Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre

Leung, Elaine; Pervaiz, Zahra; Lowe‐Zinola, Jack; Cree, Sian; Kwong, Amanda K L; Marriott, Natalie; Cole, Florence; Arum, Uchechukwu; Szopinski, Barbara; Elattar, Ahmed; Sundar, Sudha; Kehoe, Sean; Singh, Kavita; Balega, Janos; Yap, Jason

doi:10.1016/j.ygyno.2020.12.013

Cited by 20 publications

(23 citation statements)

References 10 publications

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“…The indicators that reported on “changes in cancer staging” were grouped in 3 different categories: general staging indicators (14 indicators from 8 articles [75,77,81,94–98]), proportion of earliest-stage cancers (35 indicators from 9 articles [41,71,81,99–104]), and proportion of advanced-stage cancers (61 indicators from 17 articles [39,57,63,66,77,79,87,92,93,95–102]).…”

Section: Resultsmentioning

confidence: 99%

“…Two main outcomes were addressed in the included articles: "procedures and surgical outcome measures" and "mortality". Fifteen indicators from 8 articles [93,[97][98][99][100][101][102][103] conveyed information regarding procedures' outcomes. From these indicators, 11 (73%) showed similar complication rates.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty articles reported on "changes in treatment", resulting in 304 indicators collated. A total of 106 indicators (19 articles [50,52,65,75,77,90,[96][97][98]101,102,106,118,121,135,137,138,142,154]) were collected from administrative data, 13 indicators from registry data [134,138] and 185 were surveybase information [13,46,58,70,78,85,88,[113][114][115][116]126,130,141,145,[148][149][150][151][155][156][157][158][159]. Changes in treatment are summarized in Fig.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Carvalho

Fernandes

Lange

et al. 2022

Preprint

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Objectives: Summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020), and to assess changes in the quality of care as assessed via selected indicators. Methods: Scoping review. Indicators and their reported trends were collated following the cancer care pathway. Results: Database searches retrieved 6277 articles, 838 articles met the inclusion criteria, and 135 articles were included after full-text screening, from which 917 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n=30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n=64, 58%) and in the diagnoses (n=130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed an increasing trend (n=8, 89% and n=14, 56%, respectively). Nine indicators (64%) showed stability in cancer stages distribution. A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n=9), and 70% (n=43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79% (n=82) of indicators concerning surgeries, 72% (n=41) of indicators assessing trends in radiotherapy, and 93% (n=40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64% (n=195) of indicators revealed changes in treatment. Ten indicators (83%) signalled a decreasing number of hospital admissions. Conclusion: Health systems struggled to ensure continuity of cancer care. As this pandemic keeps evolving, the trends reported over the first 6 months of 2020 provide an argument to monitor these changes closely. This information needs to be transparent, standardised, and timely, allowing to monitor quality and outcomes of care during crises and inform policy responses.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Carvalho

Fernandes

Lange

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Similarly, the number of surgeries performed was accounted for but the details of the surgical procedures were not explored. Considering the reports from other countries [ 14 ], it is possible that the number of laparoscopic surgery and highly invasive surgeries such as lymph node dissection and gastrointestinal resection may be affected, but we did not attempt to sub classify the data. Secondly, the data surveyed in this study and the JSOG data used as control data were based on reports from designated facilities only.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on gynecologic cancer treatment in Japan: a nationwide survey by the Japan Society of Gynecologic Oncology (JSGO)

