Surgical Delay Worsens Survival for Some Gastrointestinal Cancers
Analysis of effect of time to surgery on outcomes may inform triage of surgeries delayed due to COVID-19
MONDAY, July 20, 2020 (HealthDay News) -- Surgical delay is associated with an increased risk in some gastrointestinal malignancies, and understanding the impact on outcomes may assist surgeons in triaging patients whose surgeries were delayed due to the COVID-19 pandemic, according to research published online June 30 in the Journal of Gastrointestinal Surgery.
Scott C. Fligor, M.D., from Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a systematic literature review to identify studies evaluating delayed resection of gastrointestinal malignancies (colorectal, pancreatic, and gastric cancer) and oncologic outcomes.
The researchers identified 43 studies on colorectal cancer published between 2005 and 2020. They found that in primarily resected colon cancer, there was lower survival associated with delays of more than 30 to 40 days. There was decreased survival with rectal cancer when time to surgery was more than seven to eight weeks following neoadjuvant therapy. Among the nine studies evaluating pancreatic cancer, two studies demonstrated increased unexpected progression with surgery delays of more than 30 days. Of the six studies evaluating gastric cancer, no studies identified worse survival with increased time to surgery.
"During the COVID-19 pandemic, prioritization of procedures should account for available evidence on time to surgery and oncologic outcomes," the authors write.