Return to intended oncologic treatment: Definitions, perioperative prognostic factors, and interventions

In the cancer survivorship journey, many patients require both medical and surgical oncologic treatments to improve survival. The return to intended oncologic treatment (RIOT) is a relatively new concept addressing the continuity of cancer treatment after surgery. While general definitions have been published, thresholds and minimal clinically important differences (MCID) have not been standardised. For many cancers, a threshold for delayed RIOT is 6–8 weeks, while the MCID in colorectal cancer may approximate 4 weeks. Studies addressing RIOT have shown multiple demographics, socioeconomic, institutional, surgical, and postoperative factors associated with a difference in rate and time to RIOT. The most influential of these variables is the surgical approach. While research on the effect of enhanced recovery after surgery on RIOT has increased, the literature is still in its early stages. Finally, the effect of anaesthetic interventions on RIOT has been largely unexplored.