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Manzella A, Eskander MF, Grandhi MS, In H, Langan RC, Kennedy T, August D, Alexander HR, Beninato T, Pitt HA. COVID-19 Effect on Surgery for Gastrointestinal Malignancies: Have Operative Volumes Recovered? J Gastrointest Surg 2023; 27:2538-2546. [PMID: 37749458 DOI: 10.1007/s11605-023-05838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND COVID-19 disrupted elective operations, cancer screening, and routine medical care while simultaneously overwhelming hospital staff and supplies. Operations for gastrointestinal (GI) malignancies rely on endoscopic screening, staging, and neoadjuvant therapy (NAT), each of which was disrupted by the pandemic. The aim was to evaluate the effect of the COVID-19 pandemic on the US national rates of gastrointestinal oncologic operations. METHODS The Vizient Clinical Data Base® was queried for oncologic operations for esophageal, gastric, and colorectal malignancies with and without NAT from March 2019 to March 2022. Control chart analysis examined operative volume over time while Wilcoxon rank sum tests were used to compare mean monthly volume before and during the pandemic. RESULTS A total of 95,912 patients were identified over 36 months; 5.8% esophageal, 6.3% gastric, 77.5% colonic, and 10.4% rectal operations. Esophageal operative volume decreased for 9 months during the pandemic and was significantly lower during than before the pandemic (p=0.002). Gastric operations decreased for 10 months early in the pandemic, but rebounded so that after 2 years volumes were unchanged (p=0.49). Colonic operations experienced a sharp decrease for 4 months at the beginning of the pandemic, but volumes quickly increased and overall were unchanged (p=0.29). Rectal operations decreased for 13 months and were significantly lower during than before the pandemic (p=0.018). Oncologic operations for patients receiving NAT varied. CONCLUSION COVID-19 significantly disrupted the volume of gastrointestinal oncologic operations in the USA. Esophageal and rectal oncologic operations experienced prolonged and significant reductions while gastric and colonic oncologic operations transiently decreased but rebounded during the pandemic.
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Affiliation(s)
- Alexander Manzella
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Mariam F Eskander
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Miral S Grandhi
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Haejin In
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Russell C Langan
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Timothy Kennedy
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - David August
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - H Richard Alexander
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Toni Beninato
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Henry A Pitt
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA.
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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