Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates com...
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| Veröffentlicht in: | Journal of clinical oncology 2021-01, Vol.39 (1), p.66-78 |
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| creator | Glasbey, James Nepogodiev, Dmitri Simoes, Joana F.F. Omar, Omar Li, Elizabeth Venn, Mary Abou Chaar, Mohammad Capizzi, Vita Chaudhry, Daoud Desai, Anant Edwards, Jonathan Evans, Jonathan Fiore, Marco Videria, Jose Flavio Ford, Samuel Ganly, Ian Griffiths, Ewen Gujjuri, Rohan Kolias, Angelos Kaafarani, Haytham M.A. Minaya-Bravo, Ana Mckay, Siobhan Mohan, Helen Roberts, Keith San Miguel-Méndez, Carlos Pockney, Peter Shaw, Richard Smart, Neil Stewart, Grant Sundar, Mrcog, Sudha Vidya, Raghavan Bhangu, Aneel Glasbey, James Nepogodiev, Dmitri Simoes, Joana Ff Chaar, Mohammad Abou Evans, Jonathan Fiore, Marco Ganyli, Ian Kaafarani, Haytham Ma Sundar, Sudha Siaw-Acheampong, Kwabena Benson, Ruth Bywater, Edward Dawson, Brett Heritage, Emily Jones, Conor Kamarajah, Sivesh Khatri, Chetan Khaw, Rachel Keatley, James Knight, Andrew Lawday, Samuel Mann, Harvinder Marson, Ella Mclean, Kenneth Mills, Emily Pellino, Gianluca Picciochi, Maria Taylor, Elliott Tiwari, Abhinav Trout, Isobel Wilkin, Richard Jw Gallo, Gaetano Moug, Susan Pata, Francesco Di Saverio, Salomone Vallance, Abigail Vimalchandran, Dale Evans, Richard Pt Townend, Philip Isaac, John Satoi, Sohei Edwards, John Coonar, Aman Marchbank, Adrian Caruana, Edward Layton, Georgia Patel, Akshay Brunelli, Alessandro Gronchi, Alessandro Almond, Max Tirotta, Fabio Dumitra, Sinziana Price, Stephen Fountain, Daniel Jenkinson, Michael Hutchinson, Peter Marcus, Hani Piper, Rory Lippa, Laura Servadei, Franco Esene, Ignatius Freyschlag, Christian Neville, Iuri Rosseau, Gail Schaller, Karl Demetriades, Andreas Robertson, Faith Alamri, Alex |
| description | As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks. |
| doi_str_mv | 10.1200/JCO.20.01933 |
| format | Article |
| fullrecord | <record><control><sourceid>hal</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04522516v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>oai_HAL_hal_04522516v1</sourcerecordid><originalsourceid>FETCH-hal_primary_oai_HAL_hal_04522516v13</originalsourceid><addsrcrecordid>eNqVjctKAzEYRoMoOF52PkC2QjPm0jitu5K2tKJUHCnuhp9p7EQySclkKrPzHfQJfRJb9QVcfXDOgQ-hC0ZTxim9ulWLlNOUsqEQByhhkmcky6Q8RAnNBCdsIJ6P0UnTvFLK-gMhE_Q5sbqMZquxAlfqgPM2rHXosHFYLZbzMWHDr_ePadD6R5kSLH6AWL1B1-BxG4xb41jt5OgxJ8ovCd9pt9K1KW_wyOG5izo4iMY7sD1839poSr2HPax8vYEAv_e-8iHiPLar7gwdvYBt9PnfnqLL6eRJzUgFttgEU0PoCg-mmI3uij2jfcm5ZNdbJv7TfgPMiV_j</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study</title><source>American Society of Clinical Oncology Online Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana F.F. ; Omar, Omar ; Li, Elizabeth ; Venn, Mary ; Abou Chaar, Mohammad ; Capizzi, Vita ; Chaudhry, Daoud ; Desai, Anant ; Edwards, Jonathan ; Evans, Jonathan ; Fiore, Marco ; Videria, Jose Flavio ; Ford, Samuel ; Ganly, Ian ; Griffiths, Ewen ; Gujjuri, Rohan ; Kolias, Angelos ; Kaafarani, Haytham M.A. ; Minaya-Bravo, Ana ; Mckay, Siobhan ; Mohan, Helen ; Roberts, Keith ; San Miguel-Méndez, Carlos ; Pockney, Peter ; Shaw, Richard ; Smart, Neil ; Stewart, Grant ; Sundar, Mrcog, Sudha ; Vidya, Raghavan ; Bhangu, Aneel ; Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana Ff ; Chaar, Mohammad Abou ; Evans, Jonathan ; Fiore, Marco ; Ganyli, Ian ; Kaafarani, Haytham Ma ; Sundar, Sudha ; Siaw-Acheampong, Kwabena ; Benson, Ruth ; Bywater, Edward ; Dawson, Brett ; Heritage, Emily ; Jones, Conor ; Kamarajah, Sivesh ; Khatri, Chetan ; Khaw, Rachel ; Keatley, James ; Knight, Andrew ; Lawday, Samuel ; Mann, Harvinder ; Marson, Ella ; Mclean, Kenneth ; Mills, Emily ; Pellino, Gianluca ; Picciochi, Maria ; Taylor, Elliott ; Tiwari, Abhinav ; Trout, Isobel ; Wilkin, Richard Jw ; Gallo, Gaetano ; Moug, Susan ; Pata, Francesco ; Di Saverio, Salomone ; Vallance, Abigail ; Vimalchandran, Dale ; Evans, Richard Pt ; Townend, Philip ; Isaac, John ; Satoi, Sohei ; Edwards, John ; Coonar, Aman ; Marchbank, Adrian ; Caruana, Edward ; Layton, Georgia ; Patel, Akshay ; Brunelli, Alessandro ; Gronchi, Alessandro ; Almond, Max ; Tirotta, Fabio ; Dumitra, Sinziana ; Price, Stephen ; Fountain, Daniel ; Jenkinson, Michael ; Hutchinson, Peter ; Marcus, Hani ; Piper, Rory ; Lippa, Laura ; Servadei, Franco ; Esene, Ignatius ; Freyschlag, Christian ; Neville, Iuri ; Rosseau, Gail ; Schaller, Karl ; Demetriades, Andreas ; Robertson, Faith ; Alamri, Alex</creator><creatorcontrib>Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana F.F. ; Omar, Omar ; Li, Elizabeth ; Venn, Mary ; Abou Chaar, Mohammad ; Capizzi, Vita ; Chaudhry, Daoud ; Desai, Anant ; Edwards, Jonathan ; Evans, Jonathan ; Fiore, Marco ; Videria, Jose Flavio ; Ford, Samuel ; Ganly, Ian ; Griffiths, Ewen ; Gujjuri, Rohan ; Kolias, Angelos ; Kaafarani, Haytham M.A. ; Minaya-Bravo, Ana ; Mckay, Siobhan ; Mohan, Helen ; Roberts, Keith ; San Miguel-Méndez, Carlos ; Pockney, Peter ; Shaw, Richard ; Smart, Neil ; Stewart, Grant ; Sundar, Mrcog, Sudha ; Vidya, Raghavan ; Bhangu, Aneel ; Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana Ff ; Chaar, Mohammad Abou ; Evans, Jonathan ; Fiore, Marco ; Ganyli, Ian ; Kaafarani, Haytham Ma ; Sundar, Sudha ; Siaw-Acheampong, Kwabena ; Benson, Ruth ; Bywater, Edward ; Dawson, Brett ; Heritage, Emily ; Jones, Conor ; Kamarajah, Sivesh ; Khatri, Chetan ; Khaw, Rachel ; Keatley, James ; Knight, Andrew ; Lawday, Samuel ; Mann, Harvinder ; Marson, Ella ; Mclean, Kenneth ; Mills, Emily ; Pellino, Gianluca ; Picciochi, Maria ; Taylor, Elliott ; Tiwari, Abhinav ; Trout, Isobel ; Wilkin, Richard Jw ; Gallo, Gaetano ; Moug, Susan ; Pata, Francesco ; Di Saverio, Salomone ; Vallance, Abigail ; Vimalchandran, Dale ; Evans, Richard Pt ; Townend, Philip ; Isaac, John ; Satoi, Sohei ; Edwards, John ; Coonar, Aman ; Marchbank, Adrian ; Caruana, Edward ; Layton, Georgia ; Patel, Akshay ; Brunelli, Alessandro ; Gronchi, Alessandro ; Almond, Max ; Tirotta, Fabio ; Dumitra, Sinziana ; Price, Stephen ; Fountain, Daniel ; Jenkinson, Michael ; Hutchinson, Peter ; Marcus, Hani ; Piper, Rory ; Lippa, Laura ; Servadei, Franco ; Esene, Ignatius ; Freyschlag, Christian ; Neville, Iuri ; Rosseau, Gail ; Schaller, Karl ; Demetriades, Andreas ; Robertson, Faith ; Alamri, Alex</creatorcontrib><description>As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.20.01933</identifier><language>eng</language><publisher>American