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

BACKGROUND: 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. HYPOTHESIS AND STUDY...

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Autores principales: St-Amour, Pénélope, St-Amour, Pascal, Joliat, Gaëtan-Romain, Eckert, Aude, Labgaa, Ismail, Roulin, Didier, Demartines, Nicolas, Melloul, Emmanuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541355/
https://www.ncbi.nlm.nih.gov/pubmed/32918147
http://dx.doi.org/10.1007/s00423-020-01981-1
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author St-Amour, Pénélope
St-Amour, Pascal
Joliat, Gaëtan-Romain
Eckert, Aude
Labgaa, Ismail
Roulin, Didier
Demartines, Nicolas
Melloul, Emmanuel
author_facet St-Amour, Pénélope
St-Amour, Pascal
Joliat, Gaëtan-Romain
Eckert, Aude
Labgaa, Ismail
Roulin, Didier
Demartines, Nicolas
Melloul, Emmanuel
author_sort St-Amour, Pénélope
collection PubMed
description BACKGROUND: 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. HYPOTHESIS AND STUDY AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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spelling pubmed-75413552020-10-19 Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies St-Amour, Pénélope St-Amour, Pascal Joliat, Gaëtan-Romain Eckert, Aude Labgaa, Ismail Roulin, Didier Demartines, Nicolas Melloul, Emmanuel Langenbecks Arch Surg Original Article BACKGROUND: 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. HYPOTHESIS AND STUDY AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. Springer Berlin Heidelberg 2020-09-11 2020 /pmc/articles/PMC7541355/ /pubmed/32918147 http://dx.doi.org/10.1007/s00423-020-01981-1 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
St-Amour, Pénélope
St-Amour, Pascal
Joliat, Gaëtan-Romain
Eckert, Aude
Labgaa, Ismail
Roulin, Didier
Demartines, Nicolas
Melloul, Emmanuel
Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title_full Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title_fullStr Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title_full_unstemmed Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title_short Impact of ERAS compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
title_sort impact of eras compliance on the delay between surgery and adjuvant chemotherapy in hepatobiliary and pancreatic malignancies
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541355/
https://www.ncbi.nlm.nih.gov/pubmed/32918147
http://dx.doi.org/10.1007/s00423-020-01981-1
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