Table 4. Society for Surgical Oncology Resource for Management Options of Colorectal Cancer During COVID-19 (https://www.surgonc.org/wp- content/uploads/2020/04/Colorectal-Resource-during-COVID-19-4.6.20.pdf ).

Phase I	Phase II	Phase III
Conditions for which operations to be deferred  • Benign colorectal polyps • Malignant colorectal polyps (focus of cancer within polyps) • Prophylactic procedures for hereditary (e.g. familial adenomatous polyposis) or inflammatory (e.g. inflammatory bowel disease) conditions Conditions for which operations may be considered  • Emergency cases (as defined) • Non-metastatic colon cancer- curative intent surgery - Asymptomatic - Near-obstructing - Requiring frequent transfusions - Evidence of impending perforation • Non-metastatic rectal cancer - Early stage rectal cancer not appropri- ate for neoadjuvant/adjuvant therapy - Rectal cancers after neoadjuvant therapy with no response to therapy • Resectable oligometastatic disease - Exhausted effective systemic therapy	Conditions for which operations to be deferred • All procedures for asymptomatic or mini-mally-symptomatic cancers  Conditions for which operations may be considered  • Emergency cases (as defined) • Significantly symptomatic cancers (e.g. severe pain) • Near-obstructing colon and rectal cancers - Consider diversion alone for rectal or complex colon cancers • Bleeding colorectal cancers with high transfusion requirements	Conditions for which operations to be deferred • All procedures unless imminently life-threatening (death within hours with-out intervention)  Conditions for which operations may be considered • Emergency cases (as defined) with no feasible alternative approach
ALTERNATIVE CONSIDERATIONS AND APPROACHES TO DELAY SURGERY (ALL PHASES) • Locally-advanced resectable colon cancer - Consider neoadjuvant chemotherapy • Locally-advanced resectable rectal cancer - Strong consideration of total neoadjuvant therapy (TNT) - For radiation component, strongly consider short course 5 x 5 Gy regimen (vs. long course chemoradiation) - With evidence of downstaging, delay surgery post-neoadjuvant therapy up to 12-16 weeks - Consider additional systemic chemotherapy if prolonged delay • Bleeding from cancer - Consider radiation treatment, embolization where appropriate • Near-obstructing cancers - Consider stenting where possible - Consider chemotherapy, radiation where possible • Resectable oligometastatic disease - Continue effective systemic therapy - Consider non-surgical ablative/embolic approaches where appropriate • Where possible, consider transfer of urgent patients to other facilities with capacity