Society of Clinical Oncology</publisher><subject>Cancer ; Life Sciences</subject><ispartof>Journal of clinical oncology, 2021-01, Vol.39 (1), p.66-78</ispartof><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0009-0009-0538-8335 ; 0000-0002-2802-4974 ; 0000-0003-4743-620X ; 0000-0001-7688-5018 ; 0000-0002-7827-1033 ; 0000-0003-0577-4067 ; 0000-0001-7688-5018</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://hal.science/hal-04522516$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Glasbey, James</creatorcontrib><creatorcontrib>Nepogodiev, Dmitri</creatorcontrib><creatorcontrib>Simoes, Joana F.F.</creatorcontrib><creatorcontrib>Omar, Omar</creatorcontrib><creatorcontrib>Li, Elizabeth</creatorcontrib><creatorcontrib>Venn, Mary</creatorcontrib><creatorcontrib>Abou Chaar, Mohammad</creatorcontrib><creatorcontrib>Capizzi, Vita</creatorcontrib><creatorcontrib>Chaudhry, Daoud</creatorcontrib><creatorcontrib>Desai, Anant</creatorcontrib><creatorcontrib>Edwards, Jonathan</creatorcontrib><creatorcontrib>Evans, Jonathan</creatorcontrib><creatorcontrib>Fiore, Marco</creatorcontrib><creatorcontrib>Videria, Jose Flavio</creatorcontrib><creatorcontrib>Ford, Samuel</creatorcontrib><creatorcontrib>Ganly, Ian</creatorcontrib><creatorcontrib>Griffiths, Ewen</creatorcontrib><creatorcontrib>Gujjuri, Rohan</creatorcontrib><creatorcontrib>Kolias, Angelos</creatorcontrib><creatorcontrib>Kaafarani, Haytham M.A.</creatorcontrib><creatorcontrib>Minaya-Bravo, Ana</creatorcontrib><creatorcontrib>Mckay, Siobhan</creatorcontrib><creatorcontrib>Mohan, Helen</creatorcontrib><creatorcontrib>Roberts, Keith</creatorcontrib><creatorcontrib>San Miguel-Méndez, Carlos</creatorcontrib><creatorcontrib>Pockney, Peter</creatorcontrib><creatorcontrib>Shaw, Richard</creatorcontrib><creatorcontrib>Smart, Neil</creatorcontrib><creatorcontrib>Stewart, Grant</creatorcontrib><creatorcontrib>Sundar, Mrcog, Sudha</creatorcontrib><creatorcontrib>Vidya, Raghavan</creatorcontrib><creatorcontrib>Bhangu, Aneel</creatorcontrib><creatorcontrib>Glasbey, James</creatorcontrib><creatorcontrib>Nepogodiev, Dmitri</creatorcontrib><creatorcontrib>Simoes, Joana Ff</creatorcontrib><creatorcontrib>Chaar, Mohammad Abou</creatorcontrib><creatorcontrib>Evans, Jonathan</creatorcontrib><creatorcontrib>Fiore, Marco</creatorcontrib><creatorcontrib>Ganyli, Ian</creatorcontrib><creatorcontrib>Kaafarani, Haytham Ma</creatorcontrib><creatorcontrib>Sundar, Sudha</creatorcontrib><creatorcontrib>Siaw-Acheampong, Kwabena</creatorcontrib><creatorcontrib>Benson, Ruth</creatorcontrib><creatorcontrib>Bywater, Edward</creatorcontrib><creatorcontrib>Dawson, Brett</creatorcontrib><creatorcontrib>Heritage, Emily</creatorcontrib><creatorcontrib>Jones, Conor</creatorcontrib><creatorcontrib>Kamarajah, Sivesh</creatorcontrib><creatorcontrib>Khatri, Chetan</creatorcontrib><creatorcontrib>Khaw, Rachel</creatorcontrib><creatorcontrib>Keatley, James</creatorcontrib><creatorcontrib>Knight, Andrew</creatorcontrib><creatorcontrib>Lawday, Samuel</creatorcontrib><creatorcontrib>Mann, Harvinder</creatorcontrib><creatorcontrib>Marson, Ella</creatorcontrib><creatorcontrib>Mclean, Kenneth</creatorcontrib><creatorcontrib>Mills, Emily</creatorcontrib><creatorcontrib>Pellino, Gianluca</creatorcontrib><creatorcontrib>Picciochi, Maria</creatorcontrib><creatorcontrib>Taylor, Elliott</creatorcontrib><creatorcontrib>Tiwari, Abhinav</creatorcontrib><creatorcontrib>Trout, Isobel</creatorcontrib><creatorcontrib>Wilkin, Richard