Stephen J.  Savage,Aaron P.  Lesher,Andrea  Abbott,Antonio  Giordano,Biqi  Zhang,David A.  Mahvi,David M.  Mahvi,Denise  Garcia,Denise  Carneiro-Pla,E. Ramsay  Camp,Julie B. Siegel,Mahsa  Javid,Nancy Klauber  DeMore,Sara  Giordano,Whitney  Graybill,
What is Elective Oncologic Surgery in the Time of COVID-19? A Literature Review of the Impact of Surgical Delays on Outcomes in Patients with Cancer
Clinical Oncology and Research
2020
2613-4942
http://dx.doi.org/10.31487/j.COR.2020.06.05
https://www.sciencerepository.org/what-is-elective-oncologic-surgery-in-the-time-of-covid-19_COR-2020-6-105 
Abstract: Background: The impact of the COVID-19 pandemic has spread beyond those infected with SARS-CoV2. Its widespread consequences have affected cancer patients whose surgeries may be delayed in order to
minimize exposure and conserve resources.
Methods: Experts in each surgical oncology subspecialty were selected to perform a review of the relevant
literature. Articles were obtained through PubMed searches in each cancer subtype using the following
terms: delay to surgery, time to surgery, outcomes, and survival.
Results: Delays in surgery > 4 weeks in breast cancer, ductal carcinoma in situ, T1 pancreatic cancer,
ovarian cancer, and pediatric osteosarcoma, negatively impacted survival. Studies on hepatocellular cancer,
colon cancer, and melanoma (Stage I) demonstrated reduced survival with delays > 3 months.
Conclusion: Studies have shown that short-term surgical delays can result in negative impacts on patient
outcomes in multiple cancer types as well as in situ carcinoma. Conversely, other cancers such as gastric
cancer, advanced melanoma and pancreatic cancer, well-differentiated thyroid cancer, and several
genitourinary cancers demonstrated no significant outcome differences with surgical delays.
Keywords: Time to surgery, COVID-19, outcomes, surgical delays, surgical oncology