Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

D’Ascanio, Luca; Latini, Giulio; Pandolfini, Manlio; Head, Aormn; Team, Neck Cancer; Imperatori, L.; Stadio, Arianna Di

doi:10.1016/j.oraloncology.2021.105439

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…For instance, in 2020, in Lombardy, one of the Italian regions most affected by the pandemic, an overall drop of 60.1% was shown, 20 suggesting that the epidemiological situation had a great influence on the impact on oncological surgeries. Moreover, the site‐specific significant reductions that we reported in Piedmont were different from results from other regions (e.g., in Southern and Central Italy significant reduction have been revealed for breast, thyroid, and skin cancer), 21,22 indicating discrepancies that cannot be explained solely by differences in the SARS‐CoV‐2 epidemiological context. It is possible that the observed differences are due to organizational disparities; therefore, it is crucial to further investigate organizational variations in service delivery and pathways for different types of cancer, to understand which reductions were avoidable and which organizational strategies were effective.…”

Section: Discussioncontrasting

confidence: 99%

“…for breast, thyroid, and skin cancer), 21,22 indicating discrepancies that cannot be explained solely by differences in the SARS-CoV-2 epidemiological context. It is possible that the observed differences are due to organizational disparities; therefore, it is crucial to further investigate organizational variations in service delivery and pathways for different types of cancer, to understand which reductions were avoidable and which organizational strategies were effective.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the pandemic on surgical oncology in Piedmont, Italy: A retrospective observational study

Lo Moro,

Ragusa,

Previti

et al. 2024

Journal of Surgical Oncology

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Background and MethodsThis retrospective observational study analyzes how the COVID‐19 pandemic affected surgical oncology healthcare in a large sample from Piedmont, Northern Italy. Patients admitted for regular hospitalization were included (n = 99 651). Data from 2020 were compared to the averages from 2016 to 2019, stratified by tumor site, year, month, and admission method, using interrupted time series analysis post‐March 2020.ResultsIn 2020, oncological surgeries decreased by 12.3% (n = 17 923) compared to the 2016–2019 average (n = 20 432), notably dropping post‐March (incidence rate ratio = 0.858; p < 0.001). The greatest reduction was observed for breast (−19.2%), colon (−18.2%), bladder (−17.5%), kidney (−14.2%), and prostate (−14%) surgeries. There was a huge reduction in nonemergency admissions (−13.6%), especially for colon (−23.8%), breast (−19.4%), and bladder (−18.7%). The proportion of hospitalizations with emergency access increased (p < 0.001).ConclusionsThe COVID‐19 pandemic led to a significant decrease in cancer surgeries in Piedmont in 2020, with an increase in the proportion of admissions through emergency access.DiscussionThe research provides valuable insights for comparing data with other regions and evaluating the effectiveness of efforts to recover lost surgical procedures. These findings can be useful to policymakers in developing coordinated measures and more efficient access strategies to healthcare services in any future emergency situations.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the pandemic on surgical oncology in Piedmont, Italy: A retrospective observational study

Lo Moro,

Ragusa,

Previti

et al. 2024

Journal of Surgical Oncology

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“…Five out of seven published studies reported more advanced T-and N-stages of HNC patients during the pandemic [ 18 - 20 , 22 , 24 ]. Despite severe pressure on health services in northern Italy during the beginning of the virus spread, D'Ascanio et al [ 25 ] did not notice any shift to more advanced cancer stages during this period. These reports, even though geographically limited, indicate the negative side effects of the pandemic on public health.…”

Section: Discussionmentioning

confidence: 95%

Effects of the COVID-19 Pandemic on Head and Neck Cancer Stage and Treatment Duration

