Xiaofeng Zhang

and 9 more

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.