Outcomes of Cancer Surgery During the COVID-19 Pandemic: Preparedness to Practising Continuous Cancer Care
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ORIGINAL ARTICLE
Outcomes of Cancer Surgery During the COVID-19 Pandemic: Preparedness to Practising Continuous Cancer Care C. Ramachandra 1 & Pavan Sugoor 1 & Uday Karjol 1 & Ravi Arjunan 1 & Syed Altaf 1 & Rajshekar Halkud 2 & R. Krishnappa 2 & Purushotham Chavan 2 & K. T. Siddappa 2 & Rathan Shetty 2 & V. R. Pallavi 3 & Praveen Rathod 3 & K. Shobha 3 & K. S. Sabitha 4 Received: 30 July 2020 / Accepted: 6 October 2020 # The Author(s) 2020
Abstract The COVID-19 pandemic has placed unprecedented pressure on healthcare services. Deprioritisation of nonemergency clinical services and growing concerns of adverse outcomes of COVID-19 in cancer patients is having a deleterious impact across oncologic practice. We report cancer surgery outcomes taking into account the acuity of the COVID-19 situation. A prospectively maintained database of the Department of Surgical Oncology was analysed from 1st May to 30th June, 2020, to evaluate the perioperative outcomes, morbidity and mortality following major surgical procedures. A total of 359, preoperatively, tested negative for COVID19 underwent surgery. Median age was 52 years with 26.7% (n = 96) above the age of 60 years. Sixty-one percent (n = 219) patients were American Society of Anaesthesiology grades II–III. As per surgical complexity grading, 36.8% (n = 132) cases were lower grades (I–III) and 63.2% (n = 227) were complex surgeries (IV–VI). 5.3% (n = 19) had ≥ grade III Clavien-Dindo complication, and the postoperative mortality rate was 0.27% (n = 1). Major complication rates in patients > 60 years were 9.3% in comparison to 4.1% in < 60 years (p = 0·63). The median hospital stay was 1–10 days across subspecialties. Postoperatively, repeat COVID 19 testing in 2 suspected patients were negative. Our study showed that after screening, triaging and prioritisation, asymptomatic cases may undergo cancer surgeries without increased morbidity during COVID-19 pandemic. Keywords COVID-19 . SARS-CoV-2 . Pandemic . Cancer surgery . Cancer care . Surgical outcomes
Introduction Coronavirus disease 2019 (COVID-19), an emerging and evolving situation, has ensued unprecedented pressure on hospitals and ICU’s necessitating rapid redeployment of staff and resources towards the management of COVID-19 cases with deprioritisation of nonCOVID-19-related nonemergency clinical services; concurrently, lockdown, public anxiety, disruption of primary care services and hospital referrals of * Pavan Sugoor [email protected] 1
Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru 560029, India
2
Department of Head and Neck Oncology, Kidwai Memorial Institute of Oncology, Bengaluru 560029, India
3
Department of Gynec-oncology, Kidwai Memorial Institute of Oncology, Bengaluru 560029, India
4
Department of Oral Oncology, Kidwai Memorial Institute of Oncology, Bengaluru 560029, India
symptomatic cases have caused significant collateral damage to cancer care [1, 2]. Modest delay in diagnosis and timely interventions in patients with cancer may result in tumour
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