Background: The impact of the first coronavirus disease 2019 (COVID-19) wave on cancer patient management was measured within the nationwide network of the Unicancer comprehensive cancer centers in France.Patients and methods: The number of patients diagnosed and treated within 17 of the 18 Unicancer centers was collected in 2020 and compared with that during the same periods between 2016 and 2019. Unicancer centers treat close to 20% of cancer patients in France yearly. The reduction in the number of patients attending the Unicancer centers was analyzed per regions and cancer types. The impact of delayed care on cancer-related deaths was calculated based on different hypotheses. Results: A 6.8% decrease in patients managed within Unicancer in the first 7 months of 2020 versus 2019 was observed. This reduction reached 21% during April and May, and was not compensated in June and July, nor later until November 2020. This reduction was observed only for newly diagnosed patients, while the clinical activity for previously diagnosed patients increased by 4% similar to previous years. The reduction was more pronounced in women, in breast and prostate cancers, and for patients without metastasis. Using an estimated hazard ratio of 1.06 per month of delay in diagnosis and treatment of new patients, we calculated that the delays observed in the 5-month period from March to July 2020 may result in an excess mortality due to cancer of 1000-6000 patients in coming years. Conclusions: In this study, the delays in cancer patient management were observed only for newly diagnosed patients, more frequently in women, for breast cancer, prostate cancer, and nonmetastatic cancers. These delays may result is an excess risk of cancer-related deaths in the coming years.

The coronavirus disease 2019 (COVID-19) pandemic may have affected cancer management. We aimed to evaluate changes in every oncology care pathway essential steps, from screening to treatment during the pandemic. Monthly oncological activity differences between 2019 and 2020 (screening tests, histopathological analyzes, multidisciplinary tumor board meetings (MTMB), diagnostic announcement procedures (DAP), and treatments) were calculated in two French areas experiencing different pandemic's intensity (Reims and Colmar). COVID-19 has had a dramatic impact in terms of screening (-86% to-100%), diagnosis (-39%) , and surgical treatment (-30%). This global decrease in all essential oncology care pathway steps contrasted with the relative stability of chemotherapy (-9%) and radiotherapy use (-16%). Outbreak occurred earlier and with more intensity in Colmar but had a comparable impact in both areas regarding MTBM and DAP. The current ONCOCARE-COV study is still in progress, and with a longer follow-up to analyze post-lockdown situation. The Oncologist 2020;9999:• •

Endogenous infection risk score studied here was found to be relevant in discriminating cases from control groups, but requires validation in a larger cohort.

Background/Aim: Anaplastic thyroid carcinoma (ATC) is the least common but most lethal of thyroid cancer, despite various therapeutic options, with limited efficacy. In order to help therapeutic decision-making, the purpose of this study was to develop a new prognostic score providing survival estimates in patients with ATC. Patients and Methods: Based on a multivariate analysis of 149 retrospectively analyzed patients diagnosed with ATC from 1968 to 2017 at a referral center, a propensity score was developed. A model was generated providing survival probability at 6 months and median overall survival estimates. Results: The median survival was 96 days. The overall survival rate was 35% at 6 months, 20% at 1 year and 13% at 2 years. Stepwise Cox regression revealed that the most appropriate death prediction model included metastatic spread, tumor size and age class as explanatory variables. This model made it possible to define three categories of patients with different survival profiles. Conclusion: Distant metastasis, age and primary tumor size are strong independent factors that affect prognosis in patients with ATC. Using these significant pretreatment factors, we developed a score to predict survival in these patients with poor prognosis.Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the most aggressive malignancies. This type of carcinoma accounts for 1.7% of all thyroid malignancies and one-half of all thyroid cancer deaths (1, 2). The median survival for patients with ATC is 3-6 months, and it has a 1-year survival rate of 20% (3-6). Indeed, ATC most commonly presents in elderly patients with poor performance status, making it difficult to tolerate an active therapeutic approach (7), although some patients survive for a relatively long time after aggressive treatment (8, 9). In such frail patients, aggressive treatment may worsen the quality of life and occasionally even shorten survival; therefore, the selection of patients who will benefit from such aggressive multimodal therapy seems important. Optimal ATC treatment is questionable due to lack of randomized trials; most studies validate the benefit of surgery. Although some reports questioned the benefit of radiotherapy (10), improved survival has been shown with post-operative radiotherapy (11) and radiation dose escalation was also associated with longer survival rates in selected patients with metastatic disease (12). Combined chemoradiotherapy was favored over radiation alone (13,14). However, several series reported no benefit for chemotherapy (6,15). Retrospective studies identified some prognostic factors such as age, gender, presence of acute symptoms, tumor size, multicentricity, metastatic spread, white blood cell level, blood platelet level and serum albumin level, influenced survival of patients with ATC (13,16,17). Here, we reviewed data from 149 patients with ATC in an attempt to identify subsets of patients that either would benefit best from a more aggressive treatment strategy or for whom palliative care would be mo...

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