{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:54:31Z","timestamp":1792644871518,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,7,28]],"date-time":"2024-07-28T00:00:00Z","timestamp":1722124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The Commission on Cancer (CoC) recently introduced a quality metric to optimize time between major head and neck surgery and adjuvant treatment (TAT) \u22646\u2009weeks, as TAT delay adversely impacts patient survival. This study evaluates whether enhanced recovery after surgery (ERAS) for this population reduces the rate of postoperative complications, length of stay (LOS), and TAT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing larynx or oral cavity resection with free flap reconstruction, ERAS, and adjuvant treatment after 2018 were compared to a historical pre\u2010ERAS cohort. Patients underwent surgery at a single\u2010institution tertiary referral center for complex head and neck oncology. Differences between groups were compared by chi\u2010square, Fisher's exact, or Wilcoxon rank\u2010sum test. TAT &gt;6\u2009weeks was evaluated with univariate and multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010nine pre\u2010ERAS patients were compared to 39 ERAS patients. No demographic differences existed between groups. LOS was improved with ERAS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). ERAS patients were discharged to home and returned to their activities of daily living (ADL) earlier (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004, 0.001). ADL recovery was associated with on\u2010time TAT \u226442\u2009days on univariate analysis (OR 1.36, 95% CI 1.13\u20131.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). TAT delay was less frequent with ERAS (51.3% vs. 69.2%), but this was not significant after multivariable logistic regression (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ERAS decreases LOS and returns advanced head and neck cancer patients to their ADL sooner. Postoperative ADL recovery independently predicts on\u2010time adjuvant treatment. Still, compliance beyond 50% with the TAT \u22646\u2009weeks CoC quality metric remains a major treatment barrier.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.27890","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T01:35:10Z","timestamp":1722216910000},"page":"68-80","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The impact of an enhanced recovery after surgery protocol for major head and neck oncologic surgery on postoperative complications and adjuvant treatment delivery"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3223-6013","authenticated-orcid":false,"given":"Catherine H.","family":"Frenkel","sequence":"first","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Donahue","sequence":"additional","affiliation":[{"name":"Department of Cancer Biostatistics Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Cochran","sequence":"additional","affiliation":[{"name":"Department of Surgery Carolinas Center for Surgical Outcomes Science, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Brickman","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Moeller","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Carrizosa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvonimir L.","family":"Milas","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery Levine Cancer Institute, Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2003.04.171"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2022.1389"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817751679"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30651"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2019.03.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc\u20102021\u2010002495"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/dcr.0000000000001486"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.2981"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u20104753\u20100"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2022.105906"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31199"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.1126"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.09.005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11233060"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.538"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.61.5906"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871\u2010021\u201001260\u20106"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.27890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T05:59:59Z","timestamp":1733983199000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.27890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,28]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/hed.27890"],"URL":"https:\/\/doi.org\/10.1002\/hed.27890","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,28]]},"assertion":[{"value":"2024-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}