Abstract
Purpose To investigate whether the COVID-19 pandemic and national lockdown had an impact on the extent of cancer disease at FDG PET/CT staging as surrogate marker.MethodsRetrospective observational study including cancer patients submitted to FDG PET/CT staging from June 1 to October 31, 2020, and June 1 to October 31, 2019, respectively. Data regarding primary tumour, nodal (N) status and number of involved nodal stations, and presence and number of distant metastases (M) were collected. Each scan was classified in limited vs advanced status. Data were aggregated across the study population and tumour type. Bi-weekly frequencies of the observed events were analysed.ResultsSix hundred eleven patients were included (240 in 2019 vs 371 in 2020, respectively). A significant increase of advanced disease patients (rate 1.56, P < 0.001), N + or M + patients (rate 1.84 and 2.09, respectively, P < 0.001), and patients with a greater number of involved N stations or M (rate 2.01 and 2.06, respectively, P < 0.001) were found in 2020 compared with data of 2019. Analysis by tumour type showed a significant increase of advanced disease in lymphoma and lung cancer in 2020 compared with 2019 (P < 0.001). In addition, a significant increase of nodal involvement was found in lung, gastro-intestinal, and breast cancers, as well as in lymphoma patients (P < 0.02). A significant increase of distant metastases was found in lung cancers (P = 0.002).ConclusionCancer patients with advanced disease at FDG PET/CT staging increased in 2020 compared with 2019, following the national lockdown due to the COVID-19 pandemic, 1.5-fold with a significant increase of patients with N or M involvement. Targeted health interventions are needed to mitigate the effects of the pandemic on patient outcome.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00259-021-05629-0.
Highlights
The global coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare systems, economy, work, education, and social relationships
Analysis by tumour type showed a significant increase of advanced disease in lymphoma and lung cancer in 2020 compared with 2019 (P < 0.001)
A significant increase of nodal involvement was found in lung, gastrointestinal, and breast cancers, as well as in lymphoma patients (P < 0.02)
Summary
The global coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare systems, economy, work, education, and social relationships. On March 2020, National Health Services (NHSs) of many countries, starting with Italy, suddenly redesigned their services to increase the capacity for treating patients with COVID-19. The COVID-19 emergency had direct and indirect effects on the healthcare delivery process. Direct effects included the radical reorganization of health systems to respond to the acute needs of people infected with the SARS-CoV-2 and to contain the infection protecting the most vulnerable categories and healthcare personnel. Indirect effects of the pandemic are represented by the impact on people with acute and non-acute conditions not related to COVID19, especially cardiovascular and oncological diseases [1–7]. Several diagnostic and treatment pathways, used for cancer patient management, have been severely affected, especially during the “first wave”
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