Antonia L. Stengler, Jörg Kleeff, Lisa Rieder, James C. Glasbey, Aneel A. Bhangu, Ewen M. Harrison, Ulrich Ronellenfitsch, CovidSurg Collaborative, Kenneth A. McLean, Dmitri Nepogodiev, Dmitri Nepogodiev, Kwabena Siaw-Acheampong, Ruth Benson, Edward Bywater, Daoud Chaudhry, Brett E Dawson, Jonathan P. Evans, Rohan R Gujjuri, Emily Heritage, Conor S. Jones, Sivesh K. Kamarajah, Chetan Khatri, Rachel A. Khaw, James M Keatley, Andrew Knight, Samuel Lawday, Elizabeth Li, Harvinder Mann, Ella J Marson, Kenneth A. McLean, Siobhan C. McKay, Emily C. Mills, Gianluca Pellino, Maria Picciochi, Elliott H Taylor, Abhinav Tiwari, Joana F. F. Simoes, Isobel M Trout, Mary L Venn, Richard Wilkin, Neil Smart, Ana Minaya-Bravo, Jonathan P. Evans, Gaetano Gallo, Susan Moug, Francesco Pata, Peter Pockney, Salomone Di Saverio, Abigail Vallance, Dale Vimalchandran, Ewen A. Griffiths, Sivesh K. Kamarajah, Richard Evans, Philip Townend, K. Roberts, Siobhan McKay, John Isaac, Sohei Satoi, John Edwards, Aman S. Coonar, Adrian Marchbank, Edward J. Caruana, Georgia R. Layton, Akshay Patel, Alessandro Brunelli, Samuel Ford, Anant Desai, Alessandro Gronchi, Marco Fiore, Max Almond, Fabio Tirotta, Sinziana Dumitra, Angelos Kolias, Stephen J. Price, Daniel M. Fountain, Michael D. Jenkinson, Peter J. Hutchinson, Hani J. Marcus, Rory J. Piper, Laura Lippa, Franco Servadei, Ignatius Esene, Christian Freyschlag, Iuri Neville, G. Rosseau, Karl Schaller, Andreas K. Demetriades, Faith Robertson, Alex Alamri, Richard Shaw, Andrew G. Schache, Stuart C. Winter, Michael Ho, Paul Nankivell, Juan Rey Biel, Martin Batstone, Ian Ganly, Raghavan Vidya, Alex Wilkins, Jagdeep Singh
BACKGROUND: During the COVID-19 pandemic, prioritization of COVID-19 patients led to delays in oncological surgery, potentially impacting patient outcomes. This analysis examines the effects of surgical delays in various tumor entities on resectability and postoperative mortality. METHODS: Data from the COVIDSurg Cancer Collaborative, an international prospective cohort study with 19,676 patients, collected between March 26, 2020, and September 16, 2020, were analyzed. Postoperative mortality and complete resection (R0) were the outcomes, with tumor entity, stage and delay to surgery as key exposures. RESULTS: 17,486 patients underwent surgery during the study period, at a median time of three weeks after decision to operate (IQR = 4). 172 (1.0%) patients died within 30 days postoperatively. 15,143 (90.5%) patients had an R0 resection, 1352 (8.1%) an R1 resection and 230 (1.4%) had an R2 resection. Postoperative mortality was highest for oesophageal cancer (3.9%) and UICC stage IV (1.5%). For the overall population, there was no association between delay to surgery and resectability. There was an association between delay to surgery and postoperative mortality (p < 0.001), with the highest 30-day postoperative mortality observed for operations within two weeks following surgical decision. CONCLUSION: Tumor resectability and postoperative mortality in oncological surgeries are influenced by various factors. During the COVID-19 pandemic, moderate delays in surgeries were observed, with differences across tumor types, UICC stages and regions. While no tangible effects on resectability were found, postoperative mortality was higher after a shorter delay to surgery.