{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:35:46Z","timestamp":1788791746902,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metastatic spine tumor surgery consists of palliative operations performed on frail patients with multiple medical comorbidities. Enhanced recovery after surgery (ERAS) programs involve an evidence\u2010based, multidisciplinary approach to improve perioperative outcomes. This study presents clinical outcomes of a metastatic spine tumor ERAS pathway implemented at a tertiary cancer center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The metastatic spine tumor ERAS program launched in April 2019, and data from January 2018 to May 2020 were reviewed. Measured outcomes included the following: hospital length of stay (LOS), time to ambulation, urinary catheter duration, time to resumption of diet, intraoperative fluid intake, estimated blood loss (EBL), and intraoperative and postoperative day 0\u20135 cumulative opioid use (morphine milligram equivalent [MME]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 390 patients were included in the final analysis: 177 consecutive patients undergoing metastatic spine tumor surgery enrolled in the ERAS program and 213 consecutive pre\u2010ERAS patients. Although the mean case durations were similar in the ERAS and pre\u2010ERAS cohorts (265 vs. 274\u00a0min; <jats:italic>p<\/jats:italic> = .22), the ERAS cohort had decreased EBL (157 vs. 215\u00a0ml; <jats:italic>p<\/jats:italic> = .003), decreased postoperative day 0\u20135 cumulative mean opioid use (178 vs. 396 MME; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001), earlier ambulation (mean, 34 vs. 57\u00a0h; <jats:italic>p<\/jats:italic> = .0001), earlier discontinuation of urinary catheters (mean, 36 vs. 56\u00a0h; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), and shorter LOS (5.4 vs. 7.5\u00a0days; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The implementation of a multidisciplinary ERAS program designed for metastatic spine tumor surgery led to improved clinical quality metrics, including shorter hospitalizations and significant reductions in opioid consumption.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34484","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T12:02:13Z","timestamp":1665489733000},"page":"4109-4118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Patient outcomes following implementation of an enhanced recovery after surgery pathway for patients with metastatic spine tumors"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0081-6571","authenticated-orcid":false,"given":"Vikram B.","family":"Chakravarthy","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Laufer","sequence":"additional","affiliation":[{"name":"Neurological Surgery New York University Medical Center  New York New York 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