Jw</creatorcontrib><creatorcontrib>Gallo, Gaetano</creatorcontrib><creatorcontrib>Moug, Susan</creatorcontrib><creatorcontrib>Pata, Francesco</creatorcontrib><creatorcontrib>Di Saverio, Salomone</creatorcontrib><creatorcontrib>Vallance, Abigail</creatorcontrib><creatorcontrib>Vimalchandran, Dale</creatorcontrib><creatorcontrib>Evans, Richard Pt</creatorcontrib><creatorcontrib>Townend, Philip</creatorcontrib><creatorcontrib>Isaac, John</creatorcontrib><creatorcontrib>Satoi, Sohei</creatorcontrib><creatorcontrib>Edwards, John</creatorcontrib><creatorcontrib>Coonar, Aman</creatorcontrib><creatorcontrib>Marchbank, Adrian</creatorcontrib><creatorcontrib>Caruana, Edward</creatorcontrib><creatorcontrib>Layton, Georgia</creatorcontrib><creatorcontrib>Patel, Akshay</creatorcontrib><creatorcontrib>Brunelli, Alessandro</creatorcontrib><creatorcontrib>Gronchi, Alessandro</creatorcontrib><creatorcontrib>Almond, Max</creatorcontrib><creatorcontrib>Tirotta, Fabio</creatorcontrib><creatorcontrib>Dumitra, Sinziana</creatorcontrib><creatorcontrib>Price, Stephen</creatorcontrib><creatorcontrib>Fountain, Daniel</creatorcontrib><creatorcontrib>Jenkinson, Michael</creatorcontrib><creatorcontrib>Hutchinson, Peter</creatorcontrib><creatorcontrib>Marcus, Hani</creatorcontrib><creatorcontrib>Piper, Rory</creatorcontrib><creatorcontrib>Lippa, Laura</creatorcontrib><creatorcontrib>Servadei, Franco</creatorcontrib><creatorcontrib>Esene, Ignatius</creatorcontrib><creatorcontrib>Freyschlag, Christian</creatorcontrib><creatorcontrib>Neville, Iuri</creatorcontrib><creatorcontrib>Rosseau, Gail</creatorcontrib><creatorcontrib>Schaller, Karl</creatorcontrib><creatorcontrib>Demetriades, Andreas</creatorcontrib><creatorcontrib>Robertson, Faith</creatorcontrib><creatorcontrib>Alamri, Alex</creatorcontrib><title>Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study</title><title>Journal of clinical oncology</title><description>As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.</description><subject>Cancer</subject><subject>Life Sciences</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqVjctKAzEYRoMoOF52PkC2QjPm0jitu5K2tKJUHCnuhp9p7EQySclkKrPzHfQJfRJb9QVcfXDOgQ-hC0ZTxim9ulWLlNOUsqEQByhhkmcky6Q8RAnNBCdsIJ6P0UnTvFLK-gMhE_Q5sbqMZquxAlfqgPM2rHXosHFYLZbzMWHDr_ePadD6R5kSLH6AWL1B1-BxG4xb41jt5OgxJ8ovCd9pt9K1KW_wyOG5izo4iMY7sD1839poSr2HPax8vYEAv_e-8iHiPLar7gwdvYBt9PnfnqLL6eRJzUgFttgEU0PoCg-mmI3uij2jfcm5ZNdbJv7TfgPMiV_j</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Glasbey, James</creator><creator>Nepogodiev, Dmitri</creator><creator>Simoes, Joana F.F.</creator><creator>Omar, Omar</creator><creator>Li, Elizabeth</creator><creator>Venn, Mary</creator><creator>Abou Chaar, Mohammad</creator><creator>Capizzi, Vita</creator><creator>Chaudhry, Daoud</creator><creator>Desai, Anant</creator><creator>Edwards, Jonathan</creator><creator>Evans, Jonathan</creator><creator>Fiore, Marco</creator><creator>Videria, Jose Flavio</creator><creator>Ford, Samuel</creator><creator>Ganly, Ian</creator><creator>Griffiths, Ewen</creator><creator>Gujjuri, Rohan</creator><creator>Kolias, Angelos</creator><creator>Kaafarani, Haytham M.A.