Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
Background An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients wi...
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| Veröffentlicht in: | Annals of surgical oncology 2021-12, Vol.28 (13), p.8046-8053 |
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| container_title | Annals of surgical oncology |
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| creator | Kothari, Anai N. DiBrito, Sandra R. Lee, J. Jack Caudle, Abigail S. Clemens, Mark W. Gottumukkala, Vijaya N. Katz, Matthew H. G. Offodile, Anaeze C. Uppal, Abhineet Chang, George J. |
| description | Background
An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer.
Methods
This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event.
Results
A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%,
p
= 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3],
p
= 0.01).
Conclusions
A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections. |
| doi_str_mv | 10.1245/s10434-021-10291-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8235912</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2597364196</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-657bf7048de5adeb84543b47502690fb29eb9aeb66d0d69344988b5d9c7795183</originalsourceid><addsrcrecordid>eNp9kUtrFTEYhgdR7EX_gAsJuOkmmvtMNsLhUG2hpdJatyGT-eaYMpMck5kDBX-8GU-tl4WrhOR53-TjqapXlLylTMh3mRLBBSaMYkqYplg_qQ6pLEdCNfRp2RPVYM2UPKiOcr4jhNacyOfVARe0VkSRw-r7zZw23tkBXc2TiyNk5ANa2-AgoU928hCmjG5DB2kTfdig0wHc5HeAliCke7Tqp4Jeg4s7SAvRpziiSz90eIr4MpaknQq-ur7B6_gFM3Qe-qUjhhfVs94OGV4-rMfV7YfTz-szfHH18Xy9usBO1GLCStZtXxPRdCBtB20jpOCtqCVhSpO-ZRpabaFVqiOd0lwI3TSt7LSray1pw4-r9_ve7dyO0LkyU7KD2SY_2nRvovXm75vgv5pN3JmGcakpKwUnDwUpfpshT2b02cEw2ABxzoZJIXWjNacFffMPehfnFMp4hdI1V4JqVSi2p1yKOSfoHz9DiVnkmr1cU-San3KNLqHXf47xGPllswB8D-TtYgLS77f_U_sDtYCwKg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2597364196</pqid></control><display><type>article</type><title>Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><creator>Kothari, Anai N. ; DiBrito, Sandra R. ; Lee, J. Jack ; Caudle, Abigail S. ; Clemens, Mark W. ; Gottumukkala, Vijaya N. ; Katz, Matthew H. G. ; Offodile, Anaeze C. ; Uppal, Abhineet ; Chang, George J.</creator><creatorcontrib>Kothari, Anai N. ; DiBrito, Sandra R. ; Lee, J. Jack ; Caudle, Abigail S. ; Clemens, Mark W. ; Gottumukkala, Vijaya N. ; Katz, Matthew H. G. ; Offodile, Anaeze C. ; Uppal, Abhineet ; Chang, George J. ; D3CODE Team ; D3CODE Team</creatorcontrib><description>Background
An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer.
Methods
This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event.
Results
A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%,
p
= 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3],
p
= 0.01).
Conclusions
A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-10291-9</identifier><identifier>PMID: 34176060</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Cancer ; Cohort Studies ; Complications ; COVID-19 ; Elective surgery ; Elective Surgical Procedures ; Global Health Services Research ; Humans ; Infections ; Medicine ; Medicine & Public Health ; Neoplasms - surgery ; Oncology ; Patients ; Postoperative ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Surgery ; Surgical Oncology ; Surgical outcomes ; Thromboembolism ; Treatment Outcome</subject><ispartof>Annals of surgical oncology, 2021-12, Vol.28 (13), p.8046-8053</ispartof><rights>Society of Surgical Oncology 2021</rights><rights>2021. Society of Surgical Oncology.</rights><rights>Society of Surgical Oncology 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-657bf7048de5adeb84543b47502690fb29eb9aeb66d0d69344988b5d9c7795183</citedby><cites>FETCH-LOGICAL-c474t-657bf7048de5adeb84543b47502690fb29eb9aeb66d0d69344988b5d9c7795183</cites><orcidid>0000-0002-9758-5361</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-10291-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-10291-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34176060$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kothari, Anai N.</creatorcontrib><creatorcontrib>DiBrito, Sandra R.</creatorcontrib><creatorcontrib>Lee, J. Jack</creatorcontrib><creatorcontrib>Caudle, Abigail S.</creatorcontrib><creatorcontrib>Clemens, Mark W.</creatorcontrib><creatorcontrib>Gottumukkala, Vijaya N.</creatorcontrib><creatorcontrib>Katz, Matthew H. G.</creatorcontrib><creatorcontrib>Offodile, Anaeze C.</creatorcontrib><creatorcontrib>Uppal, Abhineet</creatorcontrib><creatorcontrib>Chang, George J.</creatorcontrib><creatorcontrib>D3CODE Team</creatorcontrib><creatorcontrib>D3CODE Team</creatorcontrib><title>Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer.
Methods
This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event.
Results
A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%,
p
= 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3],
p
= 0.01).
