ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2022
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
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- Patient care and access to clinical trials in gynaecological oncology: global implications of the early phase of the COVID-19 pandemic.Archives of gynecology and obstetrics · 2024Article
- Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes.World journal of methodology · 2024Article
- The Impact of the Pandemic on the Quality of Colorectal and Anal Cancer Care, and 2-Year Clinical Outcomes.Current oncology (Toronto, Ont.) · 2024Article
- Effect of the SARS-CoV-2 pandemic on colorectal cancer diagnosis and prognosis.Cancer medicine · 2024Article
- Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study.The British journal of surgery · 2024Article
- Time to surgery is not an oncological risk factor in HCC patients undergoing liver resection.Langenbeck's archives of surgery · 2023Article
- Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival.Current oncology (Toronto, Ont.) · 2023Article
- Transitional Justice after the COVID-19 Pandemic.International journal of environmental research and public health · 2022Article
- The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
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Abstract
aimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.
methodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.
resultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes.
conclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease.
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