TY  - JOUR
A1  - Adamina, Michel
A1  - Ademuyiwa, Adesoji
A1  - Adisa, Adewale
A1  - Bhangu, Aneel A.
A1  - Minaya Bravo, Ana
A1  - Cunha, Miguel F.
A1  - Emile, Sameh
A1  - Ghosh, Dhruva
A1  - Glasbey, James C.
A1  - Harris, Benjamin
A1  - Keller, Debby
A1  - Lawday, Samuel
A1  - Lederhuber, Hans
A1  - Leventoglu, Sezai
A1  - Li, Elisabeth
A1  - Modolo, Maria Marta
A1  - Mittal, Rohin
A1  - Mohan, Helen M.
A1  - Nepogodiev, Dmitri
A1  - Parreño-Sacdalan, Marie Dione
A1  - Pata, Francesco
A1  - Pockney, Peter
A1  - Rutegård, Martin
A1  - Simões, Joana F. F.
A1  - Smart, Neil
A1  - Varghese, Chris
T1  - The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
T2  - Colorectal Disease
N2  - 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: 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 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 a R0 margin. 

Results: Overall, 5453 patients from 304 hospitals in 47 countries were included, of which 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 four weeks. Delayed patients were more likely to be older, male, more comorbid, have higher BMI, 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 fifteen 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.
Y1  - 2022
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123781
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1237812
SN  - 1462-8910
SN  - 1463-1318
N1  - Published on behalf of the COVIDSurg Collaborative. Please see publisher's website for further details.
VL  - 24
IS  - 6
SP  - 708
EP  - 726
PB  - Wiley
ER  -