Surgery for pancreatic neuroendocrine tumors during the COVID-19 pandemic: a retrospective cohort from a high-volume center.

COVID-19 Pancreatic neuroendocrine tumors Pancreatic surgery Pancreatic tumors SARS-CoV2

Journal

Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818

Informations de publication

Date de publication:
21 Jul 2024
Historique:
received: 05 04 2024
accepted: 08 07 2024
medline: 21 7 2024
pubmed: 21 7 2024
entrez: 21 7 2024
Statut: aheadofprint

Résumé

During the COVID-19 pandemic, pancreatic surgery for pancreatic neuroendocrine tumors (PNETs) with surgical indications was postponed or canceled. Patients with PNET patients who underwent pancreatic surgery during the COVID-19 restriction period (3 years) were compared with a similar cohort of patients who underwent surgery in the previous 3 years. Data on patients' characteristics, waiting time, and surgical and pathology outcomes were evaluated. During the study period, 370 patients received surgery for PNETs, 205 (55%) during the first period, and 165 (45%) during the pandemic. A lengthening of the waiting list (182 [IQR 100-357] vs. 60 [40-88] days, p < 0.001) and increased use of anti-tumor medical treatments (any therapy, peptide receptor radionuclide therapy, and somatostatin analogs; all p < 0.001) was found. During the pandemic, surgery occurred after a median of 381 days [IQR 200-610] from diagnosis (vs. 103 [IQR 52-192] of the pre-COVID-19 period, p < 0.001). No statistically significant differences in tumor size and grading distribution were found between the two periods (both p > 0.05), yet only a modest increase of the median Ki67 values in cases operated during the pandemic (4% vs. 3%, p = 0.03). Lastly, these latter patients experienced less major postoperative complications (13% vs. 24%, p = 0.007). During COVID-19, the surgical waiting list of PNET patients was drastically extended, and bridge therapies were preferred. This did not result in more advanced cases at final pathology. PRRT and SSA are valid alternative therapies for PNETs when surgery is not feasible.

Identifiants

DOI: 10.1007/s13304-024-01942-z PMID: 39033485
pubmed: 39033485
doi: 10.1007/s13304-024-01942-z
pii: 10.1007/s13304-024-01942-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

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Auteurs

Salvatore Paiella (S)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.
ORCID: 0000-0001-6893-8618

Luca Landoni (L)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Matteo De Pastena (M)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Giovanni Elio (G)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Fabio Casciani (F)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Sara Cingarlini (S)

Oncology Unit, Pancreas Institute, University of Verona, Verona, Italy.

Mirko D'Onofrio (M)

Radiology Unit, Pancreas Institute, University of Verona, Verona, Italy.

Giulia Maistri (G)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Ivan Ciatti (I)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Massimiliano Tuveri (M)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Maria Vittoria Davì (MV)

Department of Medicine, Section of Endocrinology, University and Hospital Trust of Verona, Verona, Italy.

Claudio Luchini (C)

Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy.
ARC-Net Research Center for Applied Research on Cancer, University of Verona, Verona, Italy.

Katia Donadello (K)

Anaesthesia and Intensive Care Unit B, University of Verona Hospital Trust, Verona, Italy.

Gessica Manzini (G)

Surgical Block, University of Verona Hospital Trust, Verona, Italy.

Giuseppe Malleo (G)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy.

Roberto Salvia (R)

Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Policlinico GB Rossi, Piazzale Scuro 10, 37134, Verona, Italy. roberto.salvia@univr.it.

Classifications MeSH