A systematic review and meta-analysis of surgery delays and survival in breast, lung and colon cancers: Implication for surgical triage during the COVID-19 pandemic

Brett A. Johnson, Anthony C. Waddimba, Gerald O. Ogola, James W. Fleshman, John T. Preskitt

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Background: Thousands of cancer surgeries were delayed during the peak of the COVID-19 pandemic. This study examines if surgical delays impact survival for breast, lung and colon cancers. Methods: PubMed/MEDLINE, EMBASE, Cochrane Library and Web of Science were searched. Articles evaluating the relationship between delays in surgery and overall survival (OS), disease-free survival (DFS) or cancer-specific survival (CSS) were included. Results: Of the 14,422 articles screened, 25 were included in the review and 18 (totaling 2,533,355 patients) were pooled for meta-analyses. Delaying surgery for 12 weeks may decrease OS in breast (HR 1.46, 95%CI 1.28–1.65), lung (HR 1.04, 95%CI 1.02–1.06) and colon (HR 1.24, 95%CI 1.12–1.38) cancers. When breast cancers were analyzed by stage, OS was decreased in stages I (HR 1.27, 95%CI 1.16–1.40) and II (HR 1.13, 95%CI 1.02–1.24) but not in stage III (HR 1.20, 95%CI 0.94–1.53). Conclusion: Delaying breast, lung and colon cancer surgeries during the COVID-19 pandemic may decrease survival.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalAmerican journal of surgery
Volume222
Issue number2
DOIs
StatePublished - Aug 2021
Externally publishedYes

Keywords

  • Breast
  • COVID-19
  • Cancer
  • Colon
  • Lung
  • Surgery

ASJC Scopus subject areas

  • Surgery

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