The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study

[EN]Aim: The 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. Methods: This was an international prospective...

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Autores: COVIDSurg Collaborative, Adamina, M., Ademuyiwa, A., Alcázar Montero, José Antonio, Angoso Clavijo, María, Blanco Antona, Francisco, Muñoz Bellvís, Luis, Trébol, Jacobo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/161041
Acceso en línea:http://hdl.handle.net/10366/161041
Access Level:acceso abierto
Palabra clave:Colorectal cancer
Coronavirus
COVID-19
SARS-CoV-2
Surgery
Surgical delay
Colorectal Surgery
Colorectal Neoplasms
3207.13 Oncología
3213 Cirugía
coronavirus
cirugía colorrectal
neoplasias colorrectales
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oai_identifier_str oai:gredos.usal.es:10366/161041
network_acronym_str ES
network_name_str España
repository_id_str
spelling The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort studyCOVIDSurg CollaborativeAdamina, M.Ademuyiwa, A.Alcázar Montero, José AntonioAngoso Clavijo, MaríaBlanco Antona, FranciscoMuñoz Bellvís, LuisTrébol, JacoboColorectal cancerCoronavirusCOVID-19SARS-CoV-2SurgerySurgical delayCoronavirusColorectal SurgeryColorectal Neoplasms3207.13 Oncología3213 Cirugíacoronaviruscirugía colorrectalneoplasias colorrectales[EN]Aim: The 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. Methods: This 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. Results: Overall, 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. Conclusion: One 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.Wiley202420242022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/161041reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1610412026-06-07T06:28:51Z
dc.title.none.fl_str_mv The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
title The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
spellingShingle The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
COVIDSurg Collaborative
Colorectal cancer
Coronavirus
COVID-19
SARS-CoV-2
Surgery
Surgical delay
Coronavirus
Colorectal Surgery
Colorectal Neoplasms
3207.13 Oncología
3213 Cirugía
coronavirus
cirugía colorrectal
neoplasias colorrectales
title_short The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
title_full The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
title_fullStr The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
title_full_unstemmed The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
title_sort The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
dc.creator.none.fl_str_mv COVIDSurg Collaborative
Adamina, M.
Ademuyiwa, A.
Alcázar Montero, José Antonio
Angoso Clavijo, María
Blanco Antona, Francisco
Muñoz Bellvís, Luis
Trébol, Jacobo
author COVIDSurg Collaborative
author_facet COVIDSurg Collaborative
Adamina, M.
Ademuyiwa, A.
Alcázar Montero, José Antonio
Angoso Clavijo, María
Blanco Antona, Francisco
Muñoz Bellvís, Luis
Trébol, Jacobo
author_role author
author2 Adamina, M.
Ademuyiwa, A.
Alcázar Montero, José Antonio
Angoso Clavijo, María
Blanco Antona, Francisco
Muñoz Bellvís, Luis
Trébol, Jacobo
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Colorectal cancer
Coronavirus
COVID-19
SARS-CoV-2
Surgery
Surgical delay
Coronavirus
Colorectal Surgery
Colorectal Neoplasms
3207.13 Oncología
3213 Cirugía
coronavirus
cirugía colorrectal
neoplasias colorrectales
topic Colorectal cancer
Coronavirus
COVID-19
SARS-CoV-2
Surgery
Surgical delay
Coronavirus
Colorectal Surgery
Colorectal Neoplasms
3207.13 Oncología
3213 Cirugía
coronavirus
cirugía colorrectal
neoplasias colorrectales
description [EN]Aim: The 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. Methods: This 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. Results: Overall, 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. Conclusion: One 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10366/161041
url http://hdl.handle.net/10366/161041
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname:Universidad de Salamanca (USAL)
instname_str Universidad de Salamanca (USAL)
reponame_str GREDOS. Repositorio Institucional de la Universidad de Salamanca
collection GREDOS. Repositorio Institucional de la Universidad de Salamanca
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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