Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_05CDA588214C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies.
Journal
Langenbeck's archives of surgery
Author(s)
St-Amour P., St-Amour P., Joliat G.R., Eckert A., Labgaa I., Roulin D., Demartines N., Melloul E.
ISSN
1435-2451 (Electronic)
ISSN-L
1435-2443
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
405
Number
7
Pages
959-966
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Multidisciplinary approach with adjuvant chemotherapy is the key element to provide optimal outcomes in pancreas and liver malignancies. However, post-operative complications may increase the interval between surgery and chemotherapy with negative oncologic effects.
The aim of the study was to analyse whether compliance to Enhanced Recovery After Surgery (ERAS) pathway was associated with decreased interval to adjuvant chemotherapy.
Retrospective analysis of all consecutive ERAS patients with surgery for hepatobiliary or pancreatic malignancies at the University Hospital of Lausanne between 2012 and 2016. Multivariate analysis was performed to assess the impact of ERAS compliance on time to chemotherapy.
A total of 133 patients with adjuvant chemotherapy were included (n = 44 liver and n = 89 pancreatic cancer). Median compliance to ERAS was 61% (IQR 55-67) for the study population, and median delay to chemotherapy was 49 days (IQR 39-61). Overall, compliance ≥ 67% to ERAS induced a significant reduction in the interval between surgery and chemotherapy for young patients (< 65 years old) with or without severe comorbidities (reduction of 22 and 10 days, respectively). High compliance in young ASA3 patients with liver colorectal metastases was associated with an increase of 481 days of DFS.
ERAS compliance ≥ 67% tends to be associated with a reduction in the delay to adjuvant chemotherapy for young patients with hepatobiliary and pancreatic malignancies. More prospective studies with strict adhesion to the ERAS protocol are needed to confirm these results.
Keywords
Surgery, Adjuvant chemotherapy, ERAS, Liver surgery, Pancreatic surgery
Pubmed
Web of science
Open Access
Yes
Funding(s)
University of Lausanne
Create date
18/09/2020 9:49
Last modification date
15/01/2021 6:24
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