Colorectal Cancer Surgery: Still Safe During the Pandemic

According to a new study, patients undergoing surgery for colorectal cancer experienced a low rate of COVID-19 infection during the postoperative period, suggesting that colorectal cancer surgery can be performed with minimal risks during the pandemic.

“With the COVID-19 pandemic, the management of patients with cancer has been significantly impacted, from diagnosis to follow-up, leading to a proposal of treatment strategy adaptations,” write the investigators of the COVID-GRECCAR study, led by first author Jean-Jacques Tuech, MD, PhD, a Professor in the Department of Digestive Surgery at Rouen University Hospital in France. “Resumption of surgical activity is performed gradually, and the impact of SARS-CoV-2 during the postoperative period needs to be established to enable surgeons and patients to make evidence-based decisions.”

In their multicenter cohort study, Dr. Tuech and colleagues investigated the incidence of COVID-19 infection during the postoperative period in 448 patients who underwent surgery for colorectal cancer, including colon (64.7%), rectal (34.6%), or anal cancer (0.7%). Nearly half of the patients had comorbidities, including hypertension (41.9%), diabetes (29%), and coronary heart disease (8.7%), and 52.2% of the study population was overweight or obese, with a median body mass index (BMI) of 25. Between January 1 and March 31, 2020, all patients underwent surgery, performed with surgical approaches including laparoscopy (70.7%), converted laparoscopy (23.9%), and laparotomy (5.4%). The study’s primary end point was the rate of COVID-19 infection during the postoperative period.

At the time of data cutoff on June 15, 2020, all 448 patients were alive, and only six patients (1.3%) had developed COVID-19 infection. The median time between the date of surgery and COVID-19 infection was 30 days. All patients who developed COVID-19 had already been discharged from the hospital after surgery when they became infected; of these, three patients were hospitalized after their infection, and there were no fatalities.

“This is the first study examining the risk of COVID-19 infection during the postoperative period of colorectal cancer surgery,” conclude Dr. Tuech and colleagues in their publication in the International Journal of Colorectal Disease. “The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.”

For More Information

Tuech JJ, Manceau G, Ouaissi M, et al (2021). Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study. Int J Colorectal Dis. [Epub ahead of print] DOI:10.1007/s00384-021-03847-4

Image credit: CMSRC. Licensed under CC BY-SA 3.0

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