Does enhanced recovery improve the survival rates of patients 3 years after undergoing surgery to remove a tumor in the colon?

Int J Colorectal Dis. 2019 Mar;34(3):441-449. doi: 10.1007/s00384-018-3205-5. Epub 2018 Dec 7.

Abstract

Purpose: The advantages of enhanced recovery programs (ERP) after colorectal surgery for morbidity and length of stay are well known. On a longer term, evidence is much more limited. The aim of this study is to determine the impact of ERP on survival after 3 years of follow-up, following colorectal cancer surgery.

Methods: All the patients undergoing resection for colorectal cancer between the years 2010 and 2014 were included. Patients were classified according to their compliance with the ERP (< 70 or ≥ 70%).

Results: Among the 206 patients included during the period, 129 were male (62.6%). The 3-year overall survival rate was 70.4% (145 patients) and relapse-free survival was 59.2% (122 patients). The survival after 3 years was influenced by the initial metastatic status (p < 0.0001), operative morbidity (p < 0.001), and the presence of peritumoral emboli (p = 0.006). However, the compliance with the ERP ≥ 70% did not influence overall survival (p = 0.63), nor relapse-free survival (p = 0.93). The same observations were found among the "at-risk" population (synchronous metastasis and postoperative complication).

Conclusion: The ERP does not seem to influence the 3-year relapse-free survival after colorectal resection for cancer.

Keywords: Colorectal cancer; Disease-free survival; Enhanced recovery; Global survival.

MeSH terms

  • Aged
  • Colon / pathology
  • Colon / surgery*
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Male
  • Neoplasm Metastasis
  • Patient Compliance
  • Postoperative Complications / radiotherapy
  • Recurrence
  • Risk Factors
  • Survival Rate