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Impact of neurosurgical enhanced recovery after surgery (ERAS) program on health-related quality of life in glioma patients: a secondary analysis of a randomized controlled trial

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Abstract

Introduction

A novel neurosurgical enhanced recovery after surgery (ERAS) program shortens postoperative hospital stay and accelerates functional recovery in elective craniotomy patients. There is a need to evaluate the impact of ERAS program on patients’ health-related quality of life (HRQOL).

Methods

In a single-center randomized controlled trial, patients were randomized 1:1 to receive perioperative ERAS or conventional care. As a secondary outcome, HRQOL was measured with the EORTC QLQ-C30/BN20 prior to randomization (baseline), at discharge, and at 3- and 6-month follow-up.

Results

A total of 65 patients (ERAS: n = 36, conventional care: n = 29) with pathologically confirmed glioma (WHO grade 2–4) were included in the analysis. Progression-free survival at 6 months and HRQOL at baseline were similar between the two groups. Changes of scores did not vary significantly over time, but differed significantly between intervention groups. A clinically relevant better QoL (at 3-month follow-up), physical functioning (at 6-month follow-up) and role functioning (at discharge) was observed in patients in the ERAS group. Symptom scores of constipation (at discharge), motor dysfunction (at discharge, 3- and 6-month follow-up), drowsiness (at 3- and 6-month follow-up), weakness of legs (at 3-month follow-up), and nausea/vomiting (at discharge and 6-month follow-up) were significantly lower in the ERAS group.

Conclusions

The neurosurgical ERAS program seems to improve functioning and symptoms scores in glioma patients within 6-month follow-up compared with conventional care. The intervention has a significant main effect HRQOL changes without significant interaction with time. Future well-powered multicenter studies are warranted to confirm this result and address long-term benefits.

This study has been registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=16480) with registration number ChiCTR-INR-16009662.

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Data availability

Data available on request.

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Funding

This work was supported by China Natural Science Foundation (81802486).

Author information

Author notes

  1. Bolin Liu, Shujuan Liu, and Yuan Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Xi’an International Medical Center, No. 777 Xitai Road, Xi’an, Shaanxi Province, China

    Bolin Liu, Dan Lu, Lei Chen, Tao Zheng, Tao Ma & Shiming He

  2. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China

    Bolin Liu, Yuan Wang, Dan Lu, Lei Chen, Tao Zheng, Tao Ma, Yufu Zhang, Guodong Gao, Yan Qu & Shiming He

  3. Department of Obstetrics and Gynecology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi Province, China

    Shujuan Liu

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  1. Bolin Liu
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Contributions

Conception and design: BL, SL, YW, SH. Acquisition of data: BL, SL, YW, DL, LC, TZ, TM, YZ, SH. Analysis and interpretation of data: BL, SL, YW, DL, SH. Drafting the article: BL, SL. Critically revising the article: BL, SL, YW, DL, LC, TZ, TM, YZ, GG, YQ, SH. Reviewed submitted version of manuscript: all. Approved the final version of the manuscript: all. Statistical analysis: BL, SL, YW. Administrative/technical/material support: GG, YQ, SH. Study supervision: SH.

Corresponding author

Correspondence to Shiming He.

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Liu, B., Liu, S., Wang, Y. et al. Impact of neurosurgical enhanced recovery after surgery (ERAS) program on health-related quality of life in glioma patients: a secondary analysis of a randomized controlled trial. J Neurooncol 148, 555–567 (2020). https://doi.org/10.1007/s11060-020-03548-y

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  • DOI: https://doi.org/10.1007/s11060-020-03548-y

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