Patients Administered Neoadjuvant Chemotherapy Could be Enrolled into an Enhanced Recovery after Surgery Program for...

Area of Science:

• Oncology
• Surgical Gastroenterology
• Critical Care Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are standard for gastric cancer surgery.
• Exclusion of patients receiving neoadjuvant chemotherapy from ERAS studies is common.
• This study investigates ERAS feasibility in locally advanced gastric cancer patients pre-treated with neoadjuvant chemotherapy.

Purpose of the Study:

• To evaluate the safety and efficacy of ERAS protocols for locally advanced gastric cancer patients who underwent neoadjuvant chemotherapy.
• To compare postoperative outcomes between ERAS and standard care (SC) groups in this specific patient population.

Main Methods:

• A randomized controlled trial involving 114 patients with locally advanced gastric cancer who received neoadjuvant chemotherapy.
• Patients were assigned to either the ERAS program or standard care (SC) group.
• Key outcomes measured included postoperative length of stay, complication rates, bowel function recovery, and nutritional status.

Main Results:

• The ERAS group demonstrated a significantly shorter postoperative length of stay (5.9 vs. 8.1 days, P = 0.037).
• Faster recovery of bowel function was observed in the ERAS group, with earlier first flatus (2.7 vs. 4.5 days, P = 0.010) and semi-liquid diet initiation (3.2 vs. 6.3 days, P < 0.001).
• Postoperative complication rates were similar between groups (9.3% ERAS vs. 11.5% SC, P = 0.700).

Conclusions:

• Enhanced Recovery After Surgery (ERAS) is a viable and safe option for locally advanced gastric cancer patients who have received neoadjuvant chemotherapy.
• ERAS implementation in this cohort leads to improved recovery metrics without increasing complications.
• Nutritional status on postoperative day 10 was comparable, suggesting ERAS does not negatively impact nutritional recovery.