Outcomes of liver cancer patients undergoing elective surgery after
recovering from mild SARS-CoV-2 Omicron infection: A retrospective
cohort study
Abstract
With the emergence of new virus variants, there is limited data
available on the impact of SARS-CoV-2 Omicron infection on surgery
outcomes in cancer patients who have been widely vaccinated. This study
aimed to determine whether undergoing hepatectomy poses a higher risk of
postoperative complications for liver cancer patients who have had mild
Omicron infection before surgery. A propensity-matched cohort study was
conducted at a tertiary liver center from October 8, 2022, to January
13, 2023. Totally, 238 liver cancer patients who underwent hepatectomy
were included, with 57 (23.9%) recovering from preoperative SARS-CoV-2
Omicron infection and 190 (79.8%) receiving COVID-19 vaccination. The
average time from infection to surgery was 18.7 (range 7-49) days. The
overall 30-day postoperative mortality rate was 1.7% (4/238). Pre- and
post-matching, there was no significant difference in the occurrence of
postoperative outcomes between preoperative COVID-19 recovered patients
and COVID-19 negative patients. Multivariate logistic regression showed
that the COVID-19 status was not associated with postoperative major
pulmonary and cardiac complications. However, preexisting comorbidities
(odds ratio [OR], 4.645; 95% confidence interval [CI],
1.295-16.667), laparotomy (OR, 10.572; 95% CI, 1.220-91.585), and
COVID-19 unvaccinated (OR, 5.408; 95% CI, 1.489-19.633) had increased
odds of major complications related to SARS-CoV-2 infection. In
conclusion, liver cancer patients who have recovered from preoperative
COVID-19 do not face an increased risk of postoperative complications.
Therefore, elective cancer surgery can be safely performed after
recovery for patients with a history of mild SARS-CoV-2 Omicron
infection.