The ENCORE Study

Dr
Julia Dubowitz

Project Details

Effects of aNaesthesia in COloREctal cancer outcome trial (ENCORE)

Colorectal cancer (CRC) is the third commonest cancer in the world with a high postoperative mortality (2 – 6%) as well as a low 5-year survival (60%). Despite advances in surgery and the use of minimally invasive laparoscopic surgery in recent years and adjuvant chemotherapy after surgery in stage III (and advanced stage II), long-term prognosis has only improved marginally. Epidural analgesia is commonly used as a part of the perioperative management of patients undergoing open, colorectal cancer surgery. Epidurals have been shown to reduce perioperative inflammation and preserve immunological function, which may be beneficial in perioperative tumorigenesis. In several retrospective studies, anaesthesia and choice of analgesia have shown to improve long-term survival, but no randomized studies in colorectal cancer surgery have been published in the literature today. Similarly, the benefits of propofol anaesthesia in comparison to inhalational anaesthesia have recently been highlighted in relation to cancer surgery, but still lack clear evidence from prospective studies.

The ENCORE Study is a prospective, multicentre, international, observational, pragmatic study in over 10,000 adult patients scheduled for elective colorectal cancer surgery for stage I-III disease.

Study Objective

To investigate the effect of anaesthetic technique in patients undergoing surgery for colorectal cancer (stage I-III) on:

1. Time to start of adjuvant chemotherapy (RIOT) in patients planned for RIOT

2. Time to recurrence (TTR) at 3 years.

The results of this study will provide insight into perioperative techniques that may impact outcomes for patients with colorectal cancer undergoing surgical resection.