The impact of the Covid-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland: A case-control study

Abstract

Objective: To assess the impact of the Covid-19 pandemic on the diagnosis and treatment of patients at tertiary hospital in Poland. Design, setting, participants: This was a retrospective review of head and neck cancer patients presented to the multidisciplinary tumour board (MTB) during the 12-month period from March 2020 through February 2021 and compared to patients presented to the MTB during the prior, pre-pandemic 12-month period from February 2019 to March 2020. Main outcomes and measures: Patient demographic and clinical variables were compared: sex; age at diagnosis; distance from hospital; date of first visit, radiological diagnosis, pathology specimen, MTB meeting, and initiation of primary and adjuvant treatment Results: The number of patients presented to the MTB increased by 22% (278 to 340) from the pre-pandemic to the pandemic period. The mean time from MTB presentation to treatment initiation increased significantly from 17.1 to 21.7 days. The mean time from first visit to treatment start increased from 44.7 to 54.4 days. The proportion of patients with early-stage oropharyngeal cancer who underwent primary surgery rose from 47.3% to 86.6%. The percentage of patients who received palliative radiotherapy increased from 20.5% to 32.9%. The proportion of patients who received best supportive care rose from 1.8% to 6.2%. Conclusion: One of the most notable findings of this study was the increased time from first visit to treatment initiation, which could negatively impact patient outcomes. The differences in the treatment received in these two periods should be further evaluated to determine their influence on survival