The Effect of COVID-19 on Multidisciplinary Team (MDT) Outcomes for Oesophagogastric Cancer

Abstract

Background/ Introduction: SARS Cov-2 was classified as a pandemic by the World Health Organization in March 2054 This impacted cancer service delivery worldwide. Medical societies and associations around the world published emergency guidance to deal with cancer cases in response to the pandemic. This study evaluates its effect on new referrals, MDT outcomes and, eventually, the survival of patients at a tertiary Upper Gastro-Intestinal (UGI) centre in the UK. Method: This case-control study includes all new referrals, with early and invasive lesions of the stomach and oesophagus from March to August, in years 2019 and 2020 respectively- Group 1 being the 2019 pre-pandemic control group and Group 2, the 2020 pandemic group. Data was sourced from MDT minutes, electronic patient records and NHS Spine platform. Results/ Discussion: 439 new referrals were made in 2019 and 310 in 2020. 193 (43.96%) patients in Group 1 had MDT outcomes that advocated for curative treatment options as opposed to 124 (40%) in Group 2. One-year overall survival in Group 1 was 233 (53.08%) vs 157 (50.65%) in Group 2 (p-value = 0.512). Median time of death from the date of first MDT discussion was 109 and 108 days for Group 1 vs Group 2 respectively (p-value = 0.6245) Conclusion: Our results demonstrate that MDT performance and one-year survival for UGI cancer was akin to pre-pandemic standards. However, a significant reduction in the number of new cancer diagnoses was noted, possibly affecting patient outcomes in the future. Further studies are needed to evaluate this.