</creator><creator>Minaya-Bravo, Ana</creator><creator>Mckay, Siobhan</creator><creator>Mohan, Helen</creator><creator>Roberts, Keith</creator><creator>San Miguel-Méndez, Carlos</creator><creator>Pockney, Peter</creator><creator>Shaw, Richard</creator><creator>Smart, Neil</creator><creator>Stewart, Grant</creator><creator>Sundar, Mrcog, Sudha</creator><creator>Vidya, Raghavan</creator><creator>Bhangu, Aneel</creator><creator>Glasbey, James</creator><creator>Nepogodiev, 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Jw</creator><creator>Gallo, Gaetano</creator><creator>Moug, Susan</creator><creator>Pata, Francesco</creator><creator>Di Saverio, Salomone</creator><creator>Vallance, Abigail</creator><creator>Vimalchandran, Dale</creator><creator>Evans, Richard Pt</creator><creator>Townend, Philip</creator><creator>Isaac, John</creator><creator>Satoi, Sohei</creator><creator>Edwards, John</creator><creator>Coonar, Aman</creator><creator>Marchbank, Adrian</creator><creator>Caruana, Edward</creator><creator>Layton, Georgia</creator><creator>Patel, Akshay</creator><creator>Brunelli, Alessandro</creator><creator>Gronchi, Alessandro</creator><creator>Almond, Max</creator><creator>Tirotta, Fabio</creator><creator>Dumitra, Sinziana</creator><creator>Price, Stephen</creator><creator>Fountain, Daniel</creator><creator>Jenkinson, Michael</creator><creator>Hutchinson, Peter</creator><creator>Marcus, Hani</creator><creator>Piper, Rory</creator><creator>Lippa, Laura</creator><creator>Servadei, Franco</creator><creator>Esene, Ignatius</creator><creator>Freyschlag, Christian</creator><creator>Neville, Iuri</creator><creator>Rosseau, Gail</creator><creator>Schaller, Karl</creator><creator>Demetriades, Andreas</creator><creator>Robertson, Faith</creator><creator>Alamri, Alex</creator><general>American Society of Clinical Oncology</general><scope>1XC</scope><orcidid>https://orcid.org/0009-0009-0538-8335</orcidid><orcidid>https://orcid.org/0000-0002-2802-4974</orcidid><orcidid>https://orcid.org/0000-0003-4743-620X</orcidid><orcidid>https://orcid.org/0000-0001-7688-5018</orcidid><orcidid>https://orcid.org/0000-0002-7827-1033</orcidid><orcidid>https://orcid.org/0000-0003-0577-4067</orcidid><orcidid>https://orcid.org/0000-0001-7688-5018</orcidid></search><sort><creationdate>20210101</creationdate><title>Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study</title><author>Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana F.F. ; Omar, Omar ; Li, Elizabeth ; Venn, Mary ; Abou Chaar, Mohammad ; Capizzi, Vita ; Chaudhry, Daoud ; Desai, Anant ; Edwards, Jonathan ; Evans, Jonathan ; Fiore, Marco ; Videria, Jose Flavio ; Ford, Samuel ; Ganly, Ian ; Griffiths, Ewen ; Gujjuri, Rohan ; Kolias, Angelos ; Kaafarani, Haytham M.A. ; Minaya-Bravo, Ana ; Mckay, Siobhan ; Mohan, Helen ; Roberts, Keith ; San Miguel-Méndez, Carlos ; Pockney, Peter ; Shaw, Richard ; Smart, Neil ; Stewart, Grant ; Sundar, Mrcog, Sudha ; Vidya, Raghavan ; Bhangu, Aneel ; Glasbey, James ; Nepogodiev, Dmitri ; Simoes, Joana Ff ; Chaar, Mohammad Abou ; Evans, Jonathan ; Fiore, Marco ; Ganyli, Ian ; Kaafarani, Haytham Ma ; Sundar, Sudha ; Siaw-Acheampong, Kwabena ; Benson, Ruth ; Bywater, Edward ; Dawson, Brett ; Heritage, Emily ; Jones, Conor ; Kamarajah, Sivesh ; Khatri, Chetan ; Khaw, Rachel ; Keatley, James ; Knight, Andrew ; Lawday, Samuel ; Mann, Harvinder ; Marson, Ella ; Mclean, Kenneth ; Mills, Emily ; Pellino, Gianluca ; Picciochi, Maria ; Taylor, Elliott ; Tiwari, Abhinav ; Trout, Isobel ; Wilkin, Richard Jw ; Gallo, Gaetano ; Moug, Susan ; Pata, Francesco ; Di Saverio, Salomone ; Vallance, Abigail ; Vimalchandran, Dale ; Evans, Richard Pt ; Townend, Philip ; Isaac, John ; Satoi, Sohei ; Edwards, John ; Coonar, Aman ; Marchbank, Adrian ; Caruana, Edward ; Layton, Georgia ; Patel, Akshay ; Brunelli, Alessandro ; Gronchi, Alessandro ; Almond, Max ; Tirotta, Fabio ; Dumitra, Sinziana ; Price, Stephen ; Fountain, Daniel ; Jenkinson, Michael ; Hutchinson, Peter ; Marcus, Hani ; Piper, Rory ; Lippa, Laura ; Servadei, Franco ; Esene, Ignatius ; Freyschlag, Christian ; Neville, Iuri ; Rosseau, Gail ; Schaller, Karl ; Demetriades, Andreas ; Robertson, Faith ; Alamri, Alex</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-hal_primary_oai_HAL_hal_04522516v13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer</topic><topic>Life Sciences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Glasbey, James</creatorcontrib><creatorcontrib>Nepogodiev, Dmitri</creatorcontrib><creatorcontrib>Simoes, Joana F.F.</creatorcontrib><creatorcontrib>Omar, Omar</creatorcontrib><creatorcontrib>Li, Elizabeth</creatorcontrib><creatorcontrib>Venn, Mary</creatorcontrib><creatorcontrib>Abou Chaar, Mohammad</creatorcontrib><creatorcontrib>Capizzi, Vita</creatorcontrib><creatorcontrib>Chaudhry, Daoud</creatorcontrib><creatorcontrib>Desai, Anant</creatorcontrib><creatorcontrib>Edwards, Jonathan</creatorcontrib><creatorcontrib>Evans, Jonathan</creatorcontrib><creatorcontrib>Fiore, Marco</creatorcontrib><creatorcontrib>Videria, Jose Flavio</creatorcontrib><creatorcontrib>Ford, Samuel</creatorcontrib><creatorcontrib>Ganly, Ian</creatorcontrib><creatorcontrib>Griffiths, Ewen</creatorcontrib><creatorcontrib>Gujjuri, Rohan</creatorcontrib><creatorcontrib>Kolias, Angelos</creatorcontrib><creatorcontrib>Kaafarani, Haytham M.A.</creatorcontrib><creatorcontrib>Minaya-Bravo, Ana</creatorcontrib><creatorcontrib>Mckay, Siobhan</creatorcontrib><creatorcontrib>Mohan, Helen</creatorcontrib><creatorcontrib>Roberts, Keith</creatorcontrib><creatorcontrib>San Miguel-Méndez, Carlos</creatorcontrib><creatorcontrib>Pockney, Peter</creatorcontrib><creatorcontrib>Shaw, Richard</creatorcontrib><creatorcontrib>Smart, Neil</creatorcontrib><creatorcontrib>Stewart, Grant</creatorcontrib><creatorcontrib>Sundar, Mrcog, Sudha</creatorcontrib><creatorcontrib>Vidya, Raghavan</creatorcontrib><creatorcontrib>Bhangu, Aneel</creatorcontrib><creatorcontrib>Glasbey, James</creatorcontrib><creatorcontrib>Nepogodiev, Dmitri</creatorcontrib><creatorcontrib>Simoes, Joana Ff</creatorcontrib><creatorcontrib>Chaar, Mohammad Abou</creatorcontrib><creatorcontrib>Evans, Jonathan</creatorcontrib><creatorcontrib>Fiore, Marco</creatorcontrib><creatorcontrib>Ganyli, Ian</creatorcontrib><creatorcontrib>Kaafarani, Haytham