Has high compliance with enhanced recovery after surgery protocol improved 5-year survival? A cohort study of 468 non-metastatic colorectal cancer patients

Introduction The well-documented immediate benefits of enhanced recovery after surgery (ERAS) highlight the need to explore its long-term impact, particularly on survival outcomes in colorectal cancer. Objectives The aim of this study was to analyze the impact of ERAS protocol compliance on the long-term outcomes after laparoscopic colorectal resection. Patients methods Data from 468 patients who underwent laparoscopic colorectal resection between 2013 and 2017 were prospectively collected. Patients were divided into two groups based on their adherence to the ERAS protocol: group 1 with a compliance rate <80% and group 2 with a compliance rate of >80%. The association between ERAS protocol compliance and a 5-year survival was assessed with use of Kaplan-Meier method with logrank tests. Additionally, survival analysis was done separately for groups depending on cancer stages. Results Group 1 consisted of 128 patients, while Group 2 included 340 patients. There were no statistically significant differences between the groups in terms of sex, age, BMI, ASA scale or comorbidities. The Kaplan-Meier curve and log-rank test analyses indicated that the two groups of ERAS protocol adherence did not significantly differ in terms of a 5-year overall survival. In patients with AJCC stage 1-2 cancer, those with ERAS compliance of >= 80% had a significantly higher 5-year survival rate than those with compliance <80%, indicating that greater adherence to the ERAS protocol is associated with improved survival outcomes. In case of AJCC cancer stage 3 patients, the ERAS compliance did not significantly alter survival rates. Conclusion High adherence to the ERAS protocol appeared to improve a 5-year survival rate in patients with AJCC stage I-II of colorectal cancer.