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Wang Y, Cai W, He P, Cai Q, Huang J, Liu S, Chen M, Chen L, Lin Y, Hou J, Li J, Fu C, Han Z, Han H, Lin S, Xu C, Fu F, Wang C. Clinical outcomes of coronavirus disease in patients with breast cancer treated with granulocyte colony-stimulating factor following chemotherapy: Triangulation of evidence using population-based cohort and Mendelian randomization analyses. Int J Cancer 2024; 155:545-557. [PMID: 38561936 DOI: 10.1002/ijc.34914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 04/04/2024]
Abstract
Recombinant human granulocyte colony-stimulating factor (G-CSF) administration in patients with cancer and coronavirus disease (COVID-19) remains controversial. Concerns exist that it may worsen COVID-19 outcomes by triggering an inflammatory cytokine storm, despite its common use for managing chemotherapy-induced neutropenia (CIN) or febrile neutropenia post-chemotherapy. Here, we determined whether prophylactic or therapeutic G-CSF administration following chemotherapy exacerbates COVID-19 progression to severe/critical conditions in breast cancer patients with COVID-19. Between December 2022 and February 2023, all 503 enrolled breast cancer patients had concurrent COVID-19 and received G-CSF post-chemotherapy, with most being vaccinated pre-chemotherapy. We prospectively observed COVID-19-related adverse outcomes, conducted association analyses, and subsequently performed Mendelian randomization (MR) analyses to validate the causal effect of genetically predicted G-CSF or its associated granulocyte traits on COVID-19 adverse outcomes. Only 0.99% (5/503) of breast cancer patients experienced COVID-19-related hospitalization following prophylactic or therapeutic G-CSF administration after chemotherapy. No mortality or progression to severe/critical COVID-19 occurred after G-CSF administration. Notably, no significant associations were observed between the application, dosage, or response to G-CSF and COVID-19-related hospitalization (all p >.05). Similarly, the MR analyses showed no evidence of causality of genetically predicted G-CSF or related granulocyte traits on COVID-19-related hospitalization or COVID-19 severity (all p >.05). There is insufficient evidence to substantiate the notion that the prophylactic or therapeutic administration of G-CSF after chemotherapy for managing CIN in patients with breast cancer and COVID-19 would worsen COVID-19 outcomes, leading to severe or critical conditions, or even death, especially considering the context of COVID-19 vaccination.
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Affiliation(s)
- Yali Wang
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Weifeng Cai
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Peng He
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Qindong Cai
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jinhua Huang
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Shougui Liu
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Minyan Chen
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Lili Chen
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Yuxiang Lin
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jialin Hou
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jing Li
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chengbin Fu
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Zhonghua Han
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Hui Han
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Shunguo Lin
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chunsen Xu
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Fangmeng Fu
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Chuan Wang
- Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
- Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian Province, China
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Dorma MPF, Giuliani G, Guerra F, Santelli F, Esposito A, De Pastena M, Turri G, Pedrazzani C, Kauffmann EF, Boggi U, Solaini L, Ercolani G, Mastrangelo L, Jovine E, Di Franco G, Morelli L, Mazzola M, Ferrari G, Langella S, Ferrero A, La Mendola R, Abu Hilal M, Depalma N, D'Ugo S, Spampinato MG, Frisini M, Brolese A, Palaia R, Belli A, Cillara N, Deserra A, Cannavera A, Sagnotta A, Mancini S, Pinotti E, Montuori M, Coppola A, Di Benedetto F, Coratti A. The pan - COVID - AGICT study. The impact of COVID-19 pandemic on surgically treated pancreatic cancer patients. A multicentric Italian study. Surg Oncol 2024; 54:102081. [PMID: 38729088 DOI: 10.1016/j.suronc.2024.102081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/28/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND In this article we aimed to perform a subgroup analysis using data from the COVID-AGICT study, to investigate the perioperative outcomes of patients undergoing surgery for pancreatic cancers (PC) during the COVID-19 pandemic. METHODS The primary endpoint of the study was to find out any difference in the tumoral stage of surgically treated PC patients between 2019 and 2020. Surgical and oncological outcomes of the entire cohort of patients were also appraised dividing the entire peri-pandemic period into six three-month timeframes to balance out the comparison between 2019 and 2020. RESULTS Overall, a total of 1815 patients were surgically treated during 2019 and 2020 in 14 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (p = 0.846). During the pandemic, neoadjuvant chemotherapy (NCT) has dropped significantly (6.2% vs 21.4%, p < 0.001) and, for patients who didn't undergo NCT, the latency between diagnosis and surgery was shortened (49.58 ± 37 days vs 77.40 ± 83 days, p < 0.001). During 2020 there was a significant increase in minimally invasive procedures (p < 0.001). The rate of postoperative complication was the same in the two years but during 2020 there was an increase of the medical ones (19% vs 16.1%, p = 0.001). CONCLUSIONS The post-pandemic dramatic modifications in healthcare provision, in Italy, did not significantly impair the clinical history of PC patients receiving surgical resection. The present study is one of the largest reports available on the argument and may provide the basis for long-term analyses.
