Integrated perioperative host-response optimization improves functional recovery and survival after ultra-low anterior resection: A randomized controlled trial
Structured perioperative care targeting stress, sleep, and nutrition substantially improved rectal cancer survival in one trial, though independent confirmation is needed.
This single-center RCT of 194 rectal cancer patients demonstrates that a structured multicomponent perioperative optimization targeting stress, sleep, and nutrition significantly reduces postoperative inflammation and yields markedly improved 24-month disease-free and overall survival compared to standard enhanced recovery. While the magnitude of benefit (HR 0.44 for DFS, HR 0.39 for OS) is striking and warrants attention, single-center origin requires independent multicenter replication before practice change.
What the study was
- Study design
- Randomized controlled trial, single-center
- Population
- Patients with stage I-III low rectal adenocarcinoma undergoing curative ultra-low anterior resection; single center, Soochow University
- Sample size
- 194
- Category
- Treatment Innovation
- Maturity
- Exploratory
- Journal
- Surgery
Why it surfaced
RCT design with 24-month survival data; dramatically positive results; perioperative optimization is in principle low-risk and implementable; however single-center origin and very large effect sizes warrant caution in Phase 2 review
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