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Session:: ePosters-Mon330-M8: Colon & Colorectal Cancer

EP2007 - Impact of Perioperative SARS-CoV-2 Infection on Treatment Receipt and Survival in Stage III Colon Cancer: An NCDB Analysis

Monday, May 11, 2026
4:08 PM - 4:13 PM ET

    ePoster Presenter(s)

  • MP

    Michal Perets, MD

    Clinical Fellow
    Cleveland Clinic Florida
    The Hebrew University of Jerusalem, Israel
    Weston, FL, United States

    Disclosure information not submitted.

    • Author(s)

  • Sameh H. Emile, MBBCh, MSc, MD, FACS

    Project Scientist
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    Disclosure information not submitted.

  • NK

    Noam Kahana, MD

    Colorectal Fellow
    Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA; and the Department of General surgery Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Israel
    Faculty of Medicine, Hebrew University of Jerusalem, Israel
    Hollywood, FL, United States

    Disclosure information not submitted.

  • Nir Horesh, MD

    Resident Physician
    Cleveland Clinic Florida
    Tel Aviv University
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Zubair Bayat, MD

    Colorectal Surgery Fellow
    Cleveland Clinic Florida
    Weston, FL, United States

    Disclosure information not submitted.

  • Maher Al Khaldi, MD, MSc, FRCSC

    Clinical Associate
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Anjelli Wignakumar, MBBS, BSc (Hons) (she/her/hers)

    Clinical Research Fellow
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, FL, United States

    Disclosure information not submitted.

  • Marylise Boutros, MD, FRCSC, FACS, FACRS (she/her/hers)

    Colorectal Surgeon
    Cleveland Clinic Florida
    McGill University
    Weston, Florida, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no relevant relationships with ineligible companies.

  • GD

    Giovanna Dasilva, MD

    Staff Colorectal Surgeon
    Cleveland Clinic Florida
    Cleveland Clinic Florida
    Weston, Florida, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Steven D. Wexner, MD, PhD (Hon)

    Surgeon
    Cleveland Clinic Florida
    Cleveland Clinic Lerner College of Medicine at Case Western Reserve University
    Weston, Florida, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Nir Horesh, MD: This individual has no financial relationships with ineligible companies.
Maher Al Khaldi, MD, MSc, FRCSC: This individual has no financial relationships with ineligible companies.
Marylise Boutros, MD, FRCSC, FACS, FACRS: This individual has no relevant relationships with ineligible companies.
Purpose/Background: Considering COVID-19's broad impact on healthcare, we evaluated the association among perioperative SARS-CoV-2 infection, therapy, and overall survival (OS) in patients with stage III colon adenocarcinomas treated with colectomy and adjuvant chemotherapy.

Methods/Interventions: We conducted a retrospective cohort analysis of patients with pathologic stage III colon cancer who underwent colectomy followed by adjuvant chemotherapy between 2020-2022 in the National Cancer Database (NCDB). Patients were categorized by SARS status (positive vs negative). Demographic, tumor features, treatment, and outcomes were analyzed. 3 years overall survival (OS) was assessed using Kaplan-Meier statistics and Cox regression analysis, and was stratified by TNM stage.

Results/Outcomes: Among 17,780 patients, 1299 (7.3%) had perioperative SARS-CoV-2 between 2020-2022. The median age was slightly lower in SARS-positive patients (67 vs 68 years; p< 0.001), yet the two groups were comparable in terms of sex, race, sub-stage, tumor location, tumor size, histology, and surgical approach. The rates of receipt of adjuvant chemotherapy were similar (69.6% vs 68.6%; p=0.367). The rates of positive margins, 30-day mortality, 90-day mortality were comparable, while unplanned readmissions were modestly higher with SARS positivity (6.1% vs 4.8%; p=0.009). Three-year OS rate was lower in SARS-positive patients (69.5% vs 72.5%, p=0.005). This difference was only significant in stage IIIB (69.8% vs 75.7%; p< 0.001), but not in stage IIIA or IIIC. In the multivariable Cox regression model, perioperative SARS-CoV-2 infection was independently associated with reduced 3-year OS (HR 1.17; 95% CI 1.05-1.32), whereas adjuvant chemotherapy was associated with increase survival (HR 0.33; 95% CI 0.30-0.36), Increased age, Charlson-Deyo 2-3, positive margins, lymphovascular invasion, and mucinous/signet-ring histologies were associated with reduced OS.

Conclusion/Discussion: Perioperative SARS-CoV-2 infection was associated with a modest but significant reduction in 3-year OS in stage III colon cancer, primarily driven by worse outcomes in stage IIIB disease. These findings support strategies to minimize perioperative SARS-CoV-2 exposure and to preserve on-time adjuvant therapy delivery in this population.