Limited disease progression in endocrine surgery patients with treatment delays due to COVID-19

Collins, Reagan A.; DiGennaro, Catherine; Beninato, Toni; Gartland, Rajshri M.; Chaves, Natalia; Broekhuis, Jordan M.; Reddy, Lekha; Lee, Jenna; Dreimiller, Angelina; Alterio, Maeve M.; Campbell, Michael J.; Lee, Yeon Joo; Khilnani, Tyler; Stewart, Latoya A.; O’Brien, Mollie; Alvarado, Miguel Valdivia y; Zheng, Feibi; McAneny, David; Liou, Rachel; McManus, Catherine; Dream, Sophie; Wang, Tracy; Alhefdhi, Amal; Finnerty, Brendan M.; Fahey, Thomas J.; Graves, Claire E.; Laird, Amanda M.; Nehs, Matthew A.; Drake, Frederick Thurston; Lee, James A.; McHenry, Christopher R.; James, Benjamin C.; Pasieka, Janice L.; Kuo, Jennifer H.; Lubitz, Carrie C.

doi:10.1016/j.surg.2022.06.043

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Different from other sites, only a small proportion of thyroid nodules are diagnosed as suspicious for malignancy or malignant, 28,29 with the most common thyroid malignancy being low‐risk papillary carcinoma. Although some patients experienced disease progression during COVID‐19 delays in the receipt of endocrine disease‐related care, most patients with follow‐up did not 17 . A multi‐institutional, retrospective study showed a decrease in the number of operations by 64.8%, 44.7%, and 5.1% during the three phases in the first 4 months of the COVID‐19 pandemic compared with the same period in 2019, but with oncologic activity for thyroid malignancies adequately maintained and an incidence of aggressive features comparable to the same periods of the previous year 30 …”

Section: Discussionmentioning

confidence: 99%

“…Although some patients experienced disease progression during COVID-19 delays in the receipt of endocrine disease-related care, most patients with followup did not. 17 A multi-institutional, retrospective study showed a decrease in the number of operations by 64.8%, 44.7%, and 5.1%…”

Section: F I G U R Ementioning

confidence: 99%

“…However, patient outcomes data of endocrine disease-related care across 12 institutions in three countries that implemented resource triage policies, which resulted in delays to patient care, revealed that few patients experienced progression of their disease or a change in the surgical plan after their delay. 17 A decline in examinations and thyroid surgeries occurred in Brazil 18 in a series of 162,081 cases from the national public health system, with a 67% drop in FNAs, which was significantly higher compared with 32.8% on the global scale. 5 Rapid on-site evaluation (ROSE) has been reported to have a statistically significant improvement in the overall sample adequacy rate for thyroid FNA.…”

Section: Introductionmentioning

confidence: 99%

“…Those numbers were probably related to the finding that the examinations were classified as nonurgent, affecting patient management. However, patient outcomes data of endocrine disease‐related care across 12 institutions in three countries that implemented resource triage policies, which resulted in delays to patient care, revealed that few patients experienced progression of their disease or a change in the surgical plan after their delay 17 . A decline in examinations and thyroid surgeries occurred in Brazil 18 in a series of 162,081 cases from the national public health system, with a 67% drop in FNAs, which was significantly higher compared with 32.8% on the global scale 5 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Thyroid FNA cytology: Impact of the COVID‐19 pandemic and vaccination in a Brazilian series

de Andrade Natal,

Bedin,

Giongo

et al. 2023

Cancer Cytopathology

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BackgroundThe coronavirus disease 2019 pandemic prompted changes in medical practice, with a reduction in cytopathology volumes and a relative increase in the malignancy rate during lockdown and the initial postlockdown period. To date, no study has evaluated the impact of these changes on the volume of rapid on‐site evaluation (ROSE) or on the frequency of cases according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) categories after vaccination.MethodsUltrasound‐guided thyroid fine‐needle aspiration (FNA) and ROSE assessments performed from January 2019 to May 2022 were evaluated retrospectively according to TBSRTC categories for three periods: prepandemic (period 1), from transmission to expansion (period 2), and after vaccination (period 3).ResultsThere were 7531 nodules from 5815 patients. FNA cases increased throughout the pandemic despite a drop during lockdown. The frequency of TBSRTC categories changed. Nondiagnostic cases had an increase of 18.1% in period 2 and 76.2% after vaccination compared with prepandemic levels. Malignant cases increased from 2.3% to 4.2% in period 2 and to 5.1% in period 3, representing increases of 83.1% and 121.2%, respectively, compared with period 1. Data corrected by time showed increases in categories IV, V, and VI and a decrease in benign nodules during the two pandemic periods. ROSE was performed in 787 cases during the prepandemic period, and there were decreases of 29.4% and 22.8% in periods 2 and 3, respectively. The ROSE‐to‐category I ratio was reduced significantly after vaccination.ConclusionsIncreased volume with sustained lower benign rates and higher malignant rates before and after vaccination indicate better selection of patients for FNA. A worse adequacy rate was correlated with a decrease in the number of ROSE assessments.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R Ementioning

confidence: 99%