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Enhanced recovery after surgery in advanced ovarian cancer: a prospective randomized trial
  1. JL Sánchez-Iglesias1,
  2. M Carbonell Socias1,
  3. A Pérez Benavente1,
  4. NR Gómez-Hidalgo1,
  5. S Manrique Muñoz2,
  6. M García Gorriz2,
  7. R Burgos Peláez3,
  8. H Segurola Gurrutxaga3,
  9. P Gutierrez Barceló4,
  10. C Pérez Barragan4,
  11. M Pamies Serrano4,
  12. S Serrano Castro4,
  13. AA Scaillet Hopuberechts4,
  14. AM Álvarez López4,
  15. D Monroy Parada5,
  16. Y Cossio Gil5 and
  17. A Gil-Moreno1
  1. 1Gynecology Oncology Department
  2. 2Anesthesia Department
  3. 3Endocrinology and Nutrition Department
  4. 4Oncology Nurse Department
  5. 5Preventive Medicine Department, Vall d’Hebron University Hospital, Barcelona, Spain

Abstract

Introduction/Background Enhanced recovery after surgery program (ERAS) had demonstrated to reduce hospitalizations without increasing the rate of complications. However, information on how to apply the program to advanced ovarian cancer patients is still limited. We postulate that the ERAS program improve the postoperatory recovery, decreasing the length of stay at hospital, the readmissions and medical cost-related.

Methodology We designed the PROFAST trial (ClinicalTrials: NCT02172638) a prospective randomized trial. Patients diagnosed with ovarian carcinoma based on clinical or radiological suspicion and ovarian recurrences from 2014 to 2018 at Vall D’Hebron Hospital, were randomized to an specifically designed ERAS protocol or to a conventional management (CM). Reduction in the median length of stay was considered as a primary outcome. The incidence of perioperative complications and readmissions rated up to 28 days after surgery and medical cost-related were considered as secondary outcomes.

Results 99 patients were included, 50 patients were randomized to the ERAS group, and 49 to the CM group. Demographic and clinical characteristics, stage at diagnoses and surgical procedures were similar in both groups with no statistically significant difference (p >0.005). The adherence to the ERAS program was >90% for all required items except for the needed of abdominal drainage. Median length of stay at hospital was 9 days vs 7 days, respectively (p<0.05). Readmission rates were highly reduced in theERAS group. There were not statistically significant difference in complication rates. The ERAS reduced the medical costs up to 13330 euros.

Conclusion In the PROFAST trial, ERAS appears to be a safe and effective in reducing the median length of stay at hospital, readmission rates and medical- costs in advanced ovarian cancer surgery.

Disclosure Nothing to disclose

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