
==== Front
Ann Surg Oncol
Ann Surg Oncol
Annals of Surgical Oncology
1068-9265
1534-4681
Springer International Publishing Cham

38904861
15661
10.1245/s10434-024-15661-7
ASO Author Reflections
ASO Author Reflections: Enduring Impact of COVID-19 on Cancer Surgery Patients
Ju Jae-Woo MD 12
http://orcid.org/0000-0002-7134-5044
Lee Ho-Jin MD, PhD hjpainfree@snu.ac.kr

12
1 https://ror.org/01z4nnt86 grid.412484.f 0000 0001 0302 820X Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea
2 https://ror.org/04h9pn542 grid.31501.36 0000 0004 0470 5905 Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
21 6 2024
21 6 2024
2024
31 10 64086409
4 6 2024
5 6 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Seoul National UniversityOpen Access funding enabled and organized by Seoul National University.

issue-copyright-statement© Society of Surgical Oncology 2024
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pmcPast

The COVID-19 pandemic has left a lasting impact on cancer surgery patients, which may have been particularly profound. This pandemic has not only directly and severely affected the prognosis of cancer surgery patients but also has led to a widespread depletion of medical resources, preventing cancer patients from receiving timely treatment.1 Early in the pandemic, a landmark study by the COVIDSurg and GlobalSurg Collaboratives found a significant correlation between recent COVID-19 infection within 7 weeks and increased postoperative mortality, which influenced decisions on elective surgeries.2 However, determining the optimal timing of surgery in cancer patients with preoperative COVID-19 infection remains a critical issue, as delayed cancer surgery could lead to a worsening prognosis because of cancer progression.

Present

Fortunately, the impact of preoperative COVID-19 on postoperative outcomes has evolved because of the reduced virulence and vaccine availability of the virus. In our study, which utilized nationwide cohort data from South Korea in 2022, we found that preoperative COVID-19 infection in cancer surgery patients remained significantly associated with early postoperative mortality.3 However, this association was significant only for infections occurring within 2 weeks before surgery. The nonsignificant association between surgeries performed more than 2 weeks after COVID-19 infection and early postoperative mortality was more robust than the significant association found with surgeries conducted within 2 weeks of COVID-19 infection. This result aligns with the revised guidelines in 2023 regarding the recommended timing for elective surgery in patients with COVID-19 infection.4 Additionally, our study revealed that full vaccination against COVID-19 was associated with reduced postoperative mortality, highlighting the importance of vaccination in mitigating the risks for cancer surgery patients during the pandemic. Compared with our previous study using nationwide cohort data from South Korea in 2021, we observed a weaker impact of preoperative COVID-19 on early postoperative mortality.5

Future

Although the COVID-19 pandemic has transitioned to an endemic phase because of the tireless efforts of many, its risk cannot be ignored. Further research is needed to understand the impact of COVID-19 on cancer surgery patients in this endemic era. Additionally, our study found a positive effect of full vaccination against COVID-19 before surgery, but most individuals have not received additional booster shots since then, necessitating a reassessment of the effectiveness of preoperative vaccination. These efforts will help to determine the optimal timing for cancer surgery in patients during the ongoing COVID-19 endemic era, ultimately improving surgical outcomes and overall prognosis.

Funding

Open Access funding enabled and organized by Seoul National University.

Disclosure

The authors declare no conflicts of interest related to this study.

This article refers to: Ju JW, Yoon SH, Oh TK, Lee HJ. Preoperative COVID-19 and postoperative mortality in cancer surgery: A South Korean nationwide study. Ann Surg Oncol. 2024. 10.1245/s10434-024-15594-1.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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References

1. Hanna TP King WD Thibodeau S Mortality due to cancer treatment delay: systematic review and meta-analysis BMJ 2020 371 m4087 10.1136/bmj.m4087 33148535
Hanna TP, King WD, Thibodeau S, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020;371:m4087.33148535
2. COVIDSurg Collaborative, GlobalSurg Collaborative Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study Anaesthesia 2021 76 748 758 10.1111/anae.15458 33690889
COVIDSurg Collaborative, GlobalSurg Collaborative. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study. Anaesthesia. 2021;76:748–58.33690889
3. Ju JW Yoon SH Oh TK Lee HJ Preoperative COVID-19 and postoperative mortality in cancer surgery: a South Korean nationwide study Ann Surg Oncol 2024 10.1245/s10434-024-15594-1 39103686
Ju JW, Yoon SH, Oh TK, Lee HJ. Preoperative COVID-19 and postoperative mortality in cancer surgery: a South Korean nationwide study. Ann Surg Oncol. 2024. 10.1245/s10434-024-15594-1.39103686
4. American Society of Anesthesiologists, Anesthesia Patient Safety Foundation: ASA and APSF release updated recommendations for elective surgery after COVID-19 Infection. https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/asa-and-apsf-release-updated-recommendations-for-elective-surgery-after-covid-19-infection. Accessed 4 June 2024.
5. Ju JW Kim T Yoon SH Kim WH Lee HJ The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study Korean J Anesthesiol. 2024 77 185 194 10.4097/kja.23761 38273737
Ju JW, Kim T, Yoon SH, Kim WH, Lee HJ. The impact of preoperative coronavirus disease 19 infection on early postoperative mortality during the vaccination era: a nationwide retrospective cohort study. Korean J Anesthesiol. 2024;77:185–94.38273737
