| The following article features coverage from the IASLC 2021 World Conference on Lung Cancer. Click here to read more of Cancer Therapy Advisor’s conference coverage. |
Avoiding thoracotomy and using pathways that minimize exposure to SARS-CoV-2 may reduce the risk of COVID-19 among patients undergoing surgery for non-small cell lung cancer (NSCLC), according to research presented at the IASLC 2021 World Conference on Lung Cancer (WCLC).
The research involves data from CovidSurg, a group of studies representing 2006 hospitals in 120 countries. The studies include data on 190,261 patients undergoing surgery during the COVID-19 pandemic.
For the WCLC presentation, researchers reported on CovidSurg data from patients undergoing surgery for NSCLC. The researchers analyzed data dating back to the initial 3-month period after the COVID-19 pandemic began. Outcomes were compared between patients who developed perioperative COVID-19 and those who did not.
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Between March and July 2020, 1486 patients underwent surgery for NSCLC in 83 of the hospitals contributing data to CovidSurg. In all, 74 patients developed perioperative COVID-19, and 1412 did not.
Perioperative COVID-19 was associated with a 30-day mortality rate of 26%. Patients who developed COVID-19 were also more likely to undergo re-operation and be admitted to critical care.
A multivariate analysis suggested the following factors were predictive of perioperative COVID-19:
- Male sex (odds ratio [OR], 2.06; P =.027)
- Pre-existing respiratory disease (OR, 2.82; P =.001)
- Proven prior COVID-19 (OR, 27.2; P <.001)
- Probable prior COVID-19 (OR, 15.5; P <.001)
- Open surgery (OR, 2.32; P =.011)
- Lack of a COVID-19-free pathway (OR, 3.07; P =.025).
A COVID-free pathway was defined as complete segregation of the operating theater, critical care, and inpatient ward areas.
The researchers also found that perioperative COVID-19 was “the strongest independent predictor” of postoperative pulmonary complications, which was a composite endpoint encompassing pneumonia, acute respiratory distress syndrome, respiratory failure, and the need for respiratory support (OR, 7.4; P <.001).
Perioperative COVID-19 was predictive of 30-day mortality as well (OR, 11.6; P <.001).
Read more of Cancer Therapy Advisor’s coverage of WCLC 2021 by visiting the conference page.
Reference
Patel AJ, Caruana EJ, Layton G, et al. Global impact of COVID-19 on NSCLC surgery: Initial analysis of the CovidSurg-Cancer study. Presented at: IASLC 2021 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer; September 8-14, 2021. Abstract P31.04.
