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Pang Q, Duan L, Jiang Y, et al. Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review. World J Surg Oncol. 2021;19(1):191doi: 10.1186/s12957-021-02306-2.
Pang, Q., Duan, L., Jiang, Y., & Liu, H. (2021). Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review. World journal of surgical oncology, 19(1), 191. https://doi.org/10.1186/s12957-021-02306-2
Pang, Qianyun, et al. "Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review." World journal of surgical oncology vol. 19,1 (2021): 191. doi: https://doi.org/10.1186/s12957-021-02306-2
Pang Q, Duan L, Jiang Y, Liu H. Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review. World J Surg Oncol. 2021 Jun 29;19(1):191. doi: 10.1186/s12957-021-02306-2. PMID: 34187485; PMCID: PMC8243430.
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World J Surg Oncol. 2021 Jun 29;19(1):191. doi: 10.1186/s12957-021-02306-2.

Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review.

World journal of surgical oncology

Qianyun Pang, Liping Duan, Yan Jiang, Hongliang Liu

Affiliations

  1. Department of Anesthesiology, Chongqing University Cancer Hospital, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China.
  2. Department of Anesthesiology, Chongqing University Cancer Hospital, Hanyu Road No. 181, Shapingba District, Chongqing, 400030, China. [email protected].

PMID: 34187485 PMCID: PMC8243430 DOI: 10.1186/s12957-021-02306-2

Abstract

BACKGROUND: Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted.

METHODS: The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: "ERAS" or "enhanced recovery" or "fast track", "oncologic outcome", "recurrence", "metastasis", "long-term outcomes", "survival", and "cancer surgery". The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed.

RESULTS: A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy.

CONCLUSIONS: The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

Keywords: Cancer surgery; Enhanced recovery after surgery; Long-term outcome; Oncologic outcome

References

  1. Cancer Pract. 2000 May-Jun;8(3):114-9 - PubMed
  2. Dis Colon Rectum. 2013 Aug;56(8):945-51 - PubMed
  3. Ann Med Surg (Lond). 2016 Jun 13;9:15-21 - PubMed
  4. Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):553-559 - PubMed
  5. Am J Surg. 2020 Jun;219(6):1019-1023 - PubMed
  6. Br J Surg. 2019 Jun;106(7):922-929 - PubMed
  7. Eur Urol. 2018 Mar;73(3):363-371 - PubMed
  8. J Am Coll Surg. 2015 Dec;221(6):1023-30.e1-2 - PubMed
  9. Int J Colorectal Dis. 2018 Sep;33(9):1251-1258 - PubMed
  10. World J Surg. 2019 Oct;43(10):2552-2560 - PubMed
  11. J Plast Reconstr Aesthet Surg. 2018 Jun;71(6):819-826 - PubMed
  12. Int J Colorectal Dis. 2019 Mar;34(3):441-449 - PubMed
  13. Urol Int. 2020;104(1-2):55-61 - PubMed
  14. Ann Surg. 2005 Sep;242(3):326-41; discussion 341-3 - PubMed
  15. World J Surg Oncol. 2021 Mar 15;19(1):77 - PubMed
  16. Updates Surg. 2021 Feb 18;: - PubMed
  17. Arch Surg. 2011 May;146(5):571-7 - PubMed
  18. Br J Anaesth. 1997 May;78(5):606-17 - PubMed
  19. World J Gastroenterol. 2014 Oct 14;20(38):13950-5 - PubMed
  20. World J Surg Oncol. 2021 Apr 6;19(1):99 - PubMed
  21. Ann Surg. 2015 Jun;261(6):1153-9 - PubMed
  22. Eur J Surg Oncol. 2017 Aug;43(8):1433-1439 - PubMed
  23. Int J Colorectal Dis. 2018 Feb;33(2):231-234 - PubMed
  24. Cancer Manag Res. 2021 Mar 19;13:2681-2690 - PubMed
  25. Am Surg. 2020 Feb 1;86(2):e81-e83 - PubMed
  26. JAMA Surg. 2017 Mar 1;152(3):292-298 - PubMed
  27. Medicine (Baltimore). 2018 Aug;97(34):e11957 - PubMed
  28. JAMA. 2011 Jun 8;305(22):2335-42 - PubMed
  29. Ann Surg. 2013 Dec;258(6):847-53 - PubMed
  30. J Neurooncol. 2020 Jul;148(3):555-567 - PubMed
  31. Zhonghua Yi Xue Za Zhi. 2020 Mar 31;100(12):922-927 - PubMed
  32. Dis Colon Rectum. 2019 Nov;62(11):1305-1315 - PubMed
  33. Am Surg. 2020 Apr 1;86(4):293-299 - PubMed
  34. J Thorac Cardiovasc Surg. 2019 Jul;158(1):279-286.e1 - PubMed
  35. Methodist Debakey Cardiovasc J. 2018 Apr-Jun;14(2):77-88 - PubMed
  36. Langenbecks Arch Surg. 2020 Nov;405(7):959-966 - PubMed
  37. World J Surg. 2016 Jul;40(7):1741-7 - PubMed
  38. World J Gastroenterol. 2020 Oct 7;26(37):5646-5660 - PubMed
  39. J Clin Epidemiol. 2009 Oct;62(10):1006-12 - PubMed

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