The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study
Articolo
Data di Pubblicazione:
2022
Citazione:
The impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study / Adamina, M., Ademuyiwa, A., Adisa, A., Bhangu, A.A., Bravo, A.M., Cunha, M.F., Emile, S., Ghosh, D., Glasbey, J.C., Harris, B., Keller, D., Lawday, S., Lederhuber, H., Leventoglu, S., Li, E., Modolo, M.M., Mittal, R., Mohan, H.M., Nepogodiev, D., Parreno-Sacdalan, M.D., et al.. - In: COLORECTAL DISEASE. - ISSN 1462-8910. - 24:6(2022), pp. 708-726. [10.1111/codi.16117]
Abstract:
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.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
COVID-19; Coronavirus; SARS-Cov-2; colorectal cancer; surgery; surgical delay
Elenco autori:
Adamina, M.; Ademuyiwa, A.; Adisa, A.; Bhangu, A. A.; Bravo, A. M.; Cunha, M. F.; Emile, S.; Ghosh, D.; Glasbey, J. C.; Harris, B.; Keller, D.; Lawday, S.; Lederhuber, H.; Leventoglu, S.; Li, E.; Modolo, M. M.; Mittal, R.; Mohan, H. M.; Nepogodiev, D.; Parreno-Sacdalan, M. D.; Pata, F.; Pockney, P.; Rutegard, M.; Smart, N.; Varghese, C.; Glasbey, J. C.; Harris, B.; Bhangu, A. A.; Nepogodiev, D.; Siaw-Acheampong, K.; Benson, R. A.; Bywater, E.; Chaudhry, D.; Dawson, B. E.; Evans, J. P.; Glasbey, J. C.; Gujjuri, R. R.; Heritage, E.; Jones, C. S.; Kamarajah, S. K.; Khatri, C.; Khaw, R. A.; Keatley, J. M.; Knight, A.; Lawday, S.; Li, E.; Mann, H. S.; Marson, E. J.; Mclean, K. A.; Mckay, S. C.; Mills, E. C.; Pellino, G.; Picciochi, M.; Taylor, E. H.; Tiwari, A.; Trout, I. M.; Venn, M. L.; JW Wilkin, R.; Bhangu, A.; Glasbey, J. C.; Smart, N. J.; Minaya-Bravo, A.; Evans, J. P.; Gallo, G.; Moug, S.; Saverio, S. D.; Vallance, A.; Vimalchandran, D.; Griffiths, E. A.; Kamarajah, S. K.; Evans, R. P. T.; Townend, P.; Roberts, K.; Mckay, S.; Isaac, J.; Satoi, S.; Edwards, J.; Coonar, A. S.; Marchbank, A.; Caruana, E. J.; Layton, G. R.; Patel, A.; Brunelli, A.; Ford, S.; Desai, A.; Gronchi, A.; Fiore, M.; Almond, M.; Tirotta, F.; Dumitra, S.; Kolias, A.; Price, S. J.; Fountain, D. M.; Jenkinson, M. D.; Hutchinson, P.; Marcus, H. J.; Piper, R. J.; Lippa, L.; Servadei, F.; Esene, I.; Freyschlag, C.; Neville, I.; Rosseau, G.; Schaller, K.; Demetriades, A. K.; Robertson, F.; Alamri, A.; Shaw, R.; Schache, A. G.; Winter, S. C.; Ho, M.; Nankivell, P.; Biel, J. R.; Batstone, M.; Ganly, I.; Vidya, R.; Wilkins, A.; Singh, J. K.; Thekinkattil, D.; Sundar, S.; Fotopoulou, C.; Leung, E. Y. L.; Khan, T.; Chiva, L.; Sehouli, J.; Fagotti, A.; Cohen, P.; Gutelkin, M.; Ghebre, R.; Konney, T.; Pareja, R.; Bristow, R.; Dowdy, S.; Shylasree, T. S.; Seenivasagam, R. K.; Ng, J.; Fujiwara, K.; Stewart, G. D.; Lamb, B.; Narahari, K.; Mcneill, A.; Colquhoun, A.; Mcgrath, J. S.; Bromage, S.; Barod, R.; Kasivisvanathan, V.; Klatte, T.; Abbott, T. E. F.; Abukhalaf, S.; Adamina, M.; Ademuyiwa, A. O.; Agarwal, A.; Akkulak, M.; Alameer, E.; Alderson, D.; Alakaloko, F.; Albertsmeier, M.; Alser, O.; Alshaar, M.; Alshryda, S.; Arnaud, A. P.; Augestad, K. M.; Ayasra, F.; Azevedo, J.; Bankhead-Kendall, B. K.; Barlow, E.; Beard, D.; Benson, R. A.; Blanco-Colino, R.; Brar, A.; Breen, K. A.; Bretherton, C.; Buarque, I. L.; Burke, J.; Caruana, E. J.; Chaar, M.; Chakrabortee, S.; Christensen, P. A.; Cox, D.; Cukier, M.; Cunha, M. F.; Davidson, G. H.; Desai, A.; Saverio, S. D.; Drake, T. M.; Edwards, J. G.; Elhadi, M.; Emile, S.; Farik, S.; Fitzgerald, J. E.; Ford, S.; Garmanova, T.; Ghosh, D.; Gomes, G. M. A.; Grecinos, G.; Griffiths, E. A.; Gruendl, M.; Halkias, C.; Harrison, E. M.; Hisham, I.; Hutchinson, P. J.; Hwang, S.; Isik, A.; Jenkinson, M. D.; Jonker, P.; Kaafarani, H. M. A.; Keller, D.; Kruijff, S.; Lawani, I.; Leventoglu, S.; Litvin, A.; Loehrer, A.; Loffler, M. W.; Lorena, M. A.; Modolo, M. M.; Major, P.; Martin, J.; Mashbari, H. N.; Mazingi, D.; Metallidis, S.; Moore, R.; Moszkowicz, D.; Moug, S.; Ng-Kamstra, J. S.; Maimbo, M.; Negoi, I.; Niquen, M.; Ntirenganya, F.; Olivos, M.; Oussama, K.; Outani, O.; Rivera, C. J. P.; Pinkney, T. D.; van der Plas, W.; Qureshi, A.; Radenkovic, D.; Ramos-De la Medina, A.; Richards, T.; Roberts, K.; Roslani, A. C.; Rutegard, M.; Segura-Sampedro, J. J.; Santos, I.; Satoi, S.; Sayyed, R.; Schache, A.; Schnitzbauer, A. A.; Seyi-Olajide, J. O.; Sharma, N.; Shaw, C. A.; Shaw, R.; Shu, S.; Soreide, K.; Spinelli, A.; Stewart, G. D.; Sund, M.; Tabiri, S.; Townend, P.; Tsoulfas, G.; van Ramshorst, G. H.; Vidya, R.; Vimalachandran, D.; Warren, O. J.; Wedderburn, D.; Wright, N.; Valenzuela, J. I.; Alurralde, C.; Caram, E. L.; Eskinazi, D. G.; Badra, R.; Garcia, J. S.; Lucchini, S. M.; Vasey, C.; Watson, E.; Cecire, J.; Salindera, S.; Sutherland, A.; Ahn, J. H.; Chen, S.; Gauri, N.; Jang, S.; Jia, F.; Mulligan, C. S.; Yang, W.; Ye, G.; Zhang, H.;
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