Imperial College London
Alternate

DrMatthewWilliams

Faculty of Medicine, Department of Surgery & Cancer

Honorary Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 3311 0733matthew.williams Website CV

 
 
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Location

 

Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Sud:2020:10.1016/j.annonc.2020.05.009,
author = {Sud, A and Jones, ME and Broggio, J and Loveday, C and Torr, B and Garrett, A and Nicol, DL and Jhanji, S and Boyce, SA and Gronthoud, F and Ward, P and Handy, JM and Yousaf, N and Larkin, J and Suh, Y-E and Scott, S and Pharoah, PDP and Swanton, C and Abbosh, C and Williams, M and Lyratzopoulos, G and Houlston, R and Turnbull, C},
doi = {10.1016/j.annonc.2020.05.009},
journal = {Annals of Oncology},
pages = {1065--1074},
title = {Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic},
url = {http://dx.doi.org/10.1016/j.annonc.2020.05.009},
volume = {31},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundCancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients' long-term survival.Patients and methodsWe generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013–2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations.ResultsPer year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Per-patient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs.ConclusionsModest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnosti
AU  - Sud,A
AU  - Jones,ME
AU  - Broggio,J
AU  - Loveday,C
AU  - Torr,B
AU  - Garrett,A
AU  - Nicol,DL
AU  - Jhanji,S
AU  - Boyce,SA
AU  - Gronthoud,F
AU  - Ward,P
AU  - Handy,JM
AU  - Yousaf,N
AU  - Larkin,J
AU  - Suh,Y-E
AU  - Scott,S
AU  - Pharoah,PDP
AU  - Swanton,C
AU  - Abbosh,C
AU  - Williams,M
AU  - Lyratzopoulos,G
AU  - Houlston,R
AU  - Turnbull,C
DO  - 10.1016/j.annonc.2020.05.009
EP  - 1074
PY  - 2020///
SN  - 0923-7534
SP  - 1065
TI  - Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic
T2  - Annals of Oncology
UR  - http://dx.doi.org/10.1016/j.annonc.2020.05.009
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000553086700014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.sciencedirect.com/science/article/pii/S0923753420398252?via%3Dihub
UR  - http://hdl.handle.net/10044/1/83692
VL  - 31
ER  -
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