Guidance for management of cancer surgery during the COVID-19 pandemic

Guidance for management of cancer surgery during the COVID-19 pandemic

Can J Surg 2020;63(2):S2-S4 | Full Text | PDF

Christian Finley, MD, MPH; Anubha Prashad, MBA; Natasha Camuso, MSc; Corinne Daly, MSc; Armen Aprikian, MD; Chad G. Ball, MD, MSc; James Bentley, MBChB; Dhany Charest, MD; Paola Fata, MD; Lucy Helyer, MD, MSc; Daniel O’Connell, MD; Husein Moloo, MD, MSc; Andrew Seely, MD, PhD; Joel Werier, MD; Toni Zhong, MD, MHS; Craig C. Earle, MD, MSc

Summary

During the coronavirus disease 2019 (COVID-19) pandemic, delaying lifesaving cancer surgeries must be done with extreme caution and thoughtfulness. Modelling indicates that delays in high-risk cancer surgeries beyond 6 weeks could affect long-term outcomes for thousands of Canadians. Consequently, it is possible that postponing cancer surgery without consideration of its implications could cost more lives than can be saved by diverting all surgical resources to COVID-19. This article provides general guidance on supporting curative surgical treatment where appropriate and with available resources.


Affiliations: From the Canadian Partnership Against Cancer (Finley, Prashad, Camuso, Daly, Earle); the Canadian Network of Surgical Associations for Cancer Care (Aprikian, Ball, Bentley, Charest, Fata, Helyer, O’Connell, Moloo, Seely, Werier, Zhong); the Canadian Urological Association and the Division of Urology, Department of Surgery, McGill University, Montreal, Que. (Aprikian); the Canadian Hepato-Pancreatico-Biliary Association and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball); the Society for Gynecologic Oncology of Canada and the Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS (Bentley); the Canadian Neurosurgical Society and the Department of Neurosurgery, Dalhousie University New Brunswick, Moncton, NB (Charest); the Canadian Association of General Surgeons and the Division of General Surgery, Department of Surgery, McGill University, Montreal, Que. (Fata); the Canadian Society of Surgical Oncology and the Department of General Surgery, Dalhousie University, Halifax, NS (Helyer); the Canadian Association of Head and Neck Surgical Oncology and the Division of Otolaryngology – Head and Neck Surgery, University of Alberta, Edmonton, Alta.(O’Connell); the Canadian Society of Colon and Rectal Surgeons and the Division of General Surgery, Department of Surgery, University of Ottawa, and the Ottawa Hospital Research Institute, Ottawa, Ont. (Moloo); the Canadian Association of Thoracic Surgeons and the Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ont. (Seely); the Canadian Orthopaedic Oncology Society and the Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ont. (Werier); the Canadian Society of Plastic Surgeons and the Department of Surgery, University of Toronto, Toronto, Ont. (Zhong); the Department of Surgery, McMaster University, Hamilton, Ont. (Finley); the Department of Gastrointestinal Oncology, Sunnybrook Health Sciences Centre, Toronto, Ont. (Earle); and the Canadian Journal of Surgery (Ball).

Competing interests: J. Bentley is a member of the advisory boards of AstraZeneca and NSV Tech, and his institution receives funding from Merk, AstraZeneca and Clovis for trials he is involved in. T. Zhong is supported by a Canandian Institutes of Health Research (CIHR) New Investigator Award (2015–2020) and she is the inaugural Belinda Stronach Chair in Breast Cancer Reconstruction Surgery at the University Health Network (2017–2022). C. Ball is co-editor in chief of CJS; he was not the accepting editor on this manuscript. No other competing interests were declared.

Contributors: All authors contributed substantially to this guidance article. C. Finley, A. Prashad, C. Daly, L. Helyer, D. O’Connell, H. Moloo, J. Werier, T. Zhong and C. Earle conceived the idea for the article. A. Prashad, N. Camuso and C. Ball compiled the current best evidence, which all authors assessed. C. Finley, A. Prashad, N. Camuso, C. Daly, C. Ball, A. Seely, T. Zhong and C. Earle wrote the article, which all authors reviewed and approved for publication.

Acknowledgements: Both the Canadian Partnership Against Cancer and the Canadian Network of Surgical Associations for Cancer Care would like to acknowledge the valuable contributions of the Canadian Association of Provincial Cancer Agencies for their input and guidance in the production of the document.

DOI: 10.1503/cjs.005620

Correspondence to: C. Finley, Cancer Control, Canadian Partnership Against Cancer, 145 King Street West, Toronto ON M5H 1J8, Christian.Finley@partnershipagainstcancer.ca