The effect of the first year of the COVID-19 pandemic on sphincter preserving surgery for rectal cancer: A single referral center experience.
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
02
11
2021
revised:
07
02
2022
accepted:
08
02
2022
pubmed:
27
3
2022
medline:
3
5
2022
entrez:
26
3
2022
Statut:
ppublish
Résumé
COVID-19 has significantly impacted healthcare worldwide. Lack of screening and limited access to healthcare has delayed diagnosis and treatment of various malignancies. The purpose of this study was to determine the effect of the first year of the COVID-19 pandemic on sphincter-preserving surgery in patients with rectal cancer. This was a single-center retrospective study of patients undergoing surgery for newly diagnosed rectal cancer. Patients operated on during the first year of the COVID-19 pandemic (March 2020-February 2021) comprised the study group (COVID-19 era), while patients operated on prior to the pandemic (March 2016-February 2020) served as the control group (pre-COVID-19). This study included 234 patients diagnosed with rectal cancer; 180 (77%) patients in the pre-COVID-19 group and 54 patients (23%) in the COVID-19-era group. There were no differences between the groups in terms of mean patient age, sex, or body mass index. The COVID-19-era group presented with a significantly higher rate of locally advanced disease (stage T3/T4 79% vs 58%; P = .02) and metastatic disease (9% vs 3%; P = .05). The COVID-19-era group also had a much higher percentage of patients treated with total neoadjuvant therapy (52% vs 15%; P = .001) and showed a significantly lower rate of sphincter-preserving surgery (73% vs 86%; P = .028). Time from diagnosis to surgery in this group was also significantly longer (median 272 vs 146 days; P < .0001). Patients undergoing surgery for rectal cancer during the first year of the COVID-19 pandemic presented later and at a more advanced stage. They were more likely to be treated with total neoadjuvant therapy and were less likely candidates for sphincter-preserving surgery.
Sections du résumé
BACKGROUND
COVID-19 has significantly impacted healthcare worldwide. Lack of screening and limited access to healthcare has delayed diagnosis and treatment of various malignancies. The purpose of this study was to determine the effect of the first year of the COVID-19 pandemic on sphincter-preserving surgery in patients with rectal cancer.
METHODS
This was a single-center retrospective study of patients undergoing surgery for newly diagnosed rectal cancer. Patients operated on during the first year of the COVID-19 pandemic (March 2020-February 2021) comprised the study group (COVID-19 era), while patients operated on prior to the pandemic (March 2016-February 2020) served as the control group (pre-COVID-19).
RESULTS
This study included 234 patients diagnosed with rectal cancer; 180 (77%) patients in the pre-COVID-19 group and 54 patients (23%) in the COVID-19-era group. There were no differences between the groups in terms of mean patient age, sex, or body mass index. The COVID-19-era group presented with a significantly higher rate of locally advanced disease (stage T3/T4 79% vs 58%; P = .02) and metastatic disease (9% vs 3%; P = .05). The COVID-19-era group also had a much higher percentage of patients treated with total neoadjuvant therapy (52% vs 15%; P = .001) and showed a significantly lower rate of sphincter-preserving surgery (73% vs 86%; P = .028). Time from diagnosis to surgery in this group was also significantly longer (median 272 vs 146 days; P < .0001).
CONCLUSION
Patients undergoing surgery for rectal cancer during the first year of the COVID-19 pandemic presented later and at a more advanced stage. They were more likely to be treated with total neoadjuvant therapy and were less likely candidates for sphincter-preserving surgery.
Identifiants
pubmed: 35337683
pii: S0039-6060(22)00085-X
doi: 10.1016/j.surg.2022.02.006
pmc: PMC8849841
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1209-1214Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.
Références
World J Surg. 2012 Mar;36(3):675-83
pubmed: 22270980
J Natl Compr Canc Netw. 2018 Jul;16(7):874-901
pubmed: 30006429
Ann Surg. 2009 Oct;250(4):582-9
pubmed: 19710605
Int J Colorectal Dis. 2006 Jan;21(1):11-7
pubmed: 15864605
Oncology (Williston Park). 2020 Sep 15;34(9):343
pubmed: 32965661
Br J Surg. 2021 Apr 30;108(4):e164-e165
pubmed: 33793768
Br J Surg. 2020 Sep;107(10):1250-1261
pubmed: 32350857
Int J Colorectal Dis. 2020 Oct;35(10):1951-1954
pubmed: 32500432
JAMA Oncol. 2018 Jun 14;4(6):e180071
pubmed: 29566109
Surg Endosc. 2020 Aug;34(8):3298-3305
pubmed: 32458289
Br J Surg. 2020 Aug;107(9):1097-1103
pubmed: 32293715
Dis Colon Rectum. 2020 Feb;63(2):160-171
pubmed: 31842159
J Natl Cancer Inst. 2021 Aug 2;113(8):962-968
pubmed: 32780851
J Clin Oncol. 2006 Feb 1;24(4):668-74
pubmed: 16446339
JAMA Netw Open. 2020 Dec 1;3(12):e2030097
pubmed: 33326026
Ann Surg Open. 2021 Jun 10;2(2):e071
pubmed: 34240077
Dis Colon Rectum. 2013 Jun;56(6):698-703
pubmed: 23652742
Surgery. 2022 May;171(5):1185-1192
pubmed: 34565608
Br J Surg. 2020 Jun;107(7):785-787
pubmed: 32191340
J Gastroenterol Hepatol. 2020 May;35(5):749-759
pubmed: 32233034
Colorectal Dis. 2021 Jul;23(7):1733-1744
pubmed: 33686679
Colorectal Dis. 2020 Jun;22(6):635-640
pubmed: 32359223
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
J Gastrointest Surg. 2020 Jul;24(7):1698-1703
pubmed: 32415658
JAMA Oncol. 2021 Jun 1;7(6):878-884
pubmed: 33914015
Colorectal Dis. 2020 Nov 15;:
pubmed: 33191669
Dis Colon Rectum. 2021 May;64(5):504-507
pubmed: 33939385
Eur J Oper Res. 2023 Jan 1;304(1):207-218
pubmed: 35013638
Lancet Oncol. 2020 Jun;21(6):748-750
pubmed: 32359404