Ma</creatorcontrib><creatorcontrib>Sundar, Sudha</creatorcontrib><creatorcontrib>Siaw-Acheampong, Kwabena</creatorcontrib><creatorcontrib>Benson, Ruth</creatorcontrib><creatorcontrib>Bywater, Edward</creatorcontrib><creatorcontrib>Dawson, Brett</creatorcontrib><creatorcontrib>Heritage, Emily</creatorcontrib><creatorcontrib>Jones, Conor</creatorcontrib><creatorcontrib>Kamarajah, Sivesh</creatorcontrib><creatorcontrib>Khatri, Chetan</creatorcontrib><creatorcontrib>Khaw, Rachel</creatorcontrib><creatorcontrib>Keatley, James</creatorcontrib><creatorcontrib>Knight, Andrew</creatorcontrib><creatorcontrib>Lawday, Samuel</creatorcontrib><creatorcontrib>Mann, Harvinder</creatorcontrib><creatorcontrib>Marson, Ella</creatorcontrib><creatorcontrib>Mclean, Kenneth</creatorcontrib><creatorcontrib>Mills, Emily</creatorcontrib><creatorcontrib>Pellino, Gianluca</creatorcontrib><creatorcontrib>Picciochi, Maria</creatorcontrib><creatorcontrib>Taylor, Elliott</creatorcontrib><creatorcontrib>Tiwari, Abhinav</creatorcontrib><creatorcontrib>Trout, Isobel</creatorcontrib><creatorcontrib>Wilkin, Richard Jw</creatorcontrib><creatorcontrib>Gallo, Gaetano</creatorcontrib><creatorcontrib>Moug, Susan</creatorcontrib><creatorcontrib>Pata, Francesco</creatorcontrib><creatorcontrib>Di Saverio, Salomone</creatorcontrib><creatorcontrib>Vallance, Abigail</creatorcontrib><creatorcontrib>Vimalchandran, Dale</creatorcontrib><creatorcontrib>Evans, Richard Pt</creatorcontrib><creatorcontrib>Townend, Philip</creatorcontrib><creatorcontrib>Isaac, John</creatorcontrib><creatorcontrib>Satoi, Sohei</creatorcontrib><creatorcontrib>Edwards, John</creatorcontrib><creatorcontrib>Coonar, Aman</creatorcontrib><creatorcontrib>Marchbank, Adrian</creatorcontrib><creatorcontrib>Caruana, Edward</creatorcontrib><creatorcontrib>Layton, Georgia</creatorcontrib><creatorcontrib>Patel, Akshay</creatorcontrib><creatorcontrib>Brunelli, Alessandro</creatorcontrib><creatorcontrib>Gronchi, Alessandro</creatorcontrib><creatorcontrib>Almond, Max</creatorcontrib><creatorcontrib>Tirotta, Fabio</creatorcontrib><creatorcontrib>Dumitra, Sinziana</creatorcontrib><creatorcontrib>Price, Stephen</creatorcontrib><creatorcontrib>Fountain, Daniel</creatorcontrib><creatorcontrib>Jenkinson, Michael</creatorcontrib><creatorcontrib>Hutchinson, Peter</creatorcontrib><creatorcontrib>Marcus, Hani</creatorcontrib><creatorcontrib>Piper, Rory</creatorcontrib><creatorcontrib>Lippa, Laura</creatorcontrib><creatorcontrib>Servadei, Franco</creatorcontrib><creatorcontrib>Esene, Ignatius</creatorcontrib><creatorcontrib>Freyschlag, Christian</creatorcontrib><creatorcontrib>Neville, Iuri</creatorcontrib><creatorcontrib>Rosseau, Gail</creatorcontrib><creatorcontrib>Schaller, Karl</creatorcontrib><creatorcontrib>Demetriades, Andreas</creatorcontrib><creatorcontrib>Robertson, Faith</creatorcontrib><creatorcontrib>Alamri, Alex</creatorcontrib><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Glasbey, James</au><au>Nepogodiev, Dmitri</au><au>Simoes, Joana F.F.</au><au>Omar, Omar</au><au>Li, Elizabeth</au><au>Venn, Mary</au><au>Abou Chaar, Mohammad</au><au>Capizzi, Vita</au><au>Chaudhry, Daoud</au><au>Desai, Anant</au><au>Edwards, Jonathan</au><au>Evans, Jonathan</au><au>Fiore, Marco</au><au>Videria, Jose Flavio</au><au>Ford, Samuel</au><au>Ganly, Ian</au><au>Griffiths, Ewen</au><au>Gujjuri, Rohan</au><au>Kolias, Angelos</au><au>Kaafarani, Haytham M.A.