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Affiliation(s)
- Maria Pia Federica Dorma
- Department of General and Emergency Surgery, Misericordia Hospital, Azienda Usl Toscana Sud Est, School of Robotic Surgery, Grosseto, Italy; Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
| | - Giuseppe Giuliani
- Department of General and Emergency Surgery, Misericordia Hospital, Azienda Usl Toscana Sud Est, School of Robotic Surgery, Grosseto, Italy
| | - Francesco Guerra
- Department of General and Emergency Surgery, Misericordia Hospital, Azienda Usl Toscana Sud Est, School of Robotic Surgery, Grosseto, Italy
| | - Francesco Santelli
- Department of Economics, Business, Mathematics and Statistics (DEAMS), University of Trieste, Trieste, Italy
| | - Alessandro Esposito
- Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Matteo De Pastena
- Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Giulia Turri
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University and Hospital Trust of Verona, 37134, Verona, Italy
| | - Corrado Pedrazzani
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of General and Hepatobiliary Surgery, University and Hospital Trust of Verona, 37134, Verona, Italy
| | | | - Ugo Boggi
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Leonardo Solaini
- Department of Medical and Surgical Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Laura Mastrangelo
- Division of General and Emergency Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elio Jovine
- Division of General and Emergency Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gregorio Di Franco
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy
| | - Luca Morelli
- General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56125, Pisa, Italy
| | - Michele Mazzola
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Giovanni Ferrari
- Division of Minimally-Invasive Surgical Oncology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Serena Langella
- Department of General and Oncological Surgery, Mauriziano Hospital, Largo Turati 62, 10128, Turin, Italy
| | - Alessandro Ferrero
- Department of General and Oncological Surgery, Mauriziano Hospital, Largo Turati 62, 10128, Turin, Italy
| | - Roberta La Mendola
- Hepato-Bilio-Pancreatic Minimally Invasive Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Mohamnad Abu Hilal
- Hepato-Bilio-Pancreatic Minimally Invasive Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Norma Depalma
- Department of General Surgery, "Vito Fazzi" Hospital, Piazza Muratore 1-73100, Lecce, Italy
| | - Stefano D'Ugo
- Department of General Surgery, "Vito Fazzi" Hospital, Piazza Muratore 1-73100, Lecce, Italy
| | | | - Marco Frisini
- APSS, Department of General Surgery & HPB Unit, Largo Medaglie d'oro 9, 38122, Trento, Italy
| | - Alberto Brolese
- APSS, Department of General Surgery & HPB Unit, Largo Medaglie d'oro 9, 38122, Trento, Italy
| | - Raffaele Palaia
- Department of Abdominal Oncology, Division of Gastro-esophageal and Pancreatic Surgical Oncology, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Naples, 80131, Italy
| | - Andrea Belli
- Department of Abdominal Oncology, Division of Gastro-esophageal and Pancreatic Surgical Oncology, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Naples, 80131, Italy
| | - Nicola Cillara
- UOC Chirurgia Generale PO Santissima Trinità ASL Cagliari, Cagliari, Italy
| | - Antonello Deserra
- UOC Chirurgia Generale PO Santissima Trinità ASL Cagliari, Cagliari, Italy
| | | | - Andrea Sagnotta
- General and Oncology Surgery - San Filippo Neri Hospital - ASL Roma 1, Italy
| | - Stefano Mancini
- General and Oncology Surgery - San Filippo Neri Hospital - ASL Roma 1, Italy
| | - Enrico Pinotti
- Department of Surgery, Ponte San Pietro Hospital, Bergamo, Italy
| | - Mauro Montuori
- Department of Surgery, Ponte San Pietro Hospital, Bergamo, Italy
| | | | - Fabrizio Di Benedetto
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Coratti
- Department of General and Emergency Surgery, Misericordia Hospital, Azienda Usl Toscana Sud Est, School of Robotic Surgery, Grosseto, Italy
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Lohfeld L, Sharma M, Bennett D, Gavin A, Hawkins ST, Irwin G, Mitchell H, O'Neill S, McShane CM. Impact of the COVID-19 pandemic on breast cancer patient pathways and outcomes in the United Kingdom and the Republic of Ireland - a scoping review. Br J Cancer 2024:10.1038/s41416-024-02703-w. [PMID: 38704477 DOI: 10.1038/s41416-024-02703-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
The COVID-19 pandemic brought unplanned service disruption for breast cancer diagnostic, treatment and support services. This scoping review describes these changes and their impact in the UK and the Republic of Ireland based on studies published between January 2020 and August 2023. Thirty-four of 569 papers were included. Data were extracted and results thematically organized. Findings include fewer new cases; stage shift (fewer early- and more late-stage disease); and changes to healthcare organization, breast screening and treatment. Examples are accepting fewer referrals, applying stricter referral criteria and relying more on virtual consultations and multi-disciplinary meetings. Screening service programs paused during the pandemic before enacting risk-based phased restarts with longer appointment times to accommodate reduced staffing numbers and enhanced infection-control regimes. Treatments shifted from predominantly conventional to hypofractionated radiotherapy, fewer surgical procedures and increased use of bridging endocrine therapy. The long-term impact of such changes are unknown so definitive guidelines for future emergencies are not yet available. Cancer registries, with their large sample sizes and population coverage, are well placed to monitor changes to stage and survival despite difficulties obtaining definitive staging during diagnosis because surgery and pathological assessments are delayed. Multisite longitudinal studies can also provide guidance for future disaster preparedness.
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Affiliation(s)
- Lynne Lohfeld
- Queen's University Belfast, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Royal Victoria Hospital, 247 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK.
| | - Meenakshi Sharma
- Queen's University Belfast, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Royal Victoria Hospital, 247 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK
| | - Damien Bennett
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6DP, Northern Ireland, UK
| | - Anna Gavin
- Queen's University Belfast, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Royal Victoria Hospital, 247 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6DP, Northern Ireland, UK
| | - Sinéad T Hawkins
- Queen's University Belfast, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Royal Victoria Hospital, 247 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6DP, Northern Ireland, UK
| | - Gareth Irwin
- Belfast Health and Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB, Northern Ireland, UK
| | - Helen Mitchell
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6DP, Northern Ireland, UK
| | - Siobhan O'Neill
- Belfast Health and Social Care Trust, 51 Lisburn Road, Belfast, BT9 7AB, Northern Ireland, UK
| | - Charlene M McShane
- Queen's University Belfast, Centre for Public Health, School of Medicine, Dentistry & Biomedical Sciences, Royal Victoria Hospital, 247 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK
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5
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Hung TKW, Verdini NP, Gilliland JL, Chimonas S, Cracchiolo JR, Li Y, Pfister DG, Gillespie EF. When Is Telemedicine Appropriate in the Management of Head and Neck Cancer? A Mixed-Methods Assessment Among Patients and Physicians. JCO Oncol Pract 2024:OP2300608. [PMID: 38684040 DOI: 10.1200/op.23.00608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/15/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024] Open
Abstract
PURPOSE Evidence suggests that oncology patients are satisfied with and sometimes prefer telemedicine compared with in-person visits; however, data are scarce on when telemedicine is appropriate for specific cancer populations. In this study, we aim to identify factors that influence patient experience and appropriateness of telemedicine use among a head and neck cancer (HNC) population. METHODS We performed a mixed-methods study at a multisite cancer center. First, we surveyed patients with HNC and analyzed factors that may influence their telemedicine experience using multivariate regression. We then conducted focus groups among HNC oncologists (n = 15) to evaluate their perception on appropriate use of telemedicine. RESULTS From January to December 2020, we collected 1,071 completed surveys (response rate 24%), of which 551 first unique surveys were analyzed. About half of all patients (56%) reported telemedicine as "same or better" compared with in-person visits, whereas the other half (44%) reported "not as good or unsure." In multivariate analyses, patients with thyroid cancer were more likely to find telemedicine "same or better" (adjusted odds ratio, 2.08 [95% CI, 1.35 to 3.25]) compared with other HNC populations (mucosal/salivary HNC). Consistently, physician focus group noted that patients with thyroid cancer were particularly suited for telemedicine because of less emphasis on in-person examinations. Physicians also underscored factors that influence telemedicine use, including clinical suitability (treatment status, visit purpose, examination necessity), patient benefits (travel time, access), and barriers (technology, rapport-building). CONCLUSION Patient experience with telemedicine is diverse among the HNC population. Notably, patients with thyroid cancer had overall better experience and were identified to be more appropriate for telemedicine compared with other patients with HNC. Future research that optimizes patient experience and selection is needed to ensure successful integration of telemedicine into routine oncology practice.
