Frequency and natural history of emergency general surgery conditions in cancer patients: A SEER-Medicare population analysis Journal Article


Authors: Jolissaint, J. S.; Lobaugh, S. M.; Goldman, D. A.; McIntyre, S. M.; Vos, E. L.; Panageas, K. S.; Wei, A. C.
Article Title: Frequency and natural history of emergency general surgery conditions in cancer patients: A SEER-Medicare population analysis
Abstract: Objective: To determine if cancer patients experience variability in incidence or management of emergency general surgery (EGS) conditions compared to non-cancer patients. Background: The true frequency, and natural history of EGS conditions among cancer patients has not been characterized. Methods: We utilized SEER-Medicare data from January 2006–December 2015 to compare patients with breast, prostate, and lung cancer to a non-cancer cohort. Patients were followed from date of cancer diagnosis, or an index date for non-cancer patients, to the development of an EGS condition, death or last follow up. We assessed the cumulative incidence of EGS conditions over time, and fit multivariable Cox proportional hazards models to evaluate the impact of time-dependent surgical intervention on mortality. Results: We identified 322,756 patients with breast (N=82,147), lung (N=128,618), and prostate cancer (N=111,991) and 210,429 non-cancer patients.. Cancer patients had a higher incidence of an EGS condition within the first year after diagnosis (4.8% vs. 3.2%), with lung (6.8%) and breast cancer (4.0%) showing consistent rends. Cancer patients were less likely to undergo surgery for (13% vs. 14%, p=0.005), though this varied by cancer type and EGS conditions. Patients with breast (HR 1.27, 95%CI 1.17-1.39) and lung cancer (HR 3.27, 95%CI 3.07-3.48) were more likely to die within 30-days of an EGS diagnosis. Conclusions: Cancer patients experience a higher incidence of EGS conditions within the first year following diagnosis, but are less likely to undergo surgery. Future research is needed to explore the interplay between EGS conditions, their management, and receipt of intended oncologic therapy, and resulting outcomes. © 2024 Wolters Kluwer Health. All rights reserved.
Keywords: cancer; population data; emergency general surgery
Journal Title: Annals of Surgery
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Publication status: Online ahead of print
Date Published: 2024-10-02
Online Publication Date: 2024-10-02
Language: English
DOI: 10.1097/sla.0000000000006554
PUBMED: 39355926
PROVIDER: scopus
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Alice Wei -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Katherine S Panageas
    525 Panageas
  2. Debra Alyssa Goldman
    160 Goldman
  3. Alice Chia-Chi Wei
    216 Wei
  4. Stephanie Marie Lobaugh
    58 Lobaugh
  5. Elvira Lise Vos
    27 Vos