Author(s): Chan A., Ali Z., Lapsia S., Coleman H., Krige A., Kausar A., Chang D., Harris C., Subar D.
Abstract: Objectives: The Enhanced Recovery Programme (EPR) reduces length of hospital stay in patients undergoing liver resection for colorectal liver metastasis (CRLM). Progression free survival is improved by perioperative chemotherapy with time to chemotherapy shown to affect survival in other malignancies. The aim of this study was to assess the effect of ERP on time to adjuvant chemotherapy and the completion of chemotherapy in patients CRLM resection. Methods: This retrospective study of patients undergoing liver resection for CRLM between April 2005 and March 2013 compares 50 patients who received standard care and 50 patients on the ERP. Demographic and clinical outcome data was analysed, in particular, details of neo-adjuvant and adjuvant chemotherapy. Results: The mean age was 65.7 +/- 9.6 years (range 42- 88 years), with a male:female ratio of 65:35, with no statistical difference in age (p = 0.21) and sex distribution (p = 0.83) between the groups. ERP significantly decreased the length of hospital stay (p = 0.007). 54 patients proceeded to adjuvant chemotherapy, but ERP did not influence this (p = 0.229). ERP did not affect the number of cycles that patients had (p = 0.511) or the number of patients completing 6 or more cycles of chemotherapy (p = 0.606). Patients who had received neo-adjuvant chemotherapy were less likely to complete at least 6 cycles of adjuvant chemotherapy (p = 0.0610) Conclusion: Although ERP reduces length of hospital stay in patients undergoing CRLM resection it did not affect the ability of patients to complete 6 or more cycles of adjuvant chemotherapy post-hospital discharge. Neo-adjuvant chemotherapy may decrease the ability of patients to tolerate adjuvant chemotherapy.
Publication Type: Journal: Conference Abstract