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. 2021 Dec;28(13):8046-8053.
doi: 10.1245/s10434-021-10291-9. Epub 2021 Jun 26.

Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection

Anai N Kothari  1 , Sandra R DiBrito  1 , J Jack Lee  2 , Abigail S Caudle  3 , Mark W Clemens  4 , Vijaya N Gottumukkala  5 , Matthew H G Katz  1 , Anaeze C Offodile  4 , Abhineet Uppal  6 ; D3CODE Team; George J Chang  7
Affiliations

Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection

Anai N Kothari et al. Ann Surg Oncol. 2021 Dec.

Abstract

Background: An increasing number of patients with cancer diagnoses and prior SARS-CoV-2 infection will require surgical treatment. The objective of this study was to determine whether a history of SARS-CoV-2 infection increases the risk of adverse postoperative events following surgery in patients with cancer.

Methods: This was a propensity-matched cohort study from April 6, 2020 to October 31, 2020 at the UT MD Anderson Cancer Center. Cancer patients were identified who underwent elective surgery after recovering from SARS-CoV-2 infection and matched to controls based on patient, disease, and surgical factors. Primary study outcome was a composite of the following adverse postoperative events that occurred within 30 days of surgery: death, unplanned readmission, pneumonia, cardiac injury, or thromboembolic event.

Results: A total of 5682 patients were included for study, and 114 (2.0%) had a prior SARS-CoV-2 infection. The average time from infection to surgery was 52 (range 20-202) days. Compared with matched controls, there was no difference in the rate of adverse postoperative outcome (14.3% vs. 13.4%, p = 1.0). Patients with a SARS-CoV-2-related inpatient admission before surgery had increased odds of postoperative complication (adjusted odds ratio [aOR] 7.4 [1.6-34.3], p = 0.01).

Conclusions: A minimal wait time of 20 days after recovering from minimally symptomatic SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients with SARS-CoV-2 infections requiring inpatient treatment were at increased risk for adverse events after surgery. Additional wait time may be required in those with more severe infections.

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Figures

Fig. 1
Fig. 1
Study design with inclusions and exclusions to derive final analytic cohort
Fig. 2
Fig. 2
a Time from SARS-CoV-2 diagnosis to surgery, stratified by patients with symptomatic or asymptomatic infection. b Percentage of surgical procedures performed in SARS-CoV-2-recovered patients, by week, from April 6, 2020–October 31, 2020
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