UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

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

Adamina, Michel; Ademuyiwa, Adesoji; Adisa, Adewale; Bhangu, Aneel A; Bravo, Ana Minaya; Cunha, Miguel F; Emile, Sameh; ... Vale, R; + view all (2022) The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study. Colorectal Disease , 24 (6) pp. 708-726. 10.1111/codi.16117. Green open access

[thumbnail of Kasivisvanathan_Colorectal Disease - 2022 -  - The impact of surgical delay on resectability of colorectal cancer  An international.pdf]
Preview
Text
Kasivisvanathan_Colorectal Disease - 2022 - - The impact of surgical delay on resectability of colorectal cancer An international.pdf

Download (1MB) | Preview

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: 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.

Type: Article
Title: The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/codi.16117
Publisher version: https://doi.org/10.1111/codi.16117
Language: English
Keywords: Colorectal cancer, coronavirus, COVID-19, SARS-CoV-2, surgery, surgical delay
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10152088
Downloads since deposit
84Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item