Kourtidis¹,

Münst²,

Hofmann³

2022

Cureus

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To assess the efficacy of oncologic healthcare during the COVID-19 pandemic on patients with head and neck squamous cell carcinoma (SCC) in a tertiary university hospital in Germany. MethodsThis retrospective, cross-sectional, observational study included 94 patients with newly diagnosed head and neck squamous cell carcinoma during a two-year period. Patients were assigned to two date-dependent groups; referrals before (group A) and during (group B) the COVID-19 pandemic. Time intervals from the symptom(s) onset to diagnosis, diagnosis to treatment, and treatment initiation to completion were recorded. Furthermore, TNM stages and the application of reconstructive surgery with free tissue transfer were determined. Patients' outcomes and characteristics were compared between the two groups. Finally, a comprehensive literature review was carried out to identify similar epidemiological studies. ResultsThe symptom-to-diagnosis interval was longer during the COVID-19 pandemic [median 9.5 (A) versus 15 (B) weeks, p = 0.054]. The intervals from diagnosis to treatment and treatment initiation to end of treatment were approximately the same in both groups [median 3 (A) versus 3.2 (B) weeks, p = 0.264; and 6.9 (A) versus 6.3 (B) weeks, p = 0.136]. The T-and N-stages were not higher during the pandemic [early T-stage (T1+T2) versus advanced T-stage (T3+T4), p = 0.668; and N-negative (N0) versus N-positive status (N1,2,3), p = 0.301]. Patients who presented with distant metastatic disease and those who underwent reconstructive surgery with free tissue transfer were observed more frequently in the lockdown phase [M1 versus M0, p= 0.022; and flap versus no flap, p=0.007]. ConclusionThis study suggests the consistent diagnostic and therapeutical performance of the tertiary oncologic healthcare in Berlin, Germany, despite the challenges that patient care units faced during the COVID-19 pandemic.

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“…Further exploration of HNC patient care in other Canadian centers during the pandemic, along with a prospective evaluation of this transparent model for patient-centered OR prioritization in those different settings, would help determine its role on the national level moving forward. The results are also limited in their comparison to other countries which utilize healthcare systems unlike the publicly funded single-payer system in Canada (Medicare), especially in terms of wait times and access to services [28][29][30]. For example, a study by Schoonbeek et al in the Netherlands, also found a decrease in the mean time to treat interval during the first wave of the pandemic, which they attributed in part to a decline in overall patient volume and national quality indicators for HNC patient care [31].…”

Section: Study Limitationsmentioning

confidence: 99%

Prioritization of head and neck cancer patient care during the COVID-19 pandemic: A retrospective cohort study

Psycharis

Salameh

Turkdogan

et al. 2023

Journal of Otolaryngology - Head & Neck Surgery

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Background The COVID-19 pandemic placed considerable strain on the healthcare system, leading to the re-allocation of resources and implementation of new practice guidelines. The objective of this study is to assess the impact of COVID-19 guideline modifications on head and neck cancer (HNC) care at two tertiary care centers in Canada. Methods A retrospective cohort study was conducted. HNC patients seen at two tertiary care centers before and after the onset of the COVID-19 pandemic (pre-pandemic: July 1st, 2019, to February 29th, 2020; pandemic: March 1st, 2020, to October 31st, 2020) were included. The pre-pandemic and pandemic cohorts were compared according to patient and tumor characteristics, duration of HNC workup, and treatment type and duration. Mean differences in cancer care wait times, including time to diagnosis, tumor board, and treatment as well as total treatment package time and postoperative hospital stay were compared between cohorts. Univariate and multivariate analyses were used to compare characteristics and outcomes between cohorts. Results Pre-pandemic (n = 132) and pandemic (n = 133) patients did not differ significantly in sex, age, habits, or tumor characteristics. The percentage of patients who received surgery only, chemo/radiotherapy (CXRT) only, and surgery plus adjuvant CXRT did not differ significantly between cohorts. Pandemic patients experienced a significant time reduction compared to pre-pandemic patients with regards to the date first seen by a HNC service until start of treatment ($$\overline{x}$$ x ¯ = 48.7 and 76.6 days respectively; p = .0001), the date first seen by a HNC service until first presentation at tumor board ($$\overline{x}$$ x ¯ = 25.1 and 38 days respectively; p = .001), mean total package time for patients who received surgery only ($$\overline{x}$$ x ¯ = 3.7 and 9.0 days respectively; p = .017), and mean total package time for patients who received surgery plus adjuvant CXRT ($$\overline{x}$$ x ¯ = 80.2 and 112.7 days respectively; p = .035). Conclusion The time to treatment was significantly reduced during the COVID-19 pandemic as compared to pre-pandemic. This transparent model of patient-centered operative-room prioritization can serve as a model for improving resource allocation and efficiency of HNC care during emergency and non-emergency scenarios.

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Covid-19 negatively impacted on small oncology surgery but none on major procedures: Regional experience

Cited by 4 publications

References 14 publications

Impact of the pandemic on surgical oncology in Piedmont, Italy: A retrospective observational study

Impact of the pandemic on surgical oncology in Piedmont, Italy: A retrospective observational study

Effects of the COVID-19 Pandemic on Head and Neck Cancer Stage and Treatment Duration

Prioritization of head and neck cancer patient care during the COVID-19 pandemic: A retrospective cohort study

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