Comparison of Clinical and Pathological Characteristics of Thyroid Cancer Surgery in the Pandemic Era.

Abstract

Background: The COVID-19 pandemic brought significant challenges for oncology centers and cancer patients, necessitating the implementation of various preventive and restrictive protocols and postponing elective surgeries. We aimed to assess and compare tumor characteristics, including the size, metastasis, and duration of hospitalizations between the periods before and during COVID-19 in patients with thyroid cancer.

Methods: The present cross-sectional study was performed at The Institute of Cancer, Tehran University of Medical Sciences, with 143 patients observed 2 years before the pandemic and 92 during March 2020 and March 2022. Clinical and pathological tumor characteristics were compared between the 2 groups, including surgical details, hospitalization and intensive care unit (ICU) admission durations, time intervals between diagnoses and surgeries, and various metastatic factors. All data were analyzed using SPSS software 21. The chi-square test was used for the statistical analysis of qualitative data, and the t test was used for the statistical analysis of continuous data. P < 0.05 was considered statistically significant.

Results: The most frequent tumor type was papillary thyroid cancer (134 [93.7%] and 82 [89.13%]; P = 0.209). The right lobe was the most prevalent tumor site both before and during COVID-19, respectively (55 [38.5%] and 29 [31.5%]; P = 0.278). Central (64 [50.8%] and 62 [49.2%]; P < 0.001), and lateral (45 [34.5%] and 45 [48.9 %]; P = 0.045) lymph node metastasis in the first surgery and recurrence (P = 0.006 and P = 0.022, respectively) were significantly higher in patients admitted during the COVID-19 pandemic, respectively. The mean interval between the first surgery and subsequent surgery due to recurrence (P < 0.001), duration of ICU admission (P = 0.010), and hospitalization after the second operation were significantly lower during the pandemic (P = 0.006).

Conclusion: During the COVID-19 pandemic, patients exhibited larger tumors, increased lymph node metastasis, and shorter intervals between surgeries. This underscores the need for healthcare decision-makers to implement effective thyroid cancer management strategies in future outbreaks. Our study stands out by analyzing hospitalization and ICU admissions and duration for each patient, unlike any other study. Moreover, we extended our observation period beyond the typical duration found in most of the literature.