Evidence map›Paper›PMID 38381207›Full record

ArticleAnnals of surgical oncology2024

The Impact of Enhanced Recovery on Long-Term Survival in Rectal Cancer.

Ibrahim Gomaa, Sara Aboelmaaty, Avantika Lakshmi Narasimhan, Himani Bhatt, Courtney N Day, William S Harmsen, Kristen K Rumer, William R Perry, Kellie L Mathis, David W Larson

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ibrahim GomaaDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0009-0001-1841-0302
Sara AboelmaatyDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0009-0006-9411-7892
Avantika Lakshmi NarasimhanDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-0272-2512
Himani BhattDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0001-6104-8292
Courtney N DayDepartment of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
William S HarmsenDepartment of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
Kristen K RumerDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0003-2713-8811
William R PerryDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0001-8718-8306
Kellie L MathisDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-2547-5606
David W LarsonDivision of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA. Larson.David2@mayo.edu.ORCID http://orcid.org/0000-0001-9177-4586

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionImplementing perioperative interventions such as enhanced recovery pathways (ERPs) has improved short-term outcomes and minimized length of stay. Preliminary evidence suggests that adherence to the enhanced recovery after surgery protocol may also enhance 5-year cancer-specific survival (CSS) in colorectal cancer surgery. This retrospective study presents long-term survival outcomes and disease recurrence from a high-volume, single-center practice.

methodsAll patients over 18 years of age diagnosed with rectal adenocarcinoma and undergoing elective minimally invasive surgery (MIS) were retrospectively reviewed between February 2005 and April 2018. Relevant data were extracted from Mayo electronic records and securely stored in a database. Short-term morbidity and long-term oncological outcomes were compared between patients enrolled in ERP and those who received non-enhanced care.

resultsOverall, 600 rectal cancer patients underwent MIS, of whom 320 (53.3%) were treated according to the ERP and 280 (46.7%) received non-enhanced care. ERP was associated with a decrease in length of stay (3 vs. 5 days; p < 0.001) and less overall complications (34.7 vs. 54.3%; p < 0.001). The ERP group did not show an improvement in overall survival (OS) or disease-free survival (DFS) compared with non-enhanced care on multivariable (non-ERP vs. ERP OS: hazard ratio [HR] 1.268, 95% confidence interval [CI] 0.852-1.887; DFS: HR 1.050, 95% CI 0.674-1.635) analysis.

conclusionERP was found to be associated with a reduction in short-term morbidity, with no impact on long-term oncological outcomes, such as OS, CSS, and DFS.

Indexed as

Digestive System Surgical ProceduresLaparoscopyRectal NeoplasmsAdolescentAdultDisease-Free SurvivalHumansLength of StayNeoplasm Recurrence, LocalRetrospective StudiesCancer-specific survivalEnhanced recovery pathwaysLong-term survivalMinimally invasive surgeryOncological outcomesPostoperative outcomesRectal cancerRecurrence-free survival

Identifiers

PMID38381207

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.