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Program did not cut complications after bowel cancer surgery

Complications occurred in 47.5% of the preparation group versus 45.0% receiving standard care in a randomized trial of adults undergoing colon and rectal cancer surgery.

Paper by Felix Bjerregaard, Klas Pekkari, Daniel Asklid, 3 more authorsUlf O Gustafsson · Danderyds sjukhus
Figure 1. CONSORT flow diagram showing patient screening, randomization, pre- and post-randomization exclusions, and the number of participants included in the modified intention-to-treat (mITT) analysis.
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Figure 1. CONSORT flow diagram showing patient screening, randomization, pre- and post-randomization exclusions, and the number of participants included in the modified…CONSORT flow diagram showing patient screening, randomization, pre- and post-randomization exclusions, and the number of participants included in the modified intention-to-treat (mITT) analysis.Bjerregaard et al.
Randomized trial in 242 patients undergoing colorectal cancer surgery, against standard care (ERAS)Interventions

Limit: Complications were assessed without blinding, allowing treatment knowledge to influence their recording

Edited by Boris Djordjevic · AgingResearch.News

Paper
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In a randomized trial at one Stockholm hospital, 328 adults with confirmed colorectal cancer—cancer of the colon or rectum—were assigned to a pre-surgery program or standard care. The program combined medication review, nutrition counseling, supervised exercise and measures to address specific health risks. It began within three days of enrollment.

The analysis included 242 people who underwent surgery. The program did not reduce postoperative complications. Hospital stays and repeat-operation rates were also similar. Participants assigned to the program lost less weight after surgery and had modest improvements in physical performance and self-reported physical function at 30 days. Exploratory analyses suggested greater reductions in severe complications among participants with greater disability before surgery.

Why it matters

For aging research, the trial raises a question about whether disability before cancer surgery can help guide support aimed at preserving physical function.

Caveats

The analysis included only 242 of 328 randomized participants, rather than everyone assigned to a group. The disability finding was exploratory, and the trial studied adults scheduled for elective colorectal cancer surgery at one hospital.

From the paper

Participants

The final mITT population comprised 242 patients who underwent colorectal cancer surgery at the study centre (120 control, 122 intervention).

Results

Absolute difference

The incidence of complications was 47.5% (58 of 122) in the intervention group and 45.0% (54 of 120) in the control group (Table 2), corresponding to an absolute risk difference of 2.5 percentage points, which was not statistically significant.

Results, Primary outcome

Quoted word for word from the full text on academic.oup.com.

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