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Affiliation(s)
- Tony K W Hung
- Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Nicholas P Verdini
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jaime L Gilliland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Susan Chimonas
- Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Yuelin Li
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David G Pfister
- Division of Solid Tumor Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Erin F Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Radiation Oncology, University of Washington, Seattle, WA
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6
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Lichtenstein MRL, Levit LA, Schenkel C, Kirkwood K, Fashoyin-Aje LA, Bruinooge SS, Kelley MJ, Mailman JA, Magnuson A, Mirda DP, Natesan D, Hershman DL. Researcher Experience and Comfort With Telemedicine and Remote Patient Monitoring in Cancer Treatment Trials. Oncologist 2024; 29:356-363. [PMID: 37676048 PMCID: PMC10994398 DOI: 10.1093/oncolo/oyad237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/26/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Since the onset of COVID-19, oncology practices across the US have integrated telemedicine (TM) and remote patient monitoring (RPM) into routine care and clinical trials. The extent of provider experience and comfort with TM/RPM in treatment trials, however, is unknown. We surveyed oncology researchers to assess experience and comfort with TM/RPM. METHODS Between April 10 and June 1, 2022, we distributed email surveys to US-based members of the American Society of Clinical Oncology (ASCO) whose member records indicated interest or specialization in clinical research. We collected respondent demographic data, clinical trial experience, workplace characteristics, and comfort and experience with TM/RPM use across trial components in phase I and phase II/III trials. TM/RPM was defined as clinical trial-related healthcare and monitoring for patients geographically separated from trial site. RESULTS There were 141 surveys analyzed (5.1% response rate). Ninety percent of respondents had been Principal Investigators, 98% practiced in a norural site. Most respondents had enrolled patients in phase I (82%) and phase II/III trials (99%). Across all phases and trial components, there was a higher frequency of researcher comfort compared to experience. Regarding remote care in treatment trials, 75% reported using TM, RPM, or both. Among these individuals, 62% had never provided remote care to trial patients before the pandemic. CONCLUSION COVID-19 spurred the rise of TM/RPM in cancer treatment trials, and some TM/RPM use continues in this context. Among oncology researchers, higher levels of comfort compared with real-world experience with TM/RPM reveal opportunities for expanding TM/RPM policies and guidelines in oncology research.
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Affiliation(s)
- Morgan R L Lichtenstein
- Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Laura A Levit
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Caroline Schenkel
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Kelsey Kirkwood
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Lola A Fashoyin-Aje
- Oncology Center of Excellence, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Suanna S Bruinooge
- Center for Research and Analytics, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Michael J Kelley
- Department of Medicine, Duke Cancer Institute and Medical Oncology, Duke University Medical Center, and Hematology-Oncology, Durham VA Medical Center, Durham, NC, USA
| | | | - Allison Magnuson
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Daniel P Mirda
- Providence Medical Group Northern California Napa, CA, USA
| | | | - Dawn L Hershman
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
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7
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Adler RF, Baez K, Morales P, Sotelo J, Victorson D, Magasi S. Evaluating the Usability of an mHealth App for Empowering Cancer Survivors With Disabilities: Heuristic Evaluation and Usability Testing. JMIR Hum Factors 2024; 11:e51522. [PMID: 38564261 PMCID: PMC11022134 DOI: 10.2196/51522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. OBJECTIVE Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. METHODS We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). RESULTS The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. CONCLUSIONS Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.
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Affiliation(s)
- Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
- School of Information Sciences, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Kevin Baez
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Paulina Morales
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Jocelyn Sotelo
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, United States
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
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8
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Stuart CM, Meguid RA, Bronsert MR, Rodriguez Franco S, Mungo B, Schulick RD, Gleisner AL, McCarter MD, Mitchell JD, Dyas AR. The United States experience with diagnosing and treating esophageal cancer during the SARS-CoV-2 pandemic: A retrospective cohort study. Int J Cancer 2024; 154:1204-1220. [PMID: 38018276 DOI: 10.1002/ijc.34805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
The downstream effects on healthcare delivery during the initial wave of the COVID-19 pandemic remain unclear. The purpose of this study was to determine how the healthcare environment surrounding the pandemic affected the oncologic care of patients diagnosed with esophageal cancer. This was a retrospective cohort study evaluating patients in the National Cancer Database (2019-2020). Patients with esophageal cancer diagnoses were divided into pre-pandemic (2019) and pandemic (2020) groups. Patient demographics, cancer-related variables, and treatment modalities were compared. Among 26,231 esophageal cancer patients, 14,024 patients (53.5%) were in the pre-pandemic cohort and 12,207 (46.5%) were in the pandemic cohort. After controlling for demographics, patients diagnosed during the pandemic were more likely to have poorly differentiated tumors (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.08-1.42), pathologic T3 disease compared to T1 (OR 1.25, 95% CI 1.02-1.53), positive lymph nodes on pathology (OR 1.36, 95% CI 1.14-1.64), and to be pathologic stage IV (OR 1.51, 95% CI 1.29-1.76). After controlling for oncologic characteristics, patients diagnosed during the pandemic were more likely to require at least two courses of systemic therapy (OR 1.78, 95% CI 1.48-2.14) and to be offered palliative care (OR 1.13, 95% CI 1.04-1.22). While these patients were offered curative therapy at lower rates, this became non-significant after risk-adjustment (p = .15). The pandemic healthcare environment was associated with significantly increased risk-adjusted rates of patients presenting with advanced esophageal cancer. While this led to significant differences in treatment, most of these differences became non-significant after controlling for oncologic factors.
