Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection.

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.

• Authors: Anai N Kothari, Sandra R DiBrito, J Jack Lee, Abigail S Caudle, Mark W Clemens, Vijaya N Gottumukkala, Matthew H G Katz, Anaeze C Offodile, Abhineet Uppal, D3CODE Team, George J Chang
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 28 Issue 13 Pg. 8046-8053 (Dec 2021) ISSN: 1534-4681 [Electronic] United States
• PMID: 34176060 (Publication Type: Journal Article)
• Copyright: © 2021. Society of Surgical Oncology.

Topics

• COVID-19
• Cohort Studies
• Elective Surgical Procedures
• Humans
• Neoplasms (surgery)
• SARS-CoV-2
• Treatment Outcome