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01-10-2020 | Rectal Cancer | Review Article

Gastrointestinal Malignancies and the COVID-19 Pandemic: Evidence-Based Triage to Surgery

Authors: Scott C. Fligor, Sophie Wang, Benjamin G. Allar, Savas T. Tsikis, Ana Sofia Ore, Ashlyn E. Whitlock, Rodrigo Calvillo-Ortiz, Kevin R. Arndt, Sidhu P. Gangadharan, Mark P. Callery

Published in: Journal of Gastrointestinal Surgery | Issue 10/2020

Abstract

Background

The COVID-19 pandemic has led to widespread cancelation of electively scheduled surgeries, including for colorectal, pancreatic, and gastric cancer. The American College of Surgeons and the Society of Surgical Oncology have released guidelines for triage of these procedures. We seek to synthesize available evidence on delayed resection and oncologic outcomes, while also providing a critical assessment of the released guidelines.

Methods

A systematic review was conducted to identify literature between 2005 and 2020 investigating the impact of time to surgery on oncologic outcomes in colorectal, pancreatic, and gastric cancer.

Results

For colorectal cancer, 1066 abstracts were screened and 43 papers were included. In primarily resected colon cancer, delay over 30 to 40 days is associated with lower survival. In rectal cancer, time to surgery over 7 to 8 weeks following neoadjuvant therapy is associated with decreased survival. Three hundred ninety-four abstracts were screened for pancreatic cancer and nine studies were included. Two studies demonstrate increased unexpected progression with delayed surgery over 30 days. Out of 633 abstracts screened for gastric cancer, six studies were included. No identified study demonstrated worse survival with increased time to surgery.

Conclusion

Moderate evidence suggests that delayed resection of colorectal cancer worsens survival; the impact of time to surgery on gastric and pancreatic cancer outcomes is uncertain. Early resection of gastrointestinal malignancies provides the best chance for curative therapy. During the COVID-19 pandemic, prioritization of procedures should account for available evidence on time to surgery and oncologic outcomes.

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Title: Gastrointestinal Malignancies and the COVID-19 Pandemic: Evidence-Based Triage to Surgery
Authors: Scott C. Fligor
Sophie Wang
Benjamin G. Allar
Savas T. Tsikis
Ana Sofia Ore
Ashlyn E. Whitlock
Rodrigo Calvillo-Ortiz
Kevin R. Arndt
Sidhu P. Gangadharan
Mark P. Callery
Publication date: 01-10-2020
Publisher: Springer US
Keywords: Rectal Cancer
Rectal Cancer
Triage
Gastric Cancer
Gastric Cancer
COVID-19
Pancreatic Cancer
Pancreatic Cancer
Colorectal Cancer
Colorectal Cancer
Colon Cancer
Colon Cancer
Published in: Journal of Gastrointestinal Surgery / Issue 10/2020
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-020-04712-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Gastrointestinal Malignancies and the COVID-19 Pandemic: Evidence-Based Triage to Surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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