The impact of the COVID-19 pandemic on the diagnosis, stage, and treatment of esophagogastric cancer

Doeve, Benthe H.; Bakx, Jeanne A. C.; Siersema, Peter D.; Rosman, Camiel; Grieken, Nicole C.T. van; Henegouwen, Mark I. van Berge; Sandick, Johanna W. van; Verheij, Marcel; Bijlsma, Maarten F.; Verhoeven, Rob; Laarhoven, Hanneke W. M. van

doi:10.1007/s00535-023-02009-3

Cited by 5 publications

(2 citation statements)

References 28 publications

(29 reference statements)

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“…The COVID-19 pandemic, especially the first waves, had a huge impact on cancer care: cancellation of consultations, screening and diagnostic tests and surgeries; medical material scarcity; fear to go to the hospital; and patients who contracted COVID-19, among others[ 35 , 36 ]. In our series, seven patients lost their opportunity to undergo surgery with a curative intent during the first wave.…”

Section: Discussionmentioning

confidence: 99%

Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes

Trébol,

Carabias-Orgaz,

Esteban-Velasco

et al. 2024

World J Methodol

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BACKGROUND The first wave of coronavirus disease 2019 (COVID-19) pandemic in Spain lasted from middle March to the end of June 2020. Spanish population was subjected to lockdown periods and scheduled surgeries were discontinued or reduced during variable periods. In our centre, we managed patients previously and newly diagnosed with cancer. We established a strategy based on limiting perioperative social contacts, preoperative screening (symptoms and reverse transcription-polymerase chain reaction) and creating separated in-hospital COVID-19-free pathways for non-infected patients. We also adopted some practice modifications (surgery in different facilities, changes in staff and guidelines, using continuously changing personal protective equipment…), that supposed new inconveniences. AIM To analyse cancer patients with a decision for surgery managed during the first wave, focalizing on outcomes and pandemic-related modifications. METHODS We prospectively included adults with a confirmed diagnosis of colorectal, oesophago-gastric, liver-pancreatic or breast cancer with a decision for surgery, regardless of whether they ultimately underwent surgery. We analysed short-term outcomes [30-d postoperative morbimortality and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection] and outcomes after 3 years (adjuvant therapies, oncological events, death, SARS-CoV-2 infection and vaccination). We also investigated modifications to usual practice. RESULTS From 96 included patients, seven didn’t receive treatment that period and four never (3 due to COVID-19). Operated patients: 28 colon and 21 rectal cancers; laparoscopy 53.6%/90.0%, mortality 3.57%/0%, major complications 7.04%/25.00%, anastomotic leaks 0%/5.00%, 3-years disease-free survival (DFS) 82.14%/52.4% and overall survival (OS) 78.57%/76.2%. Six liver metastases and six pancreatic cancers: no mortality, one major complication, three grade A/B liver failures, one bile leak; 3-year DFS 0%/33.3% and OS 50.0%/33.3% (liver metastases/pancreatic carcinoma). 5 gastric and 2 oesophageal tumours: mortality 0%/50%, major complications 0%/100%, anastomotic leaks 0%/100%, 3-year DFS and OS 66.67% (gastric carcinoma) and 0% (oesophagus). Twenty breast cancer without deaths/major complications; 3-year OS 100% and DFS 85%. Nobody contracted SARS-CoV-2 postoperatively. COVID-19 pandemic–related changes: 78.2% treated in alternative buildings, 43.8% waited more than 4 weeks, two additional colostomies and fewer laparoscopies. CONCLUSION Some patients lost curative-intent surgery due to COVID-19 pandemic. Despite practice modifications and 43.8% delays higher than 4 weeks, surgery was resumed with minimal changes without impacting outcomes. Clean pathways are essential to continue surgery safely.

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Section: Discussionmentioning

confidence: 99%

Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes

Trébol,

Carabias-Orgaz,

Esteban-Velasco

et al. 2024

World J Methodol

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“…A Dutch study reported a decrease in esophageal cancer patients in 2020 and an increase in the proportion of patients with incurable esophageal and stomach cancer. They suggest that this was owing to patients with mild symptoms refraining from medical visits [26]. An English study reported a 37% decrease in hepatocellular carcinoma patients in 2020.…”

Section: Introductionmentioning

confidence: 99%

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Kuzuu,

Misawa,

Ashikari

et al. 2023

Cancers

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This retrospective cohort study compared the number of newly diagnosed patients, stage at diagnosis, and detection process of gastrointestinal cancers based on hospital-based cancer registry data at two tertiary Japanese hospitals. The pre-COVID-19 period was from January 2017 to February 2020, with phase 1 (midst of COVID-19 pandemic) from March to December 2020 and phase 2 (the transition period to the “new normal”) from January to December 2021. Each month, the number of patients diagnosed with esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers were aggregated, classified by stage and detection process, and compared, including a total of 6453 patients. The number of colorectal Stage 0-II patients decreased significantly in phase 1 and increased in phase 2. The total number of colorectal cancer patients returned to pre-COVID-19 levels (mean monthly patients [SD]: 41.61 [6.81] vs. 36.00 [6.72] vs. 46.00 [11.32]). The number of patients with gastric cancer Stage I significantly decreased in phase 2 following phase 1. The number of gastric cancer patients decreased significantly from pre-COVID-19 levels (30.63 [6.62] vs. 22.40 [5.85] vs. 24.50 [4.15]). During phase 2, the number of patients diagnosed after screening with colorectal cancer increased significantly, whereas that with gastric cancer remained considerably lower. The number of Stage III colorectal and gastric cancer patients increased significantly from the pre-COVID-19 levels. Thus, gastric cancer may not be optimally screened during phases 1 and 2. There was a significant increase in patients with Stage III colorectal and gastric cancers from the pre-COVID-19 period; hence, the stage at diagnosis may have progressed.

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Editorial: Comparisons of COVID-19-related disturbance in diagnosis of esophagogastric cancer between the Netherlands and Japan

Iijima,

Watanabe,

Shimodaira

2023

J Gastroenterol

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The impact of the COVID-19 pandemic on the diagnosis, stage, and treatment of esophagogastric cancer

Cited by 5 publications

References 28 publications

Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes

Digestive and breast cancer patients managed during the first wave of COVID-19 pandemic: Short and middle term outcomes

Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study

Editorial: Comparisons of COVID-19-related disturbance in diagnosis of esophagogastric cancer between the Netherlands and Japan

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