An observational study of the demographic and treatment changes in a tertiary colorectal cancer center during the COVID-19 pandemic.

Abstract

The COVID-19 pandemic has wreaked havoc in the healthcare infrastructure. While we change our surgical practice, cancer care will take a toll on unprecedented long-term outcomes. We elucidate our experience that has unfolded during this period. This study included retrospective data of patients being treated for colorectal cancer and peritoneal surface malignancy between January and May 2020. We compared the treatment changes before and after the national emergency was declared. There was a 65% decrease in outpatients with a 90% drop in endoscopy procedures. Treatment protocols were changed with a 200% increase in short course radiation in rectal cancer. Colon cancer and anal melanoma were triaged to undergo 'essential' surgery. No robotic or exenteration procedures were performed in April and May. Patients with a low peritoneal cancer index underwent surgery alone. The relative number of emergency surgeries were unchanged. There is no standard approach to deliver cancer care during the COVID-19 pandemic. Treatment decisions were made based on the state of affairs that COVID-19 had created during that cross-section of time and protocols were redrawn to strike a balance between the risk of death from colorectal cancer and the risk of death from COVID-19 infection.