The effect of delays in cancer surgery due to the COVID-19 pandemic on cancer resectability and postoperative mortality in different tumor entities
Abstract
BACKGROUND: During the COVID-19 pandemic, prioritization of COVID-19 patients led to delays in oncological surgery, potentially impacting patient outcomes. This analysis examines the effects of surgical delays in various tumor entities on resectability and postoperative mortality. METHODS: Data from the COVIDSurg Cancer Collaborative, an international prospective cohort study with 19,676 patients, collected between March 26, 2020, and September 16, 2020, were analyzed. Postoperative mortality and complete resection (R0) were the outcomes, with tumor entity, stage and delay to surgery as key exposures. RESULTS: 17,486 patients underwent surgery during the study period, at a median time of three weeks after decision to operate (IQR = 4). 172 (1.0%) patients died within 30 days postoperatively. 15,143 (90.5%) patients had an R0 resection, 1352 (8.1%) an R1 resection and 230 (1.4%) had an R2 resection. Postoperative mortality was highest for oesophageal cancer (3.9%) and UICC stage IV (1.5%). For the overall population, there was no association between delay to surgery and resectability. There was an association between delay to surgery and postoperative mortality (p < 0.001), with the highest 30-day postoperative mortality observed for operations within two weeks following surgical decision. CONCLUSION: Tumor resectability and postoperative mortality in oncological surgeries are influenced by various factors. During the COVID-19 pandemic, moderate delays in surgeries were observed, with differences across tumor types, UICC stages and regions. While no tangible effects on resectability were found, postoperative mortality was higher after a shorter delay to surgery.
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BibTeX
@article{stengler2026effect,
title = {{The effect of delays in cancer surgery due to the COVID-19 pandemic on cancer resectability and postoperative mortality in different tumor entities}},
author = {Antonia Stengler and Jörg Kleeff and Jörg Kleeff and Lisa Rieder and James Glasbey and Aneel Bhangu and Aneel Bhangu and Ewen Harrison and Ulrich Ronellenfitsch and Kenneth Mclean and Dmitri Nepogodiev and Dmitri Nepogodiev and Kwabena Siaw-Acheampong and Ruth Benson and Edward Bywater and Daoud Chaudhry and Brett Dawson and Jonathan Evans and Rohan Gujjuri and Emily Heritage and Conor Jones and Sivesh Kamarajah and Chetan Khatri and Rachel Khaw and James Keatley and Andrew Knight and Samuel Lawday and Elizabeth Li and Harvinder Mann and Ella Marson and Kenneth Mclean and Siobhan Mckay and Emily Mills and Gianluca Pellino and Maria Picciochi and Elliott Taylor and Abhinav Tiwari and Joana Simoes and Isobel Trout and Mary Venn and Richard Wilkin and Neil Smart and Ana Minaya-Bravo and Jonathan Evans and Gaetano Gallo and Susan Moug and Francesco Pata and Peter Pockney and Salomone Di Saverio and Abigail Vallance and Dale Vimalchandran and Ewen Griffiths and Sivesh Kamarajah and Richard Evans and Philip Townend and Keith Roberts and Siobhan Mckay and John Isaac and Sohei Satoi and John Edwards},
journal = {Discover Oncology},
year = {2026},
month = may,
doi = {10.1007/s12672-026-04430-5},
url = {https://hal.science/hal-05751897v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The effect of delays in cancer surgery due to the COVID-19 pandemic on cancer resectability and postoperative mortality in different tumor entities
AU - Antonia Stengler
AU - Jörg Kleeff
AU - Jörg Kleeff
AU - Lisa Rieder
AU - James Glasbey
AU - Aneel Bhangu
AU - Aneel Bhangu
AU - Ewen Harrison
AU - Ulrich Ronellenfitsch
AU - Kenneth Mclean
AU - Dmitri Nepogodiev
AU - Dmitri Nepogodiev
AU - Kwabena Siaw-Acheampong
AU - Ruth Benson
AU - Edward Bywater
AU - Daoud Chaudhry
AU - Brett Dawson
AU - Jonathan Evans
AU - Rohan Gujjuri
AU - Emily Heritage
AU - Conor Jones
AU - Sivesh Kamarajah
AU - Chetan Khatri
AU - Rachel Khaw
AU - James Keatley
AU - Andrew Knight
AU - Samuel Lawday
AU - Elizabeth Li
AU - Harvinder Mann
AU - Ella Marson
AU - Kenneth Mclean
AU - Siobhan Mckay
AU - Emily Mills
AU - Gianluca Pellino
AU - Maria Picciochi
AU - Elliott Taylor
AU - Abhinav Tiwari
AU - Joana Simoes
AU - Isobel Trout
AU - Mary Venn
AU - Richard Wilkin
AU - Neil Smart
AU - Ana Minaya-Bravo
AU - Jonathan Evans
AU - Gaetano Gallo
AU - Susan Moug
AU - Francesco Pata
AU - Peter Pockney
AU - Salomone Di Saverio
AU - Abigail Vallance
AU - Dale Vimalchandran
AU - Ewen Griffiths
AU - Sivesh Kamarajah
AU - Richard Evans
AU - Philip Townend
AU - Keith Roberts
AU - Siobhan Mckay
AU - John Isaac
AU - Sohei Satoi
AU - John Edwards
PY - 2026
DA - 2026/05/09
JO - Discover Oncology
DO - 10.1007/s12672-026-04430-5
UR - https://hal.science/hal-05751897v1
AB - BACKGROUND: During the COVID-19 pandemic, prioritization of COVID-19 patients led to delays in oncological surgery, potentially impacting patient outcomes. This analysis examines the effects of surgical delays in various tumor entities on resectability and postoperative mortality. METHODS: Data from the COVIDSurg Cancer Collaborative, an international prospective cohort study with 19,676 patients, collected between March 26, 2020, and September 16, 2020, were analyzed. Postoperative mortality and complete resection (R0) were the outcomes, with tumor entity, stage and delay to surgery as key exposures. RESULTS: 17,486 patients underwent surgery during the study period, at a median time of three weeks after decision to operate (IQR = 4). 172 (1.0%) patients died within 30 days postoperatively. 15,143 (90.5%) patients had an R0 resection, 1352 (8.1%) an R1 resection and 230 (1.4%) had an R2 resection. Postoperative mortality was highest for oesophageal cancer (3.9%) and UICC stage IV (1.5%). For the overall population, there was no association between delay to surgery and resectability. There was an association between delay to surgery and postoperative mortality (p < 0.001), with the highest 30-day postoperative mortality observed for operations within two weeks following surgical decision. CONCLUSION: Tumor resectability and postoperative mortality in oncological surgeries are influenced by various factors. During the COVID-19 pandemic, moderate delays in surgeries were observed, with differences across tumor types, UICC stages and regions. While no tangible effects on resectability were found, postoperative mortality was higher after a shorter delay to surgery.
SN - 2730-6011
ER -