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Affiliation(s)
- Christina M Stuart
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Robert A Meguid
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Michael R Bronsert
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Salvador Rodriguez Franco
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Benedetto Mungo
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Richard D Schulick
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Ana L Gleisner
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Martin D McCarter
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - John D Mitchell
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Adam R Dyas
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- Surgical Outcomes and Applied Research, University of Colorado School of Medicine, Aurora, Colorado, USA
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9
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Lugnier C, Sommerlatte S, Attenberger U, Beer AJ, Bentz M, Benz SR, Birkner T, Büntzel J, Ebert MPA, Fasching P, Fischbach W, Fokas E, Fricke B, Hense H, Grohmann E, Hofheinz RD, Hüppe D, Huster S, Jahn P, Klinkhammer-Schalke M, Knauf W, Kraeft AL, Maier BO, Marckmann G, Niegisch G, Otto L, Pelzer U, Piso P, Rosenau H, Schmitt J, Schoffer O, Sehouli J, Tannapfel A, Wedding U, Wesselmann S, Winkler EC, Zimmermann T, Wörmann B, Reinacher-Schick A, Schildmann J. Prioritization and Resource Allocation in the Context of the COVID-19 Pandemic: Recommendations for Colorectal and Pancreatic Cancer in Germany. Oncol Res Treat 2024; 47:296-305. [PMID: 38484712 DOI: 10.1159/000538171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/28/2024] [Indexed: 06/06/2024]
Abstract
In the context of the COVID-19 pandemic, there has been a scarcity of resources with various effects on the care of cancer patients. This paper provides an English summary of a German guideline on prioritization and resource allocation for colorectal and pancreatic cancer in the context of the pandemic. Based on a selective literature review as well as empirical and ethical analyses, the research team of the CancerCOVID Consortium drafted recommendations for prioritizing diagnostic and treatment measures for both entities. The final version of the guideline received consent from the executive boards of nine societies of the Association of Scientific Medical Societies in Germany (AWMF), 20 further professional organizations and 22 other experts from various disciplines as well as patient representatives. The guiding principle for the prioritization of decisions is the minimization of harm. Prioritization decisions to fulfill this overall goal should be guided by (1) the urgency relevant to avoid or reduce harm, (2) the likelihood of success of the diagnostic or therapeutic measure advised, and (3) the availability of alternative treatment options. In the event of a relevant risk of harm as a result of prioritization, these decisions should be made by means of a team approach. Gender, age, disability, ethnicity, origin, and other social characteristics, such as social or insurance status, as well as the vehemence of a patient's treatment request and SARS-CoV-2 vaccination status should not be used as prioritization criteria. The guideline provides concrete recommendations for (1) diagnostic procedures, (2) surgical procedures for cancer, and (3) systemic treatment and radiotherapy in patients with colorectal or pancreatic cancer within the context of the German healthcare system.
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Affiliation(s)
- Celine Lugnier
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Sabine Sommerlatte
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany,
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital Bonn, Bonn, Germany
| | - Ambros J Beer
- Department of Nuclear Medicine, Ulm University Medical Center, Ulm, Germany
| | - Martin Bentz
- Department of Internal Medicine III (Hematology, Oncology, Infectious Diseases and Palliative Care), Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Stefan R Benz
- Department of General, Visceral, Thoracic and Pediatric Surgery, Hospital Boeblingen, Boeblingen, Germany
| | - Thomas Birkner
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jens Büntzel
- Department of Palliative Medicine, Südharz Klinikum Nordhausen, Nordhausen, Germany
| | - Matthias P A Ebert
- Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | - Peter Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-European Metropolitan Region of Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | | | - Emmanouil Fokas
- Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt, Germany
| | - Birgit Fricke
- Arbeitskreis der Pankreatektomierten (AdP) e.V., Bonn, Germany
| | - Helene Hense
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Ralf-Dieter Hofheinz
- Department of Medical Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Dietrich Hüppe
- Speaker of the Colorectal Carcinoma Specialist Group, Professional Association of Resident Gastroenterologists (BNG), Herne, Germany
| | - Stefan Huster
- Institute for Social and Health Law, Ruhr University Bochum, Bochum, Germany
| | - Patrick Jahn
- Health Services Research Working Group, Department of Internal Medicine, University Hospital Halle (Saale), Halle (Saale), Germany
| | | | - Wolfgang Knauf
- Center for Hematology and Oncology Bethanien, Frankfurt, Germany
| | - Anna-Lena Kraeft
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Bernd Oliver Maier
- Department for Palliative Medicine and Interdisciplinary Oncology, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Georg Marckmann
- Institute of Ethics, History, and Theory of Medicine, LMU Munich, Munich, Germany
| | - Günter Niegisch
- Department of Urology, University Hospital and Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
- Center for Integrated Oncology (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Dusseldorf, Germany
| | - Lutz Otto
- Arbeitskreis der Pankreatektomierten (AdP) e.V., Bonn, Germany
| | - Uwe Pelzer
- Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pompiliu Piso
- Department for General and Visceral Surgery, Krankenhaus Barmerzige Brueder Regensburg, Regensburg, Germany
| | - Henning Rosenau
- Interdisciplinary Scientific Center Medicine - Ethics - Law of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Olaf Schoffer
- Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Ulrich Wedding
- Department of Palliative Care, Jena University Hospital, Jena, Germany
| | - Simone Wesselmann
- Head of the Certification Division of the German Cancer Society, Berlin, Germany
| | - Eva C Winkler
- Section Translational Medical Ethics, Department of Medical Oncology, National Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership between DKFZ and Heidelberg University Hospital, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Tanja Zimmermann
- Department of Psychosomatics and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Bernhard Wörmann
- Division of Hematology, Oncology and Tumour Immunology, Department of Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anke Reinacher-Schick
- Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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10
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Janczewski LM, Browner AE, Cotler JH, Palis BE, Chan K, Joung RH, Bentrem DJ, Merkow RP, Boffa DJ, Nelson H. Survival Among Patients With High-Risk Gastrointestinal Cancers During the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e240160. [PMID: 38441896 PMCID: PMC10915687 DOI: 10.1001/jamanetworkopen.2024.0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/30/2023] [Indexed: 03/07/2024] Open
Abstract
Importance Prior reports demonstrated that patients with cancer experienced worse outcomes from pandemic-related stressors and COVID-19 infection. Patients with certain malignant neoplasms, such as high-risk gastrointestinal (HRGI) cancers, may have been particularly affected. Objective To evaluate disruptions in care and outcomes among patients with HRGI cancers during the COVID-19 pandemic, assessing for signs of long-term changes in populations and survival. Design, Setting, and Participants This retrospective cohort study used data from the National Cancer Database to identify patients with HRGI cancer (esophageal, gastric, primary liver, or pancreatic) diagnosed between January 1, 2018, and December 31, 2020. Data were analyzed between August 23 and September 4, 2023. Main Outcome and Measures Trends in monthly new cases and proportions by stage in 2020 were compared with the prior 2 years. Kaplan-Meier curves and Cox regression were used to assess 1-year mortality in 2020 compared with 2018 to 2019. Proportional monthly trends and multivariable logistic regression were used to evaluate 30-day and 90-day mortality in 2020 compared with prior years. Results Of the 156 937 patients included in this study, 54 994 (35.0%) were aged 60 to 69 years and 100 050 (63.8%) were men. There was a substantial decrease in newly diagnosed HRGI cancers in March to May 2020, which returned to prepandemic levels by July 2020. For stage, there was a proportional decrease in the diagnosis of stage I (-3.9%) and stage II (-2.3%) disease, with an increase in stage IV disease (7.1%) during the early months of the pandemic. Despite a slight decrease in 1-year survival rates in 2020 (50.7% in 2018 and 2019 vs 47.4% in 2020), survival curves remained unchanged between years (all P > .05). After adjusting for confounders, diagnosis in 2020 was not associated with increased 1-year mortality compared with 2018 to 2019 (hazard ratio, 0.99; 95% CI, 0.97-1.01). The rates of 30-day (2.1% in 2018, 2.0% in 2019, and 2.1% in 2020) and 90-day (4.3% in 2018, 4.4% in 2019, and 4.6% in 2020) operative mortality also remained similar. Conclusions and Relevance In this retrospective cohort study, a period of underdiagnosis and increase in stage IV disease was observed for HRGI cancers during the pandemic; however, there was no change in 1-year survival or operative mortality. These results demonstrate the risks associated with gaps in care and the tremendous efforts of the cancer community to ensure quality care delivery during the pandemic. Future research should investigate long-term survival changes among all cancer types as additional follow-up data are accrued.
