TY - JOUR
T1 - A systematic review and meta-analysis of surgery delays and survival in breast, lung and colon cancers
T2 - Implication for surgical triage during the COVID-19 pandemic
AU - Johnson, Brett A.
AU - Waddimba, Anthony C.
AU - Ogola, Gerald O.
AU - Fleshman, James W.
AU - Preskitt, John T.
N1 - Funding Information:
None.
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Breast
KW - Cancer
KW - Colon
KW - COVID-19
KW - Lung
KW - Surgery
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U2 - 10.1016/j.amjsurg.2020.12.015
DO - 10.1016/j.amjsurg.2020.12.015
M3 - Review article
C2 - 33317814
AN - SCOPUS:85097765078
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
ER -