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

dc.contributor.authorAdamina, Michel
dc.contributor.authorAdemuyiwa, Adesoji
dc.contributor.authorAdisa, Adewale
dc.contributor.authorBhangu, Aneel A.
dc.contributor.authorBravo, Ana Minaya
dc.contributor.authorCunha, Miguel F.
dc.contributor.authorEmile, Sameh
dc.contributor.authorGhosh, Dhruva
dc.contributor.authorGlasbey, James C.
dc.contributor.authorHarris, Benjamin
dc.contributor.authorKeller, Debby
dc.contributor.authorLawday, Samuel
dc.contributor.authorLederhuber, Hans
dc.contributor.authorLeventoglu, Sezai
dc.contributor.authorLi, Elizabeth
dc.contributor.authorModolo, Maria Marta
dc.contributor.authorMittal, Rohin
dc.contributor.authorMohan, Helen M.
dc.contributor.authorNepogodiev, Dmitri
dc.contributor.authorParreno-Sacdalan, Marie Dione
dc.contributor.authorPata, Francesco
dc.contributor.authorPockney, Peter
dc.contributor.authorRutegard, Martin
dc.contributor.authorSimoes, Joana F. F.
dc.contributor.authorSmart, Neil
dc.contributor.authorVarghese, Chris
dc.contributor.authorSiaw-Acheampong, Kwabena
dc.contributor.authorBenson, Ruth A.
dc.contributor.authorBywater, Edward
dc.contributor.authorChaudhry, Daoud
dc.contributor.authorDawson, Brett E.
dc.contributor.authorEvans, Jonathan P.
dc.contributor.authorGujjuri, Rohan R.
dc.contributor.authorHeritage, Emily
dc.contributor.authorJones, Conor S.
dc.contributor.authorKamarajah, Sivesh K.
dc.contributor.authorKhatri, Chetan
dc.contributor.authorKhaw, Rachel A.
dc.contributor.authorKeatley, James M.
dc.contributor.authorKnight, Andrew
dc.contributor.authorSmart, Neil J.
dc.contributor.authorMinaya-Bravo, Ana
dc.contributor.authorGallo, Gaetano
dc.contributor.authorMoug, Susan
dc.contributor.authorDi Saverio, Salomone
dc.contributor.authorVallance, Abigail
dc.contributor.authorVimalchandra, Dale
dc.contributor.authorGriffiths, Ewen A.
dc.contributor.authorEvans, Richard P. T.
dc.contributor.authorTownen, Philip
dc.contributor.authorRoberts, Keith
dc.contributor.authorMcKay, Siobhan
dc.contributor.authorIsaac, John
dc.contributor.authorSatoi, Sohei
dc.contributor.authorEdwards, John
dc.contributor.authorCoonar, Aman S.
dc.contributor.authorMarchbank, Adrian
dc.contributor.authorCaruana, Edward J.
dc.contributor.authorLayton, Georgia R.
dc.contributor.authorPatel, Akshay
dc.contributor.authorBrunelli, Alessandro
dc.contributor.authorFord, Samuel
dc.contributor.authorDesai, Anant
dc.contributor.authorGronchi, Alessandro
dc.contributor.authorFiore, Marco
dc.contributor.authorAlmond, Max
dc.contributor.authorTirotta, Fabio
dc.contributor.authorDumitra, Sinziana
dc.contributor.authorKolias, Angelos
dc.contributor.authorPrice, Stephen J.
dc.contributor.authorFountain, Daniel M.
dc.contributor.authorJenkinson, Michael D.
dc.contributor.authorHutchinson, Peter
dc.contributor.authorMarcus, Hani J.
dc.contributor.authorPiper, Rory J.
dc.contributor.authorLippa, Laura
dc.contributor.authorServadei, Franco
dc.contributor.authorEsene, Ignatius
dc.contributor.authorFreyschlag, Christian
dc.contributor.authorNeville, Iuri
dc.contributor.authorRosseau, Gail
dc.contributor.authorSchaller, Karl
dc.contributor.authorDemetriades, Andreas K.
dc.contributor.authorRobertson, Faith
dc.contributor.authorAlamri, Alex
dc.contributor.authorShaw, Richard
dc.contributor.authorSchache, Andrew G.
dc.contributor.authorWinter, Stuart C.
dc.contributor.authorHo, Michael
dc.contributor.authorNankivell, Paul
dc.contributor.authorBiel, Juan Rey
dc.contributor.authorBatstone, Martin
dc.contributor.authorGanly, Ian
dc.contributor.authorVidya, Raghavan
dc.contributor.authorWilkins, Alex
dc.contributor.authorSingh, Jagdeep K.
dc.contributor.authorThekinkattil, Dinesh
dc.contributor.authorSundar, Sudha
dc.contributor.authorFotopoulou, Christina
dc.contributor.authorLeung, Elaine Yl
dc.contributor.authorKhan, Tabassum
dc.contributor.authorChiva, Luis
dc.contributor.authorSehouli, Jalid
dc.contributor.authorFagotti, Anna
dc.contributor.authorCohen, Paul
dc.contributor.authorGutelkin, Murat
dc.contributor.authorGhebre, Rahel
dc.contributor.authorKonney, Thomas
dc.contributor.authorPareja, Rene
dc.contributor.authorBristow, Rob
dc.contributor.authorDowdy, Sean
dc.contributor.authorShylasree, T. S.
dc.contributor.authorSeenivasagam, Rajkumar Kottayasamy
dc.contributor.authorNg, Joe
dc.contributor.authorFujiwar, Keiichi
dc.contributor.authorStewart, Grant D.