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Affiliation(s)
- Lauren M. Janczewski
- American College of Surgeons Cancer Programs, Chicago, Illinois
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Bryan E. Palis
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Kelley Chan
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Rachel H. Joung
- American College of Surgeons Cancer Programs, Chicago, Illinois
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David J. Bentrem
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ryan P. Merkow
- Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Daniel J. Boffa
- Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Heidi Nelson
- American College of Surgeons Cancer Programs, Chicago, Illinois
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11
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Kastrisiou M, Karimi M, Christou EA, Bizot A, Ropers MA, De-Jesus A, Mokdad-Adi M, To THV, Viansone A, Delaloge S, Besse B, Kfoury M. Evaluation of the satisfaction and experiences of oncology patients and doctors using teleconsultation during the COVID-19 pandemic. J Telemed Telecare 2024:1357633X241229462. [PMID: 38327172 DOI: 10.1177/1357633x241229462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, the Gustave Roussy Cancer Center introduced teleconsultation via telephone, as an alternative to face-to-face consultation to reduce patient hospital visits. This study was designed to assess patient and doctor satisfaction with this modality of care in oncology patient care during the period of the pandemic and beyond. METHODS We designed two questionnaires based on validated scores to assess satisfaction from teleconsultation in patients (EORTC OUT-PATSAT 35 and Telemedicine Satisfaction Questionnaire [TSQ] scores) and doctors (Telehealth Usability Questionnaire [TUQ]), and anxiety levels in both groups (anxiety section of the Hospital Anxiety and Depression Scale [HADS], HADS-A). These were electronically sent to patients and doctors with experience of at least one remote consultation during the first wave of the COVID-19 pandemic. RESULTS 239 patients and 32 doctors were eligible for the analyses. In the patient group, the mean satisfaction scores were 79.5 (SD 18.1) and 74.92 (SD 15.3) for EORTC OUT-PATSAT 35 and TSQ, respectively. In the doctor group, the mean satisfaction scores were 67.1 (SD 12.7) and 64.9 (SD 13.9) for TUQ and TUQ for Skype for Business, respectively. 65.7% of patients and 81.2% of doctors had no/low anxiety. Univariable analyses in patients showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores with anxiety and gender, with lower mean scores in women compared to men. Multivariable analysis showed correlation of the EORTC OUT-PATSAT 35 and TSQ scores to anxiety in both patients and doctors. CONCLUSIONS Teleconsultation via telephone is an acceptable modality of care for oncology patients, with high satisfaction from its implementation during the pandemic reported by patients and doctors. This was consistent across responder groups with different characteristics. An individualized approach to patients should be implemented for the safe and effective use of teleconsultation in oncology beyond the pandemic.
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Affiliation(s)
- Myrto Kastrisiou
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
- Tayside Cancer Centre, Ninewells Hospital and Medical School, NHS Tayside, Dundee, UK
| | - Maryam Karimi
- Oncostat (CESP U1018 INSERM), 'Ligue Contre le Cancer' Labeled Team, Paris-Saclay University, Villejuif, France
- Biostatistics and Epidemiology Department, Gustave Roussy Cancer Centre, Université Paris-Saclay, Villejuif, France
| | | | - Alexandra Bizot
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Marie-Alix Ropers
- Clinical Pharmacy Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Anne De-Jesus
- Patient Relationship Coordination, Gustave Roussy Cancer Center, Villejuif, France
| | - Meriem Mokdad-Adi
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Thi Hong Van To
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
- Department of Pneumology and Lung Transplantation, Marie Lannelongue Hospital - Paris Saint Joseph Hospital Group, Le Plessis-Robinson, France
| | - Alessandro Viansone
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Suzette Delaloge
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Benjamin Besse
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
| | - Maria Kfoury
- Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France
- Medical Oncology Department, Institut Paoli-Calmettes, Marseille, France
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12
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Peñuela R, Hernandez I, Fernandes-Pineda M, Cortina L, Zapata D, Urrego O, Herrera J, Saenz I, Orduz R, Mejia F, Moreno L, Velazco M. Spontaneous remission without treatment of acute myelomonocytic leukemia associated with COVID-19 infection. Hematol Transfus Cell Ther 2023:S2531-1379(23)02603-2. [PMID: 38199950 DOI: 10.1016/j.htct.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 01/12/2024] Open
Affiliation(s)
| | | | | | - Lázaro Cortina
- Hemato-Oncology Clinic Sebastian de Belarcazar, Cali, Colombia
| | - Diana Zapata
- Hemato-Oncology Clinic Sebastian de Belarcazar, Cali, Colombia
| | - Olga Urrego
- Imbanaco Clinical Bone Marrow Transplant Unit, Cali, Colombia
| | - Juan Herrera
- Imbanaco Clinical Bone Marrow Transplant Unit, Cali, Colombia
| | - Isabel Saenz
- Libre University, CQB clinical-pathological laboratory, Cali, Colombia
| | - Recio Orduz
- INPAC research group, Colsanitas Clinic, Bogota Colombia
| | - Fabián Mejia
- INPAC research group, Colsanitas Clinic, Bogota Colombia
| | - Liliana Moreno
- INPAC research group, Colsanitas Clinic, Bogota Colombia
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13
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Zeghondy J, Rassy E, Lapidari P, Eid R, Pistilli B. Telehealth in breast cancer following the coronavirus disease 2019 pandemic. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2023; 4:1249-1259. [PMID: 38213534 PMCID: PMC10776597 DOI: 10.37349/etat.2023.00195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/07/2023] [Indexed: 01/13/2024] Open
Abstract
Breast cancer (BC) is the second most diagnosed cancer in 2018 with around 2.3 million cases globally in 2020. In March 2020 and after its worldwide spread, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak, a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, a pandemic. During this time, cancer patients were heavily impacted and their treatment plans were changed due to measures to fight the disease and solutions had to be found to maintain their follow-up and management from a distance. Some cancer groups worldwide have recommended then the use of telemedicine for oncology patients to ensure the continuity of medical care during the pandemic. This method was considered effective and clinicians worldwide continued using telehealth even after the cessation of worldwide restrictions. To this end, current up-to-date data on the use of telemedicine in BC patient after the COVID-19 outbreak are summarized in this narrative review.
