61 - Freie Mitteilung
HPB II & general oncology
16. Mai 2019, 13:45 - 15:15, Bellavista 5, 6. OG
Impact of ERAS pathways on the delay between surgery and adjuvant chemotherapy for hepatobiliary and pancreatic malignancies: A single center cohort study
P. St-Amour, D. Roulin, G. Joliat, A. Eckert, N. Demartines, E. Melloul, Presenter: P. St-Amour (Lausanne)
Multidisciplinary approach with adjuvant chemotherapy is one of the key elements to provide optimal long term and disease free survival in pancreas and liver malignancies. However, postoperative complications may increase the interval between surgery and chemotherapy with negative oncologic effects. The aim of the present study was to analyze whether compliance to ERAS program after hepatobiliary or pancreatic surgery for malignancies was associated with a decreased interval to adjuvant chemotherapy.
Based on a prospectively maintained database, the analysis included all consecutive ERAS patients after hepatobiliary or pancreatic surgery and adjuvant chemotherapy in our institution between 2012 and 2016. Using Poisson regression model, factors that reduce the interval between surgery and first cycle of adjuvant chemotherapy were assessed.
During the study period, 148 consecutive patients were included (N=46 liver resections and N=102 pancreatic resections). Total compliance to ERAS protocol was 55% after liver resection and 64% after pancreatic resection. Multivariate analyses showed that high compliance to ERAS pathway was significantly associated with a reduction in the interval between surgery and adjuvant chemotherapy (p<0.01). An increase of 1% in compliance was associated with a reduction of 0.94 days in the interval between surgery and first cycle of chemotherapy.
High compliance to ERAS pathway after surgery for hepatobiliary and pancreatic malignancies was associated with a significant reduction in the delay to systemic chemotherapy. Further studies are necessary to confirm the positive impact of ERAS pathways on long-term oncologic outcome.