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Peer-reviewedCC BY 4.0Cancers

Enhanced Recovery After Surgery (ERAS) Protocols in Sarcoma and Metastatic Bone Disease: A Scoping Review

  • Leah Ferrie1
  • Alex Gamage1
  • Peter Lewkonia1,2,3
  • Michael M. H. Yang3
  • Khara M. Sauro2,4,5
  • Krista Goulding6
  • Shannon K. T. Puloski1,2,5
  • Michael J. Monument1,2,5
  • Joseph K. Kendal1,2,5
6 affiliations
  1. 1Department of Surgery, Section of Orthopaedic Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada
  2. 2Department of Surgery, Cumming School of Medicine, Calgary, AB T2N 4Z6, Canada
  3. 3Department of Clinical Neurosciences, Cumming School of Medicine, Calgary, AB T2N 4Z6, Canada
  4. 4Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB T2N 4Z6, Canada
  5. 5Department of Oncology, Cumming School of Medicine, Calgary, AB T2N 4Z6, Canada
  6. 6Department of Orthopaedic Surgery, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
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Abstract

Literature evaluating the effectiveness of Enhanced Recovery After Surgery (ERAS) pathways in orthopaedic oncology, particularly in bone and soft tissue sarcomas, is varied and has not been synthesized to understand the current state of evidence. However, substantial efforts have been made to evaluate ERAS in other orthopaedics procedures, particularly in hip and knee arthroplasty. This study aims to summarize the breadth and depth of literature on ERAS pathways in orthopaedic oncology to identify critical gaps and guide future research directions given the potential benefits in this complex population. The Arksey and O’Malley framework in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to generate a search strategy, define eligibility, and select studies from a comprehensive literature search. Of the nine included studies, data were extracted and analyzed using descriptive analytics. The available literature was heterogeneous; it predominantly comprised retrospective studies, concentrated on spine and spinopelvic oncology, ERAS components included, and reported outcomes (although length of stay was assessed in all included studies). Comparatively little evidence was identified in non-spine sarcoma, and no included study specifically evaluated appendicular metastatic bone disease. These findings highlight the need for prospective disease- and surgery-specific ERAS implementation studies using standardized pathway definitions, adherence measures, and perioperative outcomes.

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Cite

BibTeXRIS
BibTeX
@article{ferrie2026enhanced,
  title = {{Enhanced Recovery After Surgery (ERAS) Protocols in Sarcoma and Metastatic Bone Disease: A Scoping Review}},
  author = {Leah Ferrie and Alex Gamage and Peter Lewkonia and Michael M. H. Yang and Khara M. Sauro and Krista Goulding and Shannon K. T. Puloski and Michael J. Monument and Joseph K. Kendal},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18213424},
  url = {https://www.mdpi.com/2072-6694/18/21/3424},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Enhanced Recovery After Surgery (ERAS) Protocols in Sarcoma and Metastatic Bone Disease: A Scoping Review
AU  - Leah Ferrie
AU  - Alex Gamage
AU  - Peter Lewkonia
AU  - Michael M. H. Yang
AU  - Khara M. Sauro
AU  - Krista Goulding
AU  - Shannon K. T. Puloski
AU  - Michael J. Monument
AU  - Joseph K. Kendal
PY  - 2026
DA  - 2026/10/22
JO  - Cancers
DO  - 10.3390/cancers18213424
UR  - https://www.mdpi.com/2072-6694/18/21/3424
AB  - Literature evaluating the effectiveness of Enhanced Recovery After Surgery (ERAS) pathways in orthopaedic oncology, particularly in bone and soft tissue sarcomas, is varied and has not been synthesized to understand the current state of evidence. However, substantial efforts have been made to evaluate ERAS in other orthopaedics procedures, particularly in hip and knee arthroplasty. This study aims to summarize the breadth and depth of literature on ERAS pathways in orthopaedic oncology to identify critical gaps and guide future research directions given the potential benefits in this complex population. The Arksey and O’Malley framework in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to generate a search strategy, define eligibility, and select studies from a comprehensive literature search. Of the nine included studies, data were extracted and analyzed using descriptive analytics. The available literature was heterogeneous; it predominantly comprised retrospective studies, concentrated on spine and spinopelvic oncology, ERAS components included, and reported outcomes (although length of stay was assessed in all included studies). Comparatively little evidence was identified in non-spine sarcoma, and no included study specifically evaluated appendicular metastatic bone disease. These findings highlight the need for prospective disease- and surgery-specific ERAS implementation studies using standardized pathway definitions, adherence measures, and perioperative outcomes.
SN  - 2072-6694
ER  -