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Affiliation(s)
- Jean Zeghondy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Elie Rassy
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Pietro Lapidari
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Roland Eid
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, F-94805 Villejuif, France
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14
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da Silva JL, de Souza BSW, de Albuquerque LZ, Aleixo SB, Resende GADS, de Oliveira DGB, dos Santos EN, Nogueira-Rodrigues A, Clara RO, Gaui MDFD, Mota ACDA, de Lima VCC, Rosa DD, Munhoz RR, Morbeck IAP, Gelatti ACZ, Mathias CMDC, de Melo AC. Factors influencing COVID-19 mortality among cancer patients: A Brazilian multi-institutional study. PLoS One 2023; 18:e0295597. [PMID: 38127882 PMCID: PMC10734930 DOI: 10.1371/journal.pone.0295597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE This study aimed to describe the demographic and clinical characteristics of cancer patients with COVID-19, exploring factors associated with adverse outcomes. PATIENTS AND METHODS This retrospective cohort study methodically extracted and curated data from electronic medical records (EMRs) of numerous healthcare institutions on cancer patients diagnosed with a confirmed SARS-CoV-2 infection between May 2020 and August 2021, to identify risk factors linked to extended hospitalization and mortality. The retrieved information encompassed the patients' demographic and clinical characteristics, including the incidence of prolonged hospitalization, acute complications, and COVID-19-related mortality. RESULTS A total of 1446 cancer patients with COVID-19 were identified (mean [Standard deviation] age, 59.2 [14.3] years). Most patients were female (913 [63.1%]), non-white (646 [44.7%]), with non-metastatic (818 [56.6%]) solid tumors (1318 [91.1%]), and undergoing chemotherapy (647 [44.7%]). The rate of extended hospitalization due to COVID-19 was 46% (n = 665), which was significantly impacted by age (p = 0.012), sex (p = 0.003), race and ethnicity (p = 0.049), the presence of two or more comorbidities (p = 0.006), hematologic malignancies (p = 0.013), metastatic disease (p = 0.002), and a performance status ≥ 2 (p = 0.001). The COVID-19-related mortality rate was 18.9% (n = 273), and metastatic disease (<0.001), performance status ≥2 (<0.001), extended hospitalization (p = 0.028), renal failure (p = 0.029), respiratory failure (p < 0.001), sepsis (p = 0.004), and shock (p = 0.040) significantly and negatively influenced survival. CONCLUSION The rate of extended hospitalization and COVID-19-specific death in cancer patients was notably high and could be influenced by comorbidities, cancer treatment status, and clinical fragility. These observations may aid in developing risk counseling strategies regarding COVID-19 in individuals diagnosed with cancer.
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Affiliation(s)
- Jessé Lopes da Silva
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Clinical Oncology, Galeao Air Force Hospital, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lucas Zanetti de Albuquerque
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sabina Bandeira Aleixo
- Department of Clinical Oncology, Evangelical Hospital of Cachoeiro de Itapemirim, Cachoeiro de Itapemirim, Espírito Santo, Brazil
| | | | | | | | - Angélica Nogueira-Rodrigues
- Department of General Medicine UFMG, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Brazilian Society of Clinical Oncology, São Paulo, São Paulo, Brazil
| | | | | | | | | | - Daniela Dornelles Rosa
- Brazilian Society of Clinical Oncology, São Paulo, São Paulo, Brazil
- Department of Clinical Oncology, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Ana Caroline Zimmer Gelatti
- Oncoclinicas Group of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Brazilian Group of Thoracic Tumors, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Andréia Cristina de Melo
- Division of Clinical Research and Technological Development, Brazilian National Cancer Institute, Rio de Janeiro, Rio de Janeiro, Brazil
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15
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Girardi F, Marini S, Porra F, Carpentieri S, Marchet A, Saibene T, Lo Mele M, Giarratano T, Giorgi CA, Mioranza E, Falci C, Faggioni G, Caumo F, Griguolo G, Dieci MV, Guarneri V. The Impact of COVID-19 on Treatment Practices for Patients With Early Breast Cancer: A Cross-Sectional Study From a Large Cancer Center in Italy. Oncologist 2023; 28:e1179-e1184. [PMID: 37699107 PMCID: PMC10712907 DOI: 10.1093/oncolo/oyad255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/08/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION The Coronavirus Disease 2019 (COVID-19) has disrupted health services worldwide. The evidence on the impact of the pandemic on cancer care provision, however, is conflicting. We aimed to audit the management of patients diagnosed with early breast cancer (EBC) during the pandemic in a large, tertiary-level cancer center in Italy. METHODS We conducted a cross-sectional study to track the route to first treatment for patients diagnosed with EBC during 2019, 2020, and 2021. We abstracted data for all consecutive patients referred to the Veneto Institute of Oncology (Padua, Italy). We defined as point of contact (POC) the date of the first consultation with a breast cancer specialist of the breast unit. First treatment was defined as either upfront surgery or neoadjuvant chemotherapy (NACT). RESULTS We reviewed medical records for 878 patients for whom an MDT report during 2019-2021 (April through June) was available. Of these, 431 (49%) were eligible. The proportion of screen-detected tumors was larger in 2019 and 2021 than in 2020 (59%). Conversely, the proportion of screen-detected tumors was offset by the proportion of palpable tumors in 2020 (P = .004). Distribution of tumor and nodal stage was unchanged over time, but in situ tumors were slightly fewer in 2020 than in 2019 or 2021. The adjusted odds ratio for treatment delay (45 days or more) was 0.87 for 2020 versus 2019 (95% CI, 0.5-1.53) and 0.9 for 2021 versus 2019 (95% CI, 0.52-1.55). CONCLUSIONS There was no evidence for major changes in the management of patients with EBC during 2019-2021 and no treatment delays were observed. Our findings suggest that more women presented with palpable nodules at diagnosis, but the stage distribution did not change over time. Validation on a larger cohort of patients is warranted to robustly assess the impact of the COVID-19 pandemic on treatment practices for patients with EBC.
