Colorectal cancer treatment outcomes during the pandemic: Our experience of COVID-19 at a tertiary referral center

IF 1.4 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2024-02-23 DOI:10.1111/ajco.14051

Christy Kei, Richard Gartrell, Yasser Arafat, Elizabeth Degabriele, Josephine Yeung, Steven Chan, Ian Faragher, Justin M. C. Yeung

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Abstract

Backgrounds

The coronavirus disease 2019 (COVID-19) has led to major shifts in the management of colorectal cancer (CRC). This study aims to identify the impact and early outcomes of COVID-19 following CRC management at a tertiary referral center in Victoria, Australia.

Methods

This was a retrospective study, utilizing the Australian Comprehensive Cancer Outcomes and Research Database and inpatient records. Patients presenting for CRC management at our institution were identified coinciding with the first Victorian outbreak of COVID-19 (March 26 to September 26, 2020) (COVID). Management decisions including chemoradiotherapy utilization and surgical outcomes were analyzed within 6 months and compared with the corresponding period in 2019 (pre-COVID).

Results

A total of 276 patients were included in this study (147 pre-COVID period, 129 COVID period). During the COVID period, more patients (47.6% vs. 60.5%; p = 0.033) presented symptomatically and less for surveillance (10.9% vs. 2.3%; p < 0.01). Eighty-four pre-COVID and 69 COVID period patients proceeded to surgery. The average time from diagnosis date to surgery was 15.6 days less during the COVID period. There were no significant differences in postoperative utilization of higher care (p = 0.74), complications (p = 0.93), median hospital length of stay (p = 0.67), 30-day readmission (p = 0.50), or 30-day reoperation (p = 0.74). In 1.6% of cases, pandemic impacts resulted in a change in management.

Conclusion

Presentation of patients with CRC varied, with a significant increase in symptomatic presentations and decreased numbers for surveillance. Through flexibility and change in practice, our institution helped improve access to surgical intervention and oncological therapies. Further prospective work is required to identify long-term outcomes and characterize the effects of ongoing disruptions.

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大流行期间的结直肠癌治疗结果：我们在一家三级转诊中心接受 COVID-19 治疗的经验。

背景：2019年冠状病毒疾病（COVID-19）已导致结直肠癌（CRC）管理发生重大转变。本研究旨在确定 COVID-19 对澳大利亚维多利亚州一家三级转诊中心 CRC 管理的影响和早期结果：这是一项回顾性研究，利用了澳大利亚综合癌症结果与研究数据库和住院病历。在维多利亚州首次爆发 COVID-19（2020 年 3 月 26 日至 9 月 26 日）（COVID）时，在本院接受 CRC 治疗的患者被识别出来。分析了6个月内的管理决策，包括化放疗使用情况和手术结果，并与2019年同期（COVID前）进行了比较：本研究共纳入 276 例患者（COVID 前 147 例，COVID 期间 129 例）。在 COVID 期间，有症状的患者较多（47.6% 对 60.5%；P = 0.033），而接受监测的患者较少（10.9% 对 2.3%；P 结论：COVID 期间，CRC 患者的症状各不相同：CRC 患者的就诊情况各不相同，有症状的就诊人数显著增加，而接受监测的人数则有所减少。我院通过灵活改变诊疗方法，帮助提高了手术治疗和肿瘤治疗的可及性。需要进一步开展前瞻性工作，以确定长期疗效并描述持续中断的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.