A new study provides important data on the safety of head and neck cancer surgery during the COVID-19 pandemic.
The study examined information on 1137 patients with head and neck cancer undergoing potentially curative surgery in 26 countries. The most common sites were the oral cavity (38%) and the thyroid (21%).
The findings, published in Cancer, show that the death rate within 30 days after surgery was 1.2 per cent, a rate that would be normally expected in this patient population, without a pandemic. Twenty-nine (3%) patients tested positive for COVID-19 within 30 days of surgery; of these 13 (44.8%) developed severe respiratory complications and three (10.3%) died.
Patients were more likely to test positive for COVID-19 when they lived in communities with high levels of COVID-19, when they had oral tumours, and when they received a tracheostomy.
“The early consensus was that head and neck surgery was very risky for patients, particularly less fit or elderly patients, or those who required complex procedures or reconstructive surgery,” said corresponding author Professor Richard J. Shaw of the University of Liverpool Cancer Research Centre. “Our data are reassuring in this regard, showing that there is no additional risk of COVID-19 for these groups.”
Based on the findings, Prof Shaw concluded: “For patients with head and neck cancer, the tumours present a much greater threat to life than the risk of developing COVID-19, assuming precautions are taken.”
The study is part of the COVIDSurg Collaborative, an initiative to describe surgical practices during the early period of the pandemic, when many hospitals had limited capacity and when it was unclear whether it was safer to delay or continue in-hospital cancer treatments.
