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The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
Journal Contribution - Journal Article
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.
Journal: Colorectal Disease
ISSN: 1462-8910
Issue: 6
Volume: 24
Pages: 708 - 726
Publication year:2022
- WoS Id: 000789560800001
- PubMed Id: 35286766
- DOI: https://doi.org/10.1111/codi.16117
- Institutional Repository URL: https://lirias.kuleuven.be/3747192
Accessibility:Open
Authors/publisher
- Michel Adamina (First author)
- Adesoji Ademuyiwa (Author)
- Adewale Adisa (Author)
- Aneel A Bhangu (Author)
- Ana Minaya Bravo (Author)
- Miguel F Cunha (Author)
- Sameh Emile (Author)
- Dhruva Ghosh (Author)
- James C Glasbey (Author)
- Benjamin Harris (Author)
- Debby Keller (Author)
- Samuel Lawday (Author)
- Hans Lederhuber (Author)
- Sezai Leventoglu (Author)
- Elizabeth Li (Author)
- Maria Marta Modolo (Author)
- Rohin Mittal (Author)
- Helen M Mohan (Author)
- Dmitri Nepogodiev (Author)
- Marie Dione Parreno-Sacdalan (Author)
- Francesco Pata (Author)
- Peter Pockney (Author)
- Martin Rutegard (Author)
- Joana FF Simoes (Author)
- Neil Smart (Author)
- Chris Varghese (Author)
- Kwabena Siaw-Acheampong (Author)
- Ruth A Benson (Author)
- Edward Bywater (Author)
- Daoud Chaudhry (Author)
- Brett E Dawson (Author)
- Jonathan P Evans (Author)
- Rohan R Gujjuri (Author)
- Emily Heritage (Author)
- Conor S Jones (Author)
- Sivesh K Kamarajah (Author)
- Chetan Khatri (Author)
- Rachel A Khaw (Author)
- James M Keatley (Author)
- Andrew Knight (Author)
- Neil J Smart (Author)
- Ana Minaya-Bravo (Author)
- Gaetano Gallo (Author)
- Susan Moug (Author)
- Salomone Di Saverio (Author)
- Abigail Vallance (Author)
- Dale Vimalchandra (Author)
- Ewen A Griffiths (Author)
- Richard PT Evans (Author)
- Philip Townen (Author)
- Keith Roberts (Author)
- Siobhan McKay (Author)
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- R McEwen (Author)
- J Pereca (Author)
- S Arumugam (Author)
- B Ibrahim (Author)
- K Khan (Author)
- K Gash (Author)
- L Gourbault (Author)
- TA Maccabe (Author)
- C Newton (Author)
- M Baig (Author)
- H Bates (Author)
- N Dunne (Author)
- A Khajuria (Author)
- Sarma Dr (Author)
- T Shortland (Author)
- N Tewari (Author)
- MA Akhtar (Author)
- A Brunt (Author)
- J McIntyre (Author)
- K Milne (Author)
- MM Rashid (Author)
- A Sgro (Author)
- KE Stewart (Author)
- A Turnbull (Author)
- G Gossedge (Author)
- S O'Donnell (Author)
- F Oldfield (Author)
- Aguilar M Gonzalez (Author)
- S Talukder (Author)
- P Eskander (Author)
- M Hanna (Author)
- J Olivier (Author)
- P Basnyat (Author)
- H Davis (Author)
- P Montauban (Author)
- A Shrestha (Author)
- C Magee (Author)
- S Powell (Author)
- I Flindall (Author)
- A Hanson (Author)
- V Mahendran (Author)
- S Green (Author)
- M Lim (Author)
- L MacDonald (Author)
- V Miu (Author)
- L Onos (Author)
- K Sheridan (Author)
- R Young (Author)
- F Alam (Author)
- O Griffiths (Author)
- C Houlden (Author)
- VS Kolli (Author)
- AK Lala (Author)
- Z Seymour (Author)
- E Consorti (Author)
- R Gonzalez (Author)
- R Kwan-Feinberg (Author)
- T Liu (Author)
- Z Cooper (Author)
- S Hirji (Author)
- D Mahvi (Author)
- B Okafor (Author)
- V Roxo (Author)
- A Salim (Author)
- A Loehrer (Author)
- K Telma (Author)
- M Bokenkamp (Author)
- AB Haynes (Author)
- C Hill (Author)
- E Leede (Author)
- K McElhinney (Author)
- KA Olson (Author)
- C Riley (Author)
- B Bigelow (Author)
- EW Etchill (Author)
- A Gabre-Kidan (Author)
- HE Jenny (Author)
- A Kent (Author)
- MR Ladd (Author)
- C Long (Author)
- H Malapati (Author)
- A Margalit (Author)
- S Rapaport (Author)
- J Rose (Author)
- K Stevens (Author)
- L Tsai (Author)
- D Vervoort (Author)
- P Yesantharao (Author)
- D Klaristenfeld (Author)
- KT Huynh (Author)
- H Kaafarani (Author)
- L Naar (Author)
- M Qadan (Author)
- DE Cha (Author)
- E Gleeson (Author)
- C Horn (Author)
- U Sarpel (Author)
- A Bhama (Author)
- K Colling (Author)
- M Najarian (Author)
- M Azam (Author)
- A Choudhry (Author)
- W Marx (Author)
- R Chokshi (Author)
- N Glass (Author)
- G Tsui (Author)
- MK Abel (Author)
- M Boeck (Author)
- H Chern (Author)
- LZ Kornblith (Author)
- B Nunez-Garcia (Author)
- D Ozgediz (Author)
- A Sarin (Author)
- MG Varma (Author)
- D Abbott (Author)
- A Acher (Author)
- T Aiken (Author)
- J Barrett (Author)
- E Foley (Author)
- PB Schwartz (Author)
- SN Zafar (Author)
- AT Hawkins (Author)
- A Maiga (Author)
- NM Ruzgar (Author)
- M Sion (Author)
- S Ullrich (Author)
- H Al-Naggar (Author)
- M Al-Shehari (Author)
- A Almassaudi (Author)
- M Alsayadi (Author)
- R Alsayadi (Author)
- S Shream (Author)
- L Uberruck (Author)
- M Angelo (Author)
- A Alga (Author)
- F Celebi (Author)
- E Colak (Author)
- H Ogucu (Author)
- A Arulanantham (Author)
- GBKD Bandara (Author)
- U Jayarajah (Author)
- S Ravindrakumar (Author)
- VSD Rodrigo (Last author)
Research units
- Cardiac Surgery(Division)