Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1969
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dc.date.accessioned2022-10-25T01:44:42Z-
dc.date.available2022-10-25T01:44:42Z-
dc.date.issued2022-
dc.identifier.govdoc01938en_US
dc.identifier.urihttp://hdl.handle.net/11054/1969-
dc.descriptionIncludes data from BHS.en_US
dc.description.abstractAim 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. What does this paper add to the literature? This was a prospective cohort study of 5453 patients with a decision for curative colorectal cancer surgery. Surgical delays of up to 12 weeks were not associated with worse rates of complete resection. Any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease and should be the focus of postoperative surveillance programmes.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2022-08-22T04:41:30Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2022-10-25T01:44:42Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2022-10-25T01:44:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2022en
dc.titleThe impact of surgical delay on resectability of colorectal cancer: an international prospective cohort study.en_US
dc.typeJournal Articleen_US
dc.type.specifiedArticleen_US
dc.contributor.corpauthorCOVIDSurg Collaborativeen_US
dc.bibliographicCitation.titleColorectal Diseaseen_US
dc.bibliographicCitation.volume24en_US
dc.bibliographicCitation.issue6en_US
dc.bibliographicCitation.stpage708en_US
dc.bibliographicCitation.endpage726en_US
dc.subject.healththesaurusCOVID-19en_US
dc.subject.healththesaurusSARS-CoV-2en_US
dc.subject.healththesaurusCOLORECTAL CANCERen_US
dc.subject.healththesaurusCORONAVIRUSen_US
dc.subject.healththesaurusSURGERYen_US
dc.subject.healththesaurusSURGICAL DELAYen_US
dc.identifier.doihttps://doi.org/10.1111/codi.16117en_US
Appears in Collections:Research Output

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