Conclusions
A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections.</description><subject>Cancer</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>COVID-19</subject><subject>Elective surgery</subject><subject>Elective Surgical Procedures</subject><subject>Global Health Services Research</subject><subject>Humans</subject><subject>Infections</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasms - surgery</subject><subject>Oncology</subject><subject>Patients</subject><subject>Postoperative</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical outcomes</subject><subject>Thromboembolism</subject><subject>Treatment Outcome</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUtrFTEYhgdR7EX_gAsJuOkmmvtMNsLhUG2hpdJatyGT-eaYMpMck5kDBX-8GU-tl4WrhOR53-TjqapXlLylTMh3mRLBBSaMYkqYplg_qQ6pLEdCNfRp2RPVYM2UPKiOcr4jhNacyOfVARe0VkSRw-r7zZw23tkBXc2TiyNk5ANa2-AgoU928hCmjG5DB2kTfdig0wHc5HeAliCke7Tqp4Jeg4s7SAvRpziiSz90eIr4MpaknQq-ur7B6_gFM3Qe-qUjhhfVs94OGV4-rMfV7YfTz-szfHH18Xy9usBO1GLCStZtXxPRdCBtB20jpOCtqCVhSpO-ZRpabaFVqiOd0lwI3TSt7LSray1pw4-r9_ve7dyO0LkyU7KD2SY_2nRvovXm75vgv5pN3JmGcakpKwUnDwUpfpshT2b02cEw2ABxzoZJIXWjNacFffMPehfnFMp4hdI1V4JqVSi2p1yKOSfoHz9DiVnkmr1cU-San3KNLqHXf47xGPllswB8D-TtYgLS77f_U_sDtYCwKg</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Kothari, Anai N.</creator><creator>DiBrito, Sandra R.</creator><creator>Lee, J. Jack</creator><creator>Caudle, Abigail S.</creator><creator>Clemens, Mark W.</creator><creator>Gottumukkala, Vijaya N.</creator><creator>Katz, Matthew H. G.</creator><creator>Offodile, Anaeze C.</creator><creator>Uppal, Abhineet</creator><creator>Chang, George J.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9758-5361</orcidid></search><sort><creationdate>20211201</creationdate><title>Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection</title><author>Kothari, Anai N. ; DiBrito, Sandra R. ; Lee, J. Jack ; Caudle, Abigail S. ; Clemens, Mark W. ; Gottumukkala, Vijaya N. ; Katz, Matthew H. G. ; Offodile, Anaeze C. ; Uppal, Abhineet ; Chang, George J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-657bf7048de5adeb84543b47502690fb29eb9aeb66d0d69344988b5d9c7795183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer</topic><topic>Cohort Studies</topic><topic>Complications</topic><topic>COVID-19</topic><topic>Elective surgery</topic><topic>Elective Surgical Procedures</topic><topic>Global Health Services Research</topic><topic>Humans</topic><topic>Infections</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasms - surgery</topic><topic>Oncology</topic><topic>Patients</topic><topic>Postoperative</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical outcomes</topic><topic>Thromboembolism</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kothari, Anai N.</creatorcontrib><creatorcontrib>DiBrito, Sandra R.</creatorcontrib><creatorcontrib>Lee, J. Jack</creatorcontrib><creatorcontrib>Caudle, Abigail S.</creatorcontrib><creatorcontrib>Clemens, Mark W.</creatorcontrib><creatorcontrib>Gottumukkala, Vijaya N.</creatorcontrib><creatorcontrib>Katz, Matthew H. G.</creatorcontrib><creatorcontrib>Offodile, Anaeze C.</creatorcontrib><creatorcontrib>Uppal, Abhineet</creatorcontrib><creatorcontrib>Chang, George J.</creatorcontrib><creatorcontrib>D3CODE Team</creatorcontrib><creatorcontrib>D3CODE Team</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kothari, Anai N.</au><au>DiBrito, Sandra R.</au><au>Lee, J. Jack</au><au>Caudle, Abigail S.</au><au>Clemens, Mark W.</au><au>Gottumukkala, Vijaya N.</au><au>Katz, Matthew H. G.</au><au>Offodile, Anaeze C.</au><au>Uppal, Abhineet</au><au>Chang, George J.</au><aucorp>D3CODE Team</aucorp><aucorp>D3CODE Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>28</volume><issue>13</issue><spage>8046</spage><epage>8053</epage><pages>8046-8053</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer.
Methods
This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event.
Results
A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20–202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%,
p
= 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6–34.3],
p
= 0.01).
Conclusions
A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34176060</pmid><doi>10.1245/s10434-021-10291-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9758-5361</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2021-12, Vol.28 (13), p.8046-8053 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink (Online service) |
| subjects | Cancer Cohort Studies Complications COVID-19 Elective surgery Elective Surgical Procedures Global Health Services Research Humans Infections Medicine Medicine & Public Health Neoplasms - surgery Oncology Patients Postoperative SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Surgery Surgical Oncology Surgical outcomes Thromboembolism Treatment Outcome |
| title | Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection |
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