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Affiliation(s)
- Fabio Girardi
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Sabrina Marini
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Francesca Porra
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Sonia Carpentieri
- Division of Breast Surgery, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Alberto Marchet
- Division of Breast Surgery, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Tania Saibene
- Division of Breast Surgery, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Marcello Lo Mele
- Division of Surgical Pathology, Azienda Ospedale-Università Padova, Padua, Italy
| | - Tommaso Giarratano
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Carlo Alberto Giorgi
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Eleonora Mioranza
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Cristina Falci
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Giovanni Faggioni
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Francesca Caumo
- Division of Breast Imaging, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Gaia Griguolo
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Maria Vittoria Dieci
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Valentina Guarneri
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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16
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Mitchell JD, Laurie M, Xia Q, Dreyfus B, Jain N, Jain A, Lane D, Lenihan DJ. Risk profiles and incidence of cardiovascular events across different cancer types. ESMO Open 2023; 8:101830. [PMID: 37979325 PMCID: PMC10774883 DOI: 10.1016/j.esmoop.2023.101830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/04/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Cancer survivors are at increased risk for cardiovascular (CV) disease, although additional data are needed to better understand the incidence of CV events across different malignancies. This study sought to characterize the incidence of major adverse CV events [myocardial infarction, stroke, unstable angina (MACE), or heart failure (HF)] across multiple cancer types after cancer diagnosis. PATIENTS AND METHODS Patients were identified from a USA-based administrative claims database who had index cancer diagnoses of breast, lung, prostate, melanoma, myeloma, kidney, colorectal, leukemia, or lymphoma between 2011 and 2019, with continuous enrollment for ≥12 months before diagnosis. Baseline CV risk factors and incidence rates of CV events post-index were identified for each cancer. Multivariable Cox hazards models assessed the cumulative incidence of MACE, accounting for baseline risk factors. RESULTS Among 839 934 patients across nine cancer types, CV risk factors were prevalent. The cumulative incidence of MACE was highest in lung cancer and myeloma, and lowest in breast cancer, prostate cancer, and melanoma. MACE cumulative incidence for lung cancer was 26% by 4 years (2.7-fold higher relative to breast cancer). The incidence of stroke was especially pronounced in lung cancer, while HF was highest in myeloma and lung cancer. CONCLUSIONS CV events were especially increased following certain cancer diagnoses, even after accounting for baseline risk factors. Understanding the variable patient characteristics and associated CV events across different cancers can help target appropriate CV risk factor modification and develop strategies to minimize adverse CV events and improve patient outcomes.
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Affiliation(s)
- J D Mitchell
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, USA; International Cardio-Oncology Society, Tampa, USA.
| | - M Laurie
- Bristol Myers Squibb, Lawrenceville, USA
| | - Q Xia
- Bristol Myers Squibb, Lawrenceville, USA
| | - B Dreyfus
- Bristol Myers Squibb, Lawrenceville, USA
| | - N Jain
- Mu Sigma, Northbrook, USA
| | - A Jain
- Mu Sigma, Northbrook, USA
| | - D Lane
- Bristol Myers Squibb, Lawrenceville, USA
| | - D J Lenihan
- International Cardio-Oncology Society, Tampa, USA; Cape Cardiology Group, Saint Francis Healthcare, Cape Girardeau, USA
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17
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Mottet T, Hémar V, Enfedaque S, Mathoulin-Pélissier S, Charitansky H, Godbert Y, Roubaud G, Cabart M, Chakiba C, Chomy F, Haik L, Le Dantec N, Bouleftour W, Magné N, Quenel Tueux N. Evaluating video-based consultations in routine clinical practice at a comprehensive cancer center. Acta Oncol 2023; 62:1905-1912. [PMID: 37948066 DOI: 10.1080/0284186x.2023.2278758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Integrating telemedicine into cancer care remains a major challenge. There are little clinical evidence for teleconsultation efficacy and safety in daily oncology practice. This study as a pioneering experience, aimed to analyze patient and physician opinions regarding the implementation of telemedicine consultations, and to identify major limitations of telehealth spread in an oncology institute. MATERIAL AND METHODS During COVID-19 lockdown, patients and physicians who took part to at least one video-based teleconsultation between March and May 2020, were enrolled in this observational study. All eligible patients received an anonymous online questionnaire. On the other hand, all physicians eligible to participate were asked through email to complete a questionnaire. RESULTS In this study, 31 physicians and 304 patients consented to participate in this study by answering the questionnaire and were included. Regarding telemedicine satisfaction, 65.8% of patients were satisfied. The lack of clinical examination was the major limitation reported by 77% of patients. Patients belonging to a high socio-professional category were statistically more dissatisfied with the relationship with their doctor (OR = 2.31 and 95% CI [1.12; 4.74]). CONCLUSION This study showed promising results of incorporating video-based teleconsultations into cancer patient management. Randomized clinical trials are needed in order to accelerate the digital implementation in clinical practice.
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Affiliation(s)
- Thibaut Mottet
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Victor Hémar
- Department of Internal Medicine and Infectious Diseases, Hôpital Saint-André, Bordeaux, France
| | - Sylvia Enfedaque
- Department of Quality and Risk Management, Institut Bergonié, Bordeaux, France
| | | | | | - Yann Godbert
- Department of Nuclear Medicine, Institut Bergonié, Bordeaux, France
| | - Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Mathilde Cabart
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Camille Chakiba
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - François Chomy
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Laura Haik
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | | | - Wafa Bouleftour
- Department of Medical Oncology, CHU Saint Etienne, Saint-Etienne, France
| | - Nicolas Magné
- Department of Radiation Oncology, Institut Bergonié, Bordeaux, France
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18
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Halpern N, Boursi B, Shacham-Shmueli E, Gal-Yam EN, Margalit O, Golan T, Beller T, Strauss G, Yahav D, Leshem E. Early Systemic Anti-neoplastic Treatment Post SARS-CoV-2 Infection in Patients with Breast Cancer. Oncol Ther 2023; 11:513-519. [PMID: 37864026 PMCID: PMC10673789 DOI: 10.1007/s40487-023-00247-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
INTRODUCTION It is unclear how soon after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection it is safe to resume systemic anti-neoplastic treatment in patients with cancer. We assessed the risk of admissions or postponed treatment cycle in vaccinated patients with breast cancer receiving early systemic anti-neoplastic treatment following SARS-CoV-2 infection. METHODS This was a retrospective cohort study conducted during Omicron SARS-CoV-2 outbreak in Israel, January-July 2022. SARS-CoV-2 cohort included 30 vaccinated patients with breast cancer with SARS-CoV-2 infection 7-14 days prior to systemic treatment. All patients had resolved symptoms and a negative antigen detection test on the day of treatment. The pre-coronavirus disease 2019 (COVID-19) pandemic cohort consisted of 49 matched patients with breast cancer treated with systemic anti-neoplastic agents during 2019. RESULTS In 30 vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days following SARS-CoV-2 infection, compared with 49 matched patients treated in 2019, the rates of emergency department (ED) visits (13% versus 6%, respectively), hospitalizations (3% versus 4%), next cycle of treatment given per protocol (90% versus 88%), and death (0% versus 0%) were similar. CONCLUSION In a cohort of vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days after SARS-CoV-2 infection, we did not observe substantially higher rates of ED visits, hospitalizations, or deaths compared with a similar cohort of pre-COVID-19 patients with breast cancer. Most patients received the next planned cycle on time. Early resumption of systemic anti-neoplastic treatment following SARS-CoV-2 infection in vaccinated patients with breast cancer with a negative antigen test at the day of treatment appeared to be safe. Additional data on larger cohorts and other malignancies are needed to support clinical guidelines.
