Delays in Surgery for Advanced Esophageal Cancer Lead to Poorer Survival

The COVID-19 pandemic has forced health systems and patients to make difficult decisions about delaying certain surgical procedures to lessen risk of infection. These delays can affect patient outcomes, according to a recent study on operable esophageal cancer in the Journal of the American College of Surgeons (JACS). 

The findings in this study—one the earliest to examine the impact of an extended 3-month delay in esophagectomy for esophageal cancer—revealed that although the relative survival rate for patients with stage 1 disease who had delayed procedures were similar to those who had surgery earlier, the results were much different in patients with more advanced disease (stage 2 or 3). The key figure: the 5-year survival rate for patients with stage 2 or 3 disease who had delayed surgery was approximately 45% worse than for those who had earlier surgery.

At the pandemic’s outset, the ACS and other surgical organizations recommended delaying some operations to free up resources to manage nascent COVID-19 outbreaks. Research findings are now only beginning to determine the impact of delays on the outcomes for patients with cancer, including esophageal cancer. This study suggests that patients with advanced disease should get surgery as soon as possible and shows that health systems will need to make careful decisions about prioritizing cancer surgery and allocating resources in response to future COVID-19 surges or pandemics.

See more in the ACS press release, including comments from study authors and a video summary from lead author Simar Bajaj.