The COVID - AGICT study: COVID-19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes.
Advanced cancer
COVID-19
Colorectal cancer
Gastroesophageal cancer
Gastrointestinal cancers
Pancreatic cancer
Journal
Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
30
08
2022
revised:
31
12
2022
accepted:
22
01
2023
medline:
28
3
2023
pubmed:
17
3
2023
entrez:
16
3
2023
Statut:
ppublish
Résumé
This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic. Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes. Furthermore, to assess the impact of the COVID-19 pandemic on surgical outcomes, perioperative data of both 2020 and 2019 were also examined. Overall, a total of 8250 patients, 4370 (53%) and 3880 (47%) were surgically treated during 2019 and 2020 respectively, in 62 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (P = 0.25). Nevertheless, the analysis of quarters revealed that in the second half of 2020 the rate of advanced cancer resected, tented to be higher compared with the same months of 2019 (P = 0.05). During the pandemic year 'Charlson Comorbidity Index score of cancer patients (5.38 ± 2.08 vs 5.28 ± 2.22, P = 0.036), neoadjuvant treatments (23.9% vs. 19.5%, P < 0.001), rate of urgent diagnosis (24.2% vs 20.3%, P < 0.001), colorectal cancer urgent resection (9.4% vs. 7.37, P < 0.001), and the rate of positive nodes on the total nodes resected per surgery increased significantly (7 vs 9% - 2.02 ± 4.21 vs 2.39 ± 5.23, P < 0.001). Although the SARS-CoV-2 pandemic did not influence the pathological stage of colorectal, gastroesophageal, and pancreatic cancers at the time of surgery, our study revealed that the pandemic scenario negatively impacted on several perioperative and post-operative outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic.
METHOD
METHODS
Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes. Furthermore, to assess the impact of the COVID-19 pandemic on surgical outcomes, perioperative data of both 2020 and 2019 were also examined.
RESULTS
RESULTS
Overall, a total of 8250 patients, 4370 (53%) and 3880 (47%) were surgically treated during 2019 and 2020 respectively, in 62 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (P = 0.25). Nevertheless, the analysis of quarters revealed that in the second half of 2020 the rate of advanced cancer resected, tented to be higher compared with the same months of 2019 (P = 0.05). During the pandemic year 'Charlson Comorbidity Index score of cancer patients (5.38 ± 2.08 vs 5.28 ± 2.22, P = 0.036), neoadjuvant treatments (23.9% vs. 19.5%, P < 0.001), rate of urgent diagnosis (24.2% vs 20.3%, P < 0.001), colorectal cancer urgent resection (9.4% vs. 7.37, P < 0.001), and the rate of positive nodes on the total nodes resected per surgery increased significantly (7 vs 9% - 2.02 ± 4.21 vs 2.39 ± 5.23, P < 0.001).
CONCLUSIONS
CONCLUSIONS
Although the SARS-CoV-2 pandemic did not influence the pathological stage of colorectal, gastroesophageal, and pancreatic cancers at the time of surgery, our study revealed that the pandemic scenario negatively impacted on several perioperative and post-operative outcomes.
Identifiants
pubmed: 36924550
pii: S0960-7404(23)00007-5
doi: 10.1016/j.suronc.2023.101907
pmc: PMC9892255
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101907Investigateurs
Lorenzo De Franco
(L)
Roberto Benigni
(R)
Angela Tribuzi
(A)
Ubaldo Marra
(U)
Michele Di Marino
(M)
Chiara Cova
(C)
Beatrice Bianchi
(B)
Sara Nobile
(S)
Luigi Zorcolo
(L)
Giorgio Lisi
(G)
Fabrizio Allisiardi
(F)
Michele Grieco
(M)
Carolina Righetti
(C)
Marco Frisini
(M)
Alberto Brolese
(A)
Michele Grassia
(M)
Andrea Lucchi
(A)
Giulia Bagaglini
(G)
Giuseppe S Sica
(GS)
Michele Manara
(M)
Luca Turati
(L)
Lorenzo Macone
(L)
Roberta Carminati
(R)
Pierpaolo Mariani
(P)
Gianluca Rizzo
(G)
Claudio Coco
(C)
Francesca Pennetti Pennella
(FP)
Fabio Rondelli
(F)
Lucia Romano
(L)
Antonio Giuliani
(A)
Raffaele Palaia
(R)
Andrea Belli
(A)
Vittorio Albino
(V)
Maddalena Leongito
(M)
Giulia David
(G)
Pasquale Misitano
(P)
Silvia Pasulo
(S)
Gian Luca Baiocchi
(GL)
Roberta La Mendola
(R)
Mohamnad Abu Hilal
(MA)
Ludovica Baldari
(L)
Elisa Cassinotti
(E)
Luigi Boni
(L)
Gabriella Teresa Capolupo
(GT)
Marco Caricato
(M)
Enrico Pinotti
(E)
Mauro Montuori
(M)
Cristina Bombardini
(C)
Gabriele Anania
(G)
Rigers Dibra
(R)
Gennaro Martines
(G)
Leonardo Solaini
(L)
Giorgio Ercolani
(G)
Renato Oliva
(R)
Maria Vittoria Carati
(MV)
Gian Luca Grazi
(GL)
Giacomo Ghio
(G)
Francesco Marchegiani
(F)
Salvatore Pucciarelli
(S)
Filippo La Torre
(F)
Immacolata Iannone
(I)
Dimitri Krizzuk
(D)
Francesco Sammartino
(F)
Giorgia Catalano
(G)
Paolo Strignano
(P)
Renato Romagnoli
(R)
Domenico Piccione
(D)
Bruno Nardo
(B)
Rossella Reddavid
(R)
Maurizio Degiuli
(M)
Martino Gerosa
(M)
Dario Maggioni
(D)
Michele Zuolo
(M)
Marco Rigamonti
(M)
Omar Ghazouani
(O)
Raffaele Galleano
(R)
Andrea Percivale
(A)
Luca Tirloni
(L)
Luca Moraldi
(L)
Nicolò Fabbri
(N)
Carlo Vittorio Feo
(CV)
Samuele Colombo
(S)
Salomone Di Saverio
(S)
Giuseppe Barbato
(G)
Francesco Coratti
(F)
Andrea Sagnotta
(A)
Stefano Mancini
(S)
Nicola Cillara
(N)
Antonello Deserra
(A)
Alessandro Cannavera
(A)
Giampaolo Formisano
(G)
Informations de copyright
Copyright © 2023 Elsevier Ltd. All rights reserved.
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