et al. 2022

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Objective As coronavirus disease 2019 (COVID-19) rages on, it is a challenging task to balance resources for treatment of COVID-19 and malignancy-based treatment. For the development of optimal strategies, assessing the conditions and constrains in treatment during the COVID-19 pandemic is pertinent. This study reported about a nationwide survey conducted by the Japan Society of Gynecologic Oncology. Methods We interviewed 265 designated training facilities about the state of their clinical practice from the time period between March and December 2020. We asked the facility doctors in charge to fill a web-based questionnaire. Results A total of 232 facilities (87.5%) responded. A decrease in the number of outpatient visits was reported, and the major reason attributed was reluctance of patients to visit hospitals rather than facility restrictions. The actual number of surgeries decreased by 3.9%, compared to 2019. There was a significant difference when the variable of “Prefectures operating under special safety precautions” or not was introduced. There was no increase in the rate of advanced stages in the three cancer types studied. However, 34.1% participants perceived COVID-19 affected management and prognosis. Conclusion Refraining from visiting hospitals based on the patient's judgment may be expected to be an issue in the future. No significant decrease in surgeries was observed, and it would seem that there were few forced changes in treatment plans, but “the State of Emergency” had an impact. There was no increase in the rate of advanced cancers, but this will need to be monitored.

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“…74 Lastly, data from the United Kingdom, Turkey, and Italy show that while maintaining gynecologic cancer treatment during the pandemic time the Covid-19 infection rate is found at a low level, 1/289 is Covid-19 positive and 1 post-operative death suspected of Covid-19 (UK), 2/200 is suspected with Covid-19 but neither was positive for COVID-19 on polymerase chain reaction testing (Turkey), and 1/930 is Covid-19 positive (Italy). [75][76][77] We hope these ndings will be useful among gynecologist-oncologists in cancer centers or tertiary cancer referral centers who provide care to gynecologic cancer patients during the ongoing Covid-19 pandemic.…”

Section: Gynecologic Cancer Vs Hematologic Cancer Discussionmentioning

confidence: 99%

Outcome of Gynecologic Cancer Patients With The Covid-19 Infection : A Systematic Review And Meta Analysis

Winata

Simatupang

Polim

et al. 2022

Preprint

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Objective Cancer is comorbidity, which can lead to progressive worsening of Covid-19 with increased mortality. This is a systematic review and meta-analysis to get evidence of adverse outcomes of Covid-19 in gynecologic cancer. Methods Searches through PubMed, Google Scholar, ScienceDirect, and medRxiv to find articles on the outcome of gynecologic cancer with Covid-19 (24 July 2021-19 February 2022). Newcastle-Ottawa Scale tool used to evaluate the quality of included studies. Pooled odds ratio (OR), 95% confidence interval (CI), random-effects model were presented. This study was registered to PROSPERO (CRD42021256557). Results We accepted 49 studies with (1994 gynecologic cancer with Covid-19). Covid-19 infection was lower in gynecologic cancer vs hematologic cancer (OR 0.71, CI 0.56–0.89, p 0.003). Severe Covid and death were lower in gynecologic cancer vs lung and hematologic cancer (OR 0.36, CI 0.16–0.80, p 0.01), (OR 0.26, CI 0.10–0.67 p 0.005), (OR 0.52, CI 0.43–0.63, p < 0.0001), (OR 0.65, CI 0.49–0.87, p 0.003) respectively. Increased Covid death is seen in gynecologic cancer vs breast, non-covid cancer, and non-cancer covid (OR 1.51, CI 1.20–1.90, p 0.0004), (OR 12.21, CI 8.39–17.77, p < 0.0001), (OR 3.06, CI 2.32–4.04, p < 0.0001) respectively. Conclusion Gynecologic cancer had increased Covid-19 adverse outcomes compared to non-cancer, breast cancer, non-metastatic, and Covid-19 negative population. Gynecologic cancer had lowered Covid-19 adverse outcomes compared to other cancer types, lung cancer, and hematologic cancer. Lack of age and comorbidities stratification due to limited data were limitations. These findings may aid health policies and services during the ongoing global pandemic.

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Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre

Cited by 20 publications

References 10 publications

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a Scoping Review

Impact of COVID-19 on gynecologic cancer treatment in Japan: a nationwide survey by the Japan Society of Gynecologic Oncology (JSGO)

Outcome of Gynecologic Cancer Patients With The Covid-19 Infection : A Systematic Review And Meta Analysis

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