</au><au>Minaya-Bravo, Ana</au><au>Mckay, Siobhan</au><au>Mohan, Helen</au><au>Roberts, Keith</au><au>San Miguel-Méndez, Carlos</au><au>Pockney, Peter</au><au>Shaw, Richard</au><au>Smart, Neil</au><au>Stewart, Grant</au><au>Sundar, Mrcog, Sudha</au><au>Vidya, Raghavan</au><au>Bhangu, Aneel</au><au>Glasbey, James</au><au>Nepogodiev, Dmitri</au><au>Simoes, Joana Ff</au><au>Chaar, Mohammad Abou</au><au>Evans, Jonathan</au><au>Fiore, Marco</au><au>Ganyli, Ian</au><au>Kaafarani, Haytham Ma</au><au>Sundar, Sudha</au><au>Siaw-Acheampong, Kwabena</au><au>Benson, Ruth</au><au>Bywater, Edward</au><au>Dawson, Brett</au><au>Heritage, Emily</au><au>Jones, Conor</au><au>Kamarajah, Sivesh</au><au>Khatri, Chetan</au><au>Khaw, Rachel</au><au>Keatley, James</au><au>Knight, Andrew</au><au>Lawday, Samuel</au><au>Mann, Harvinder</au><au>Marson, Ella</au><au>Mclean, Kenneth</au><au>Mills, Emily</au><au>Pellino, Gianluca</au><au>Picciochi, Maria</au><au>Taylor, Elliott</au><au>Tiwari, Abhinav</au><au>Trout, Isobel</au><au>Wilkin, Richard Jw</au><au>Gallo, Gaetano</au><au>Moug, Susan</au><au>Pata, Francesco</au><au>Di Saverio, Salomone</au><au>Vallance, Abigail</au><au>Vimalchandran, Dale</au><au>Evans, Richard Pt</au><au>Townend, Philip</au><au>Isaac, John</au><au>Satoi, Sohei</au><au>Edwards, John</au><au>Coonar, Aman</au><au>Marchbank, Adrian</au><au>Caruana, Edward</au><au>Layton, Georgia</au><au>Patel, Akshay</au><au>Brunelli, Alessandro</au><au>Gronchi, Alessandro</au><au>Almond, Max</au><au>Tirotta, Fabio</au><au>Dumitra, Sinziana</au><au>Price, Stephen</au><au>Fountain, Daniel</au><au>Jenkinson, Michael</au><au>Hutchinson, Peter</au><au>Marcus, Hani</au><au>Piper, Rory</au><au>Lippa, Laura</au><au>Servadei, Franco</au><au>Esene, Ignatius</au><au>Freyschlag, Christian</au><au>Neville, Iuri</au><au>Rosseau, Gail</au><au>Schaller, Karl</au><au>Demetriades, Andreas</au><au>Robertson, Faith</au><au>Alamri, Alex</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study</atitle><jtitle>Journal of clinical oncology</jtitle><date>2021-01-01</date><risdate>2021</risdate><volume>39</volume><issue>1</issue><spage>66</spage><epage>78</epage><pages>66-78</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.</abstract><pub>American Society of Clinical Oncology</pub><doi>10.1200/JCO.20.01933</doi><orcidid>https://orcid.org/0009-0009-0538-8335</orcidid><orcidid>https://orcid.org/0000-0002-2802-4974</orcidid><orcidid>https://orcid.org/0000-0003-4743-620X</orcidid><orcidid>https://orcid.org/0000-0001-7688-5018</orcidid><orcidid>https://orcid.org/0000-0002-7827-1033</orcidid><orcidid>https://orcid.org/0000-0003-0577-4067</orcidid><orcidid>https://orcid.org/0000-0001-7688-5018</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0732-183X |
| ispartof | Journal of clinical oncology, 2021-01, Vol.39 (1), p.66-78 |
| issn | 0732-183X 1527-7755 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_04522516v1 |
| source | American Society of Clinical Oncology Online Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Cancer Life Sciences |
| title | Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study |
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