直肠癌治疗中的复原力:捷克共和国 COVID-19 时代的经验教训。

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2024-06-17 eCollection Date: 2024-01-01 DOI:10.2147/TCRM.S455332
Peter Ihnát, Lubomír Martínek, Lubomír Tulinský, Zdeněk Kala, Tomáš Grolich, Robert Gurlich, Jan Šturma, Dušan Klos, Petr Špička, Čestmír Neoral, Vladimir Černý
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引用次数: 0

摘要

导言:对 COVID-19 感染者的管理给世界各地的医疗系统带来了巨大压力。本研究的目的是通过与疫情爆发前相同诊断的直肠癌患者进行比较,调查 COVID-19 大流行对直肠癌患者治疗效果的影响:对COVID-19大流行期间(2020-2021年)和大流行前2年(2018-2019年)在四所大学医院接受多模式治疗的直肠癌患者进行回顾性数据分析:研究共纳入了693名直肠癌患者(流行前319名,流行期374名)。两个研究期间患者的人口统计学和临床特征以及手术治疗范围具有可比性。大流行时期的姑息手术更为常见(18% 对 13%,P=0.084)。在 COVID-19 大流行期间,接受微创手术的患者比例更高(P=0.025)。研究期间的术后并发症发生率/严重程度、30 天死亡率和住院时间在统计学上没有明显差异。切除边缘阳性的数量相似(5% vs 5%)。根据这些结果,COVID-19 对直肠癌手术患者的术后发病率和死亡率没有影响。新辅助治疗在大流行前更为常见(50% 对 45%)。大流行前主要提供长程 RT,大流行期间则提供短程 RT。大流行期间,"诊断-手术 "时间间隔明显缩短(23 天 vs 33 天,P=0.0002)。两个分析研究期间的 "手术-辅助治疗 "间隔时间相似(P=0.219):我们的研究表明,尽管COVID-19大流行令人担忧,但直肠癌的多模式治疗与术后发病率不变、短程新辅助RT用药频率增加和 "诊断-手术 "间隔缩短有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Resilience in Rectal Cancer Treatment: Lessons from the COVID-19 Era in Czech Republic.

Introduction: The management of patients with COVID-19 infection has placed great pressure on the healthcare systems around the world. The aim of this study was to investigate the impact of the COVID-19 pandemic on the treatment outcomes of patients with rectal cancer by comparing them to those of patients with the same diagnosis in the pre-pandemic period.

Methods: Retrospective data analysis of patients undergoing multimodal treatment for rectal cancer at the four university hospitals during the COVID-19 pandemic (2020-2021) and the 2-year pre-pandemic period (2018-2019).

Results: A total of 693 patients (319 in the pre-pandemic period and 374 in the pandemic period) with rectal cancer were included in the study. The demographic and clinical characteristics of patients in both study periods were comparable, as was the spectrum of surgical procedures. Palliative surgery was more common in the pandemic period (18% vs 13%, p=0.084). The proportion of patients undergoing minimally invasive surgery was higher during the COVID-19 pandemic (p=0.025). There were no statistically significant differences between the study periods in the incidence/severity of post-operative complications, 30-day mortality and length of hospital stay. The number of positive resection margins was similar (5% vs 5%). Based on these results, COVID-19 had no effect on the postoperative morbidity and mortality in patients undergoing surgery for rectal cancer. Neoadjuvant treatment was more common in the pre-pandemic period (50% vs 45%). Long-course RT was predominantly offered in the pre-pandemic period, short-course RT during the pandemic. Significantly shorter "diagnosis-surgery" intervals were observed during the pandemic (23 days vs 33 days, p=0.0002). The "surgery-adjuvant therapy" interval was similar in both analysed study periods (p=0.219).

Conclusion: Our study showed, that despite concerns about the COVID-19 pandemic, multimodal treatment of rectal cancer was associated with unchanged postoperative morbidity rates, increased frequency of short-course neoadjuvant RT administration and shorter "diagnosis-surgery" intervals.

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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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