The effect of delays in cancer surgery due to the COVID-19 pandemic on cancer resectability and postoperative mortality in different tumor entities
During the COVID-19 pandemic, prioritization of COVID-19 patients led to delays in oncological surgery, potentially impacting patient outcomes. This analysis examines the effects of surgical delays in various tumor entities on resectability and postoperative mortality. Data from the COVIDSurg Cancer Collaborative, an international prospective cohort study with 19,676 patients, collected between March 26, 2020, and September 16, 2020, were analyzed. Postoperative mortality and complete resection (R0) were the outcomes, with tumor entity, stage and delay to surgery as key exposures. 17,486 patients underwent surgery during the study period, at a median time of three weeks after decision to operate (IQR = 4). 172 (1.0%) patients died within 30 days postoperatively. 15,143 (90.5%) patients had an R0 resection, 1352 (8.1%) an R1 resection and 230 (1.4%) had an R2 resection. Postoperative mortality was highest for oesophageal cancer (3.9%) and UICC stage IV (1.5%). For the overall population, there was no association between delay to surgery and resectability. There was an association between delay to surgery and postoperative mortality (p < 0.001), with the highest 30-day postoperative mortality observed for operations within two weeks following surgical decision. Tumor resectability and postoperative mortality in oncological surgeries are influenced by various factors. During the COVID-19 pandemic, moderate delays in surgeries were observed, with differences across tumor types, UICC stages and regions. While no tangible effects on resectability were found, postoperative mortality was higher after a shorter delay to surgery.
Authors
- Laura Lippa (ORCID: https://orcid.org/0000-0001-9920-430X)
- Mary L Venn (ORCID: https://orcid.org/0000-0002-3015-7039)
- Elliott H Taylor (ORCID: https://orcid.org/0000-0002-8462-6582)
- Juan Rey Biel
- Rory J. Piper (ORCID: https://orcid.org/0000-0002-6422-5853)
- K. Roberts
- Georgia R. Layton (ORCID: https://orcid.org/0000-0002-2209-0559)
- Ella J Marson
- Neil Smart (ORCID: https://orcid.org/0000-0002-3043-8324)
- Emily C. Mills (ORCID: https://orcid.org/0000-0001-5397-8836)
- James M Keatley
- Ulrich Ronellenfitsch (ORCID: https://orcid.org/0000-0003-1107-813X)
- Gaetano Gallo (ORCID: https://orcid.org/0000-0003-1066-4671)
- Siobhan McKay (ORCID: https://orcid.org/0000-0003-0590-2153)
- Gianluca Pellino (ORCID: https://orcid.org/0000-0002-8322-6421)
- Salomone Di Saverio (ORCID: https://orcid.org/0000-0001-5685-5022)
- Jörg Kleeff (ORCID: https://orcid.org/0000-0003-3432-6669)
- Raghavan Vidya (ORCID: https://orcid.org/0000-0002-6129-2444)
- G. Rosseau
- Samuel Lawday (ORCID: https://orcid.org/0000-0001-9165-4023)
- Ruth Benson (ORCID: https://orcid.org/0000-0001-5889-4391)
- Stuart C. Winter (ORCID: https://orcid.org/0000-0002-8152-816X)
- Elizabeth Li (ORCID: https://orcid.org/0000-0001-5961-2894)
- Isobel M Trout
- Ewen A. Griffiths (ORCID: https://orcid.org/0000-0001-6630-3547)
- Chetan Khatri (ORCID: https://orcid.org/0000-0002-3961-1314)
- Abhinav Tiwari (ORCID: https://orcid.org/0000-0001-7860-7361)
- Max Almond (ORCID: https://orcid.org/0000-0003-4133-312X)
- Francesco Pata (ORCID: https://orcid.org/0000-0003-2634-1199)
- Rohan R Gujjuri (ORCID: https://orcid.org/0000-0002-3998-8162)
- Richard Wilkin (ORCID: https://orcid.org/0000-0001-5459-3962)
- Michael D. Jenkinson (ORCID: https://orcid.org/0000-0003-4587-2139)
- Maria Picciochi (ORCID: https://orcid.org/0000-0003-0397-5076)
- Jagdeep K. Singh (ORCID: https://orcid.org/0000-0003-4539-5870)
- Emily Heritage
- Fabio Tirotta (ORCID: https://orcid.org/0000-0003-0631-9867)
- Brett E Dawson
- Ewen M. Harrison (ORCID: https://orcid.org/0000-0002-5018-3066)
- Sohei Satoi (ORCID: https://orcid.org/0000-0001-6527-5409)
- Hani Joseph Marcus (ORCID: https://orcid.org/0000-0001-8000-392X)
- Alex Wilkins (ORCID: https://orcid.org/0000-0002-5557-2263)
- Franco Servadei (ORCID: https://orcid.org/0000-0002-3595-3464)
- Sivesh K. Kamarajah (ORCID: https://orcid.org/0000-0002-2748-0011)
- Dale Vimalchandran
- Stephen John Price (ORCID: https://orcid.org/0000-0002-7535-3009)
- Peter Pockney
- Harvinder Mann
- Richard Evans
- Karl Schaller (ORCID: https://orcid.org/0009-0001-8477-5553)
- Lisa Rieder
- Martin Batstone
- Daniel M. Fountain
- Christian Freyschlag
- Siobhan C. McKay
- Aneel A. Bhangu
- Rachel A. Khaw
- Andrew Knight
- Peter J. Hutchinson
- CovidSurg Collaborative
- Iuri Neville
- Kenneth A. McLean
- Akshay Patel
- John Isaac
- Andrew G. Schache
- Kwabena Siaw-Acheampong
- Andreas K. Demetriades
- Michael Ho
- Paul Nankivell
- Sinziana Dumitra
- Conor S. Jones
- Abigail Vallance
- Daoud Chaudhry
- Dmitri Nepogodiev
- Angelos Kolias
- Anant Desai
- Adrian Marchbank
- Alessandro Brunelli
- Jonathan P. Evans
- Aman S. Coonar
- Antonia L. Stengler
- Ana Minaya-Bravo
- Faith Robertson
- Philip Townend
- Alessandro Gronchi
- James C. Glasbey
- Richard Shaw
- Samuel Ford
- Edward J. Caruana
- Marco Fiore
- Alex Alamri
- Susan Moug
- Ignatius Esene
- Edward Bywater
- Ian Ganly
- Joana F. F. Simoes
- John Edwards
Institutions
- Edinburgh College (GB)
- University Hospital in Halle (DE)
- Martin Luther University Halle-Wittenberg (DE)
- University of Birmingham (GB)
- University of Edinburgh (GB)
Publication Details
- Journal
- Discover Oncology
- Published
- 2026-05-09
- DOI
- https://doi.org/10.1007/s12672-026-04430-5
- Primary Topic
- COVID-19 and healthcare impacts
- Type
- article
- Field-Weighted Citation Impact
- 0.00