dc.contributor.authorLamb, Benjamin
dc.contributor.authorNarahari, Krishna
dc.contributor.authorMcNeill, Alan
dc.contributor.authorColquhoun, Alexandra
dc.contributor.authorMcGrath, John S.
dc.contributor.authorBromage, Steve
dc.contributor.authorBarod, Ravi
dc.contributor.authorKasivisvanathan, Veeru
dc.contributor.authorKlatte, Tobias
dc.contributor.authorAbbott, Tom E. F.
dc.contributor.authorAbukhalaf, Sadi
dc.contributor.authorAdemuyiwa, Adesoji O.
dc.contributor.authorAgarwal, Arnav
dc.contributor.authorAkkulak, Murat
dc.contributor.authorAlameer, Ehab
dc.contributor.authorAlderson, Derek
dc.contributor.authorAlakaloko, Felix
dc.contributor.authorAlbertsmeier, Markus
dc.contributor.authorAlser, Osaid
dc.contributor.authorAlshaar, Muhammad
dc.contributor.authorAlshryda, Sattar
dc.contributor.authorArnaud, Alexis P.
dc.contributor.authorAugestad, Knut Magne
dc.contributor.authorAyasra, Faris
dc.contributor.authorAzevedo, Jose
dc.contributor.authorBankhead-Kendall, Brittany K.
dc.contributor.authorBarlow, Emma
dc.contributor.authorBeard, David
dc.contributor.authorBlanco-Colino, Ruth
dc.contributor.authorBrar, Amanpreet
dc.contributor.authorBreen, Kerry A.
dc.contributor.authorBretherton, Chris
dc.contributor.authorBuarque, Igor Lima
dc.contributor.authorBurke, Joshua
dc.contributor.authorChaar, Mohammad
dc.contributor.authorChakrabortee, Sohini
dc.contributor.authorChristensen, Peter
dc.contributor.authorCox, Daniel
dc.contributor.authorCukier, Moises
dc.contributor.authorDavidson, Giana H.
dc.contributor.authorDrake, Thomas M.
dc.contributor.authorEdwards, John G.
dc.contributor.authorElhadi, Muhammed
dc.contributor.authorFarik, Shebani
dc.contributor.authorFitzgerald, J. Edward
dc.contributor.authorGarmanova, Tatiana
dc.contributor.authorGomes, Gustavo Mendonca Ataide
dc.contributor.authorGrecinos, Gustavo
dc.contributor.authorGruendl, Magdalena
dc.contributor.authorHalkias, Constantine
dc.contributor.authorHarrison, Ewen M.
dc.contributor.authorHisham, Intisar
dc.contributor.authorHutchinson, Peter J.
dc.contributor.authorHwang, Shelley
dc.contributor.authorIsik, Arda
dc.contributor.authorJonker, Pascal
dc.contributor.authorKaafarani, Haytham M. A.
dc.contributor.authorKruijff, Schelto
dc.contributor.authorLawani, Ismail
dc.contributor.authorLitvin, Andrey
dc.contributor.authorLoehrer, Andrew
dc.contributor.authorLoffler, Markus W.
dc.contributor.authorLorena, Maria Aguilera
dc.contributor.authorMajor, Piotr
dc.contributor.authorMartin, Janet
dc.contributor.authorMashbari, Hassan N.
dc.contributor.authorMazingi, Dennis
dc.contributor.authorMetallidis, Symeon
dc.contributor.authorMoore, Rachel
dc.contributor.authorMoszkowicz, David
dc.contributor.authorNg-Kamstra, Joshua S.
dc.contributor.authorMaimbo, Mayaba
dc.contributor.authorNegoi, Ionut
dc.contributor.authorNiquen, Milagros
dc.contributor.authorNtirenganya, Faustin
dc.contributor.authorOlivos, Maricarmen
dc.contributor.authorOussama, Kacimi
dc.contributor.authorOutani, Oumaima
dc.contributor.authorRivera, Carlos Jose Perez
dc.contributor.authorPinkney, Thomas D.
dc.contributor.authorvan der Plas, Willemijn
dc.contributor.authorQureshi, Ahmad
dc.contributor.authorRadenkovic, Dejan
dc.contributor.authorRamos-De La Medina, Antonio
dc.contributor.authorRichards, Toby
dc.contributor.authorRoslani, April C.
dc.contributor.authorSegura-Sampedro, Juan Jose
dc.contributor.authorSantos, Irene
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dc.contributor.authorSharma, Neil
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dc.contributor.authorSpinelli, Antonino
dc.contributor.authorSund, Malin
dc.contributor.authorTabiri, Stephen
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dc.contributor.authorTsoulfas, Georgios
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dc.contributor.authorRazali I, Md
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dc.date.accessioned2023-02-21T12:43:40Z
dc.date.available2023-02-21T12:43:40Z
dc.date.issued2022-01-01
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.
dc.description.issue6
dc.description.issueJUN
dc.description.pages708-726
dc.description.volume24
dc.identifier.doi10.1111/codi.16117
dc.identifier.urihttps://hdl.handle.net/11443/2896
dc.identifier.urihttp://dx.doi.org/10.1111/codi.16117
dc.identifier.wosWOS:000789560800001
dc.publisherWILEY
dc.relation.ispartofCOLORECTAL DISEASE
dc.subjectcolorectal cancer
dc.subjectcoronavirus
dc.subjectCOVID-19
dc.subjectSARS-CoV-2
dc.subjectsurgery
dc.subjectsurgical delay
dc.titleThe impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
dc.typeArticle

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