Management of Common Gastrointestinal Cancers During the COVID-19 Pandemic - Volume Indicators and Case Fatality Rates from LMICs as a Basis for Cancer Care Policy

Abstract

Background: The primary focus of the study was to evaluate the impact of COVID-19 pandemic on the management of common gastrointestinal cancer patients and develop baseline data to form cancer care policy. Methods: The patient data was collected for two study periods: between 1 Jan 2020 to 22 March 2020 (T1) and 23 March 2020 and 30 May 2020 (T2). Objectives of the study were to evaluate the differences in patient presentation, treatment patterns/modifications and 100 - day case fatality rates across the study periods T1 and T2. Findings: There were 20,112 footfalls between 1 Jan 2020 and 22 March 2020 and 10,804 footfalls between 23 March 2020 and 30 May 2020. 3177 patients in T1 and 1069 patients in T2 with gastrointestinal cancers were evaluated. A greater proportion of patients were planned for systemic therapy (70.5% vs. 74.8%, OR-0.85; 95% CI:0.75- 0.96;p= 0.007), monotherapy (18% vs 23%, OR-0.81; 95% CI:0.72-0.91; pInterpretation: Maintaining standard of care treatment with limited modifications during COVID-19 pandemic for patients receiving chemotherapy or undergoing surgery results in short term outcomes comparable to the pre-COVID-19 scenario.Trial Registration: Clinical Trials Registry of India (CTRI) registration; REF/2020/07/035004.Funding Statement: None.Declaration of Interests: Dr Vikas Ostwal and Dr Anant Ramaswamy declare the receipt of the grants to Tata Memorial Centre, Mumbai for other biomedical (investigator initiated) studies from Reddy’s lab pvt ltd and Cadila Pharmaceutical pvt ltd. Dr Vikas Ostwal received a travel grant from Novartis pvt ltd for an advisory meeting. No conflict of interest / financial interest related to this work. Ethics Approval Statement: IEC/0620/3480/001