TY - JOUR
T1 - Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection
AU - D3CODE Team
AU - Kothari, Anai N.
AU - DiBrito, Sandra R.
AU - Lee, J. Jack
AU - Caudle, Abigail S.
AU - Clemens, Mark W.
AU - Gottumukkala, Vijaya N.
AU - Katz, Matthew H.G.
AU - Offodile, Anaeze C.
AU - Uppal, Abhineet
AU - Chang, George J.
N1 - Funding Information:
The authors would like to especially acknowledge the contribution of Andrew T. Trans, Mark Knafl, and Benju Vicknamparampil, members of the D3CODE Team at MD Anderson. This work is supported in part by the National Cancer Institute of the National Institutes of Health under Award Number CA016672 (The University of Texas MD Anderson Cancer Center Support Grant).
Publisher Copyright:
© 2021, Society of Surgical Oncology.
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
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U2 - 10.1245/s10434-021-10291-9
DO - 10.1245/s10434-021-10291-9
M3 - Article
C2 - 34176060
AN - SCOPUS:85111381061
SN - 1068-9265
VL - 28
SP - 8046
EP - 8053
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 13
ER -