O018 - OPTIMIZATION OF ERAS COMPLIANCE IMPROVES SURGICAL INFLAMMATION AND LONG-TERM SURVIVAL IN SARCOPENIA WITH COLORECTAL CANCER

O018

OPTIMIZATION OF ERAS COMPLIANCE IMPROVES SURGICAL INFLAMMATION AND LONG-TERM SURVIVAL IN SARCOPENIA WITH COLORECTAL CANCER

I. K. Lee^1,*, I. K. Kim¹

¹Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, Republic Of

Rationale: We aimed to evaluate whether ERAS compliance can mitigate surgical stress-related inflammation and improve short- and long-term outcomes in patients with sarcopenia undergoing colorectal cancer surgery.

Methods: This single-center prospective cohort study included 616 patients who underwent colorectal cancer surgery between July 1, 2018, and December 31, 2021. Preoperative sarcopenia was assessed using bioelectrical impedance analysis. 

Results: Among the 616 patients included in this study, 126 (20.5%) had sarcopenia. Regarding long-term outcomes, sarcopenia was not associated with OS, contrary to previous findings; however, ERAS compliance significantly influenced OS. Patients with sarcopenia and low ERAS compliance had significantly worse 3-year OS than did non-sarcopenic patients (51.60% vs. 67.43%, p = 0.009) and patients with sarcopenia and high ERAS compliance (51.60% vs. 66.86%, p = 0.046). Notably, sarcopenia with high compliance achieved OS rates comparable to non-sarcopenia (67.43% vs. 67.43%, p = 0.0786). Multivariate analysis identified sarcopenia with low ERAS compliance as an independent risk factor for worse OS (p = 0.045). Surgical stress-related inflammatory markers showed that patients with sarcopenia and low compliance had significantly higher proportions of increased white blood cell counts and neutrophil-lymphocyte ratios than did those without sarcopenia and those with sarcopenia with high compliance.

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Conclusion: Preoperative assessment of sarcopenia and optimization of ERAS compliance significantly affect long-term survival following colorectal cancer surgery. Applying ERAS protocols and improving compliance can reduce surgical stress, accelerate early recovery after surgery, and improve overall survival rates, even in patients with sarcopenia.

Disclosure of Interest: None declared