- All surgeons and staff are at a high risk and should be equipped with the highest standard of PPE
- All strategies to manage colorectal cancer should be utilized prior to surgery as long as they don’t require hospitalization


Ohio State University, Columbus

- This paper provides some insight into what new guidelines should be put in place for new care procedures regarding colorectal cancer
- This paper conveys new guidelines by providing sets of statements and giving a description as to how these statements pertain to new guidelines being set in place
- This paper is broken up into the following sections: Surgical Considerations based on Cancer and Patient Characteristics, Intervention Options and Timing of Delays, and Nonsurgical Modalities to Consider


Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic

O'Leary, M. P., Choong, K. C., Thornblade, L. W., Fakih, M. G., Fong, Y., & Kaiser, A. M. (2020). Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic. Annals of surgery, 272(2), e98–e105. https://doi.org/10.1097/SLA.0000000000004029

URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373490/


- While surgery is now very high risk, it is entirely necessary for patients with colon or rectal cancer
- All less invasive treatment options should be utilized before surgery due to new allocation of resources for hospitals as well as possible modes of infection
- All non emergency colon surgeries should be delayed for a minimum of 6 to 8 weeks as they may have a negative impact overall
- Any colon cancer that came from polyps that may require surgery should be deferred as it is extremely early stage
- Stage 1 rectal cancer should undergo surgery with approximately a 6 to 8 week delay as radiation therapy is largely ineffective on this cancer type
- Stage 2 or 3 rectal cancer should be treated with neoadjuvant chemoradiation with short course treatment and surgery or with long course chemotherapy
- Stage 4 or metastatic colorectal cancer should be treated with neoadjuvant cytotoxic chemotherapy as well as expedited surgeries
- Active COVID-19 prior to treatment is indicative of poorer patient outcomes and higher mortality


Surgical Considerations based on Cancer and Patient Characteristics

Intervention Options and Timing of Delays

- 2 new trials have been looked into the efficacy of neoadjuvant chemotherapy treatment of stage 2 and 3 colon cancers
- The FOxTROT trial was presented in 2019 and showed significant tumor downstaging and a trend toward a lower 2-year failure rate
- These treatments are now vital as avoidance of the operating room as much as possible is the number 1 priority in patient care for colorectal cancer


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