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ERAS pathway adherence and its association with return to intended oncological therapy after gastrectomy.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Bretscher AL
  • Melchor JR
  • Nebreda MG
  • Motos AA
  • Morales CI
  • Tena Guerrero JM
  • Lapetra CG
  • Orts Micó FJ
  • Pérez ML
  • Menéndez PG
  • Alday-Muñoz E
  • Domínguez JP
  • Sierra BU
  • Bellosta AMP
  • Navarro-Perez R
  • Risco R
  • Álvarez RG
  • Zamora IM
  • Gurumeta AA
  • Crespo GP

Grupos

Abstract

BACKGROUND: Enhanced Recovery After Surgery (ERAS) pathways improve short-term outcomes in abdominal surgery, but their impact on timely initiation of adjuvant chemotherapy (Return to Intended Oncologic Therapy, RIOT) in gastric cancer remains uncertain. METHODS: This multicenter, prospective cohort study (POWER4, NCT03865810) analysed 742 patients undergoing gastrectomy across 72 Spanish hospitals (2019-2020). ERAS adherence was assessed by quartiles. PRIMARY OUTCOME: timely RIOT (chemotherapy initiation =56 days post-surgery). SECONDARY OUTCOME: time to RIOT (days). Multivariable logistic and Cox regression models adjusted for clinical/tumour factors. RESULTS: Of 742 patients, 65 % achieved timely RIOT. Quartile-based univariable analysis revealed shorter time to RIOT with higher adherence (Q4 vs. Q1: HR 0.64, 95 % CI 0.42-0.97, *p* = 0.034), but this association disappeared in multivariable models. Advanced TNM stage (e.g. , IIIC: HR 18.6, *p* < 0.001) and ASA class were stronger predictors of delayed RIOT. CONCLUSIONS: While ERAS pathways may aid recovery, their impact on RIOT depends on high adherence and is overshadowed by tumour-related factors. Future efforts should integrate ERAS with prehabilitation for high-risk patients and target adherence thresholds =70 %.

Copyright © 2025. Published by Elsevier Ltd.

Datos de la publicación

ISSN/ISSNe:
0960-7404, 1879-3320

SURGICAL ONCOLOGY-OXFORD  Elsevier BV

Tipo:
Article
Páginas:
102346-102346
PubMed:
41478224
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,635 SCImago ℠
Cuartil:
Q2 SCImago ℠

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Keywords

  • Adjuvant treatment; ERAS pathway; Gastric cancer; Oncological treatment; Perioperative care; RIOT

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