.

Conclusion

ERP was found to be associated with a reduction in short-term morbidity, with no impact on long-term oncological outcomes, such as OS, CSS, and DFS.

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Title: The Impact of Enhanced Recovery on Long-Term Survival in Rectal Cancer
Authors: Ibrahim Gomaa, MD
Sara Aboelmaaty, MD
Avantika Lakshmi Narasimhan, MD
Himani Bhatt, MD
Courtney N. Day, MS
William S. Harmsen, MS
Kristen K. Rumer, MD
William R. Perry, MD
Kellie L. Mathis, MD
David W. Larson, MD, MBA
Publication date: 21-02-2024
Publisher: Springer International Publishing
Keywords: Rectal Cancer
Rectal Cancer
Minimally Invasive Surgery
Published in: Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-14998-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Impact of Enhanced Recovery on Long-Term Survival in Rectal Cancer

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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