Timing and safety of lung cancer surgery after SARS-CoV-2 infection: A multicenter retrospective study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Zhe ^1,2 , ZHU Qihang ⁴ , LI Xianglin ¹ , TANG Dezhao ¹ , WU Junhan ¹ , CHEN Yizhang ¹ , CHEN Qibin ¹ , ZHANG Qipeng ^2,3 , XU Enwu ³ , XIAO Haiping ⁴ , TANG Yong ¹ ,  QIAO Guibin ¹

1. Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P. R. China;
2. The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, P. R. China;
3. Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, 510010, P. R. China;
4. Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangdong Pharmaceutical University, 510080, P. R. China;

Corresponding author：

QIAO Guibin, Email: guibinqiao@126.com

Keywords：

Lung cancer surgery; surgical timing; safety; COVID-19

DOI：

10.7507/1007-4848.202303012

Video：

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Objective To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. Conclusion It is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.

Citation： HE Zhe, ZHU Qihang, LI Xianglin, TANG Dezhao, WU Junhan, CHEN Yizhang, CHEN Qibin, ZHANG Qipeng, XU Enwu, XIAO Haiping, TANG Yong, QIAO Guibin. Timing and safety of lung cancer surgery after SARS-CoV-2 infection: A multicenter retrospective study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(7): 945-949. doi: 10.7507/1007-4848.202303012 Copy

1.	Nepogodiev D, Omar OM, Glasbey JC, et al. Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: Globgal predictive modelling to inform surgical recovery plans. J Br Surg, 2020, 107(11): 1440-1449.
2.	Ponholzer F, Kroepfl V, Caecilia NG, et al. Delay to surgical treatment in lung cancer patients and its impact on survival in a video-assisted thoracoscopic lobectomy cohort. Sci Rep, 2021, 11(1): 4914.
3.	Verhagen NB, Koerber NK, Szabo A, et al. Vaccination against SARS-CoV-2 decreases risk of adverse events in patients who develop COVID-19 following cancer surgery. Ann Surg Oncol, 2023, 30(3): 1305-1308.
4.	Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccinationcampaign in Israel: An observational study using national surveillance data. Lancet, 2021, 397(10287): 1819-1829.
5.	Bernal JL, Andrews N, Gower C, et al. Effectiveness of COVID-19 vaccines against the B. 1. 617. 2 (Delta) variant. N Engl J Med, 2021, 385(3): 585-594.
6.	Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: An retrospective cohort study. Lancet, 2021, 398(10309): 1407-1416.
7.	Collie S, Champion J, Moultrie H, et al. Effectiveness of BNT162b2 vaccine against Omicron variant in South Africa. N Engl J Med, 2022, 386(5): 494-496.
8.	Le ST, Kipnis P, Cohn B, et al. COVID-19 vaccination and the timing of surgery following COVID-19 infection. Ann Surg, 2022, 276(5): 265-272.
9.	Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
10.	Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, 2020, 382(18): 1708-1720.
11.	Tan L, Wang Q, Zhang DY, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Signal Transduct Target Ther, 2020, 5(1): 33.
12.	Collaborative C, Collaborative G. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
13.	El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 2021, 76(7): 940-946.
14.	Anesthesia Patient Safety Foundation. American Society of Anesthesiologists and Anesthesia Patient Safety Foundation Joint Statement on Elective Surgery and Anesthesia for Patients After COVID-19 Infection. 2022. URL: https://www.apsf.org/news-updates/asa-and-apsf-joint-statement-on-elective-surgery-and-anesthesia-for-patients-after-covid-19-infection. Accessed on 2022-03-22.
15.	COVIDSurg Collaborative. Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: An international, prospective, cohort study. Lancet Oncol, 2021, 22(11): 1507-1517.
16.	Jain A, Dai T BK, Myers C. COVID-19 created an elective surgery backlog: How can hospitals get back on track. Harv Bus Rev, 2020, 10: 2-7.

1. Nepogodiev D, Omar OM, Glasbey JC, et al. Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: Globgal predictive modelling to inform surgical recovery plans. J Br Surg, 2020, 107(11): 1440-1449.
2. Ponholzer F, Kroepfl V, Caecilia NG, et al. Delay to surgical treatment in lung cancer patients and its impact on survival in a video-assisted thoracoscopic lobectomy cohort. Sci Rep, 2021, 11(1): 4914.
3. Verhagen NB, Koerber NK, Szabo A, et al. Vaccination against SARS-CoV-2 decreases risk of adverse events in patients who develop COVID-19 following cancer surgery. Ann Surg Oncol, 2023, 30(3): 1305-1308.
4. Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccinationcampaign in Israel: An observational study using national surveillance data. Lancet, 2021, 397(10287): 1819-1829.
5. Bernal JL, Andrews N, Gower C, et al. Effectiveness of COVID-19 vaccines against the B. 1. 617. 2 (Delta) variant. N Engl J Med, 2021, 385(3): 585-594.
6. Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: An retrospective cohort study. Lancet, 2021, 398(10309): 1407-1416.
7. Collie S, Champion J, Moultrie H, et al. Effectiveness of BNT162b2 vaccine against Omicron variant in South Africa. N Engl J Med, 2022, 386(5): 494-496.
8. Le ST, Kipnis P, Cohn B, et al. COVID-19 vaccination and the timing of surgery following COVID-19 infection. Ann Surg, 2022, 276(5): 265-272.
9. Deng JZ, Chan JS, Potter AL, et al. The risk of postoperative complications after major elective surgery in active or resolved COVID-19 in the United States. Ann Surg, 2022, 275(2): 242-246.
10. Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med, 2020, 382(18): 1708-1720.
11. Tan L, Wang Q, Zhang DY, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Signal Transduct Target Ther, 2020, 5(1): 33.
12. Collaborative C, Collaborative G. Timing of surgery following SARS-CoV-2 infection: An international prospective cohort study. Anaesthesia, 2021, 76(6): 748-758.
13. El-Boghdadly K, Cook TM, Goodacre T, et al. SARS-CoV-2 infection, COVID-19 and timing of elective surgery: A multidisciplinary consensus statement on behalf of the Association of Anaesthetists, the Centre for Peri-operative Care, the Federation of Surgical Specialty Associations, the Royal College of Anaesthetists and the Royal College of Surgeons of England. Anaesthesia, 2021, 76(7): 940-946.
14. Anesthesia Patient Safety Foundation. American Society of Anesthesiologists and Anesthesia Patient Safety Foundation Joint Statement on Elective Surgery and Anesthesia for Patients After COVID-19 Infection. 2022. URL: https://www.apsf.org/news-updates/asa-and-apsf-joint-statement-on-elective-surgery-and-anesthesia-for-patients-after-covid-19-infection. Accessed on 2022-03-22.
15. COVIDSurg Collaborative. Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: An international, prospective, cohort study. Lancet Oncol, 2021, 22(11): 1507-1517.
16. Jain A, Dai T BK, Myers C. COVID-19 created an elective surgery backlog: How can hospitals get back on track. Harv Bus Rev, 2020, 10: 2-7.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Timing and safety of lung cancer surgery after SARS-CoV-2 infection: A multicenter retrospective study

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