CRC surgery delay may reduce survival

  • Fligor SC & al.
  • J Gastrointest Surg
  • 30 Jun 2020

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A review of studies in colorectal cancer (CRC), pancreatic cancer, and gastric cancer finds surgical delay may result in reduced survival in CRC.
  • The review found no clear evidence in pancreatic or gastric cancer.

Why this matters

  • Surgical delays have become common in gastrointestinal cancers during the COVID-19 pandemic.
  • The findings could help prioritize surgical procedures during this time.
  • The authors suggest that if timely resection cannot be performed, neoadjuvant treatment or other alternative therapies should be considered.

Study design

  • Systematic review of studies in colorectal cancer (43), pancreatic cancer (9), and gastric cancer (6).
  • Funding: None disclosed.

Key results

  • In primary resected colon cancer, surgical delay of >30-40 days was associated with lower survival.
  • In rectal cancer, >7-8 weeks of delay after neoadjuvant therapy was associated with lower survival.
  • In pancreatic cancer, 2 studies showed an association between surgical delay >30 days and an increase in unexpected progression.
  • In gastric cancer, no studies found an association between time to surgery and survival.

Limitations

  • All studies in the review were retrospective.
  • Study data were not pooled because of heterogeneity among patient populations, study designs, and evaluated outcomes.