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Affiliation(s)
- Naama Halpern
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel.
- Tel Aviv University, Tel Aviv, Israel.
| | - Ben Boursi
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Einat Shacham-Shmueli
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Einav Nili Gal-Yam
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Ofer Margalit
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Talia Golan
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Tamar Beller
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Gal Strauss
- Division of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Dafna Yahav
- Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Eyal Leshem
- Infectious Diseases Unit, Sheba Medical Center, Tel-Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
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19
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Beard KR, Borca F, Phan H, Brown E, Fenton PA, Stansby J, Defty J, Clark TW. Routine, molecular point-of-care testing for SARS-CoV-2 and other respiratory viruses within an acute oncology service improves patient care. J Infect 2023; 87:516-523. [PMID: 37802471 DOI: 10.1016/j.jinf.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV-2, within an Acute Oncology Service (AOS). METHODS This pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK. We collected data from two periods: November 25th, 2019 to November 24th, 2020, when respiratory virus testing utilised laboratory PCR, and December 1st, 2020 to May 31st, 2021 following the introduction of mPOCT. The primary outcome was the time to results. RESULTS 2189 patients were tested in the pre-implementation period and 1540 in the post implementation period. Median (IQR) time to results was 5.8 h (4.2-10.6) pre-implementation and 1.9 h (1.5-3.0) post-implementation (difference -3.6 h [95%CI to -3.8 to -3.5]; p < 0.0001). Median time spent in assessment areas was 6.0 h (4.1-7.9) pre-implementation and 5.5 h (3.8-7.4) post-implementation (p < 0.0001). 20 (0.9%) patients admitted via AOS assessment unit developed hospital-acquired respiratory virus infection pre-implementation versus 0 (0%) post-implementation (p = 0.031). CONCLUSIONS Routine mPOCT for respiratory viruses, including SARS-CoV-2, was associated with a reduced time to results, reduced time in assessment areas, and a reduction in the rates of hospital-acquired respiratory virus infection in an acute oncology assessment unit.
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Affiliation(s)
- Kate R Beard
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Florina Borca
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Hang Phan
- School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK
| | - Emma Brown
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul A Fenton
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jessica Stansby
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Defty
- Macmillan Acute Oncology Service, Cancer Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Health Sciences, University of Southampton, Southampton, UK
| | - Tristan W Clark
- Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK Trust, Southampton, UK
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20
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Carujo A, Ferreira L, Bergantim R, Santos Silva A, Vasconcelos AL. Relapsing COVID-19 in a Patient With Non-Hodgkin Lymphoma on Chemotherapy. Cureus 2023; 15:e49974. [PMID: 38179390 PMCID: PMC10766046 DOI: 10.7759/cureus.49974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Hematologic malignancies and chemotherapy are risk factors for COVID-19 progression and mortality. Immunocompromised hosts, particularly those with severe B-cell depletion, can shed viable viruses for extended periods, which can lead to persistent infection. We present the case of a 73-year-old male with diffuse large B-cell lymphoma (stage IV-B) under curative immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). After the first episode of mild COVID-19, he developed two severe relapses following the third and fourth cycles of R-CHOP. Lung CT scans performed in both episodes showed new-onset ground-glass infiltrates and fibrosis of previously affected pulmonary segments. In light of similar semiquantitative SARS-CoV-2 viral loads between episodes, without further risk exposure or microbiological findings, persistent COVID-19 with severe clinical relapses was assumed and successfully treated with polyclonal immunoglobulin and remdesivir. Whole-genome sequencing was performed in all samples, confirming the same specimen, which belonged to the B.1.177 lineage. This case stands out for the unusually long viral persistence and the various relapses of severe COVID-19 related to the worsening immune status with each immunochemotherapy cycle.
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Affiliation(s)
- António Carujo
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
| | - Luís Ferreira
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
| | - Rui Bergantim
- Clinical Hematology Department, São João University Hospital, Porto, PRT
- Faculty of Medicine, University of Porto, Porto, PRT
- Hemato-Oncology Department, Lusíadas Hospital of Porto, Porto, PRT
| | - André Santos Silva
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
| | - António Ludgero Vasconcelos
- Infectious Diseases Department, Santo António University Hospital, Porto, PRT
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, PRT
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21
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Gao W, Lu Y, Huang O, Chen X, He J, Chen W, Li Y, Xu H, Wu J, Shen K. Safety analysis of immediate breast reconstruction with a deep inferior epigastric perforator (DIEP) flap in the post-COVID-19 era: a comparison between pre- and post-pandemic cohorts. Gland Surg 2023; 12:1475-1484. [PMID: 38107490 PMCID: PMC10721559 DOI: 10.21037/gs-23-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/17/2023] [Indexed: 12/19/2023]
Abstract
Background The demand for immediate breast reconstruction with a deep inferior epigastric perforator (DIEP) flap is recovering as coronavirus disease 2019 (COVID-19) transitions from a pandemic to an endemic. This study sought to evaluate the safety of resuming DIEP flap reconstruction in the post-COVID-19 era. Methods Consecutive breast cancer patients who underwent immediate breast reconstruction with a DIEP flap at the Comprehensive Breast Health Center, Ruijin Hospital were retrospectively included in the study. The patients were divided into a post-pandemic group (Group A) and a pre-pandemic group (Group B). The clinicopathological factors, surgical procedures, and rates of post-operative complications were compared between the two groups using the Mann-Whitney U test and Chi-squared test. Results A total of 167 patients were included in the study, of whom 119 (71.3%) were in Group A and 48 (28.7%) were in Group B. The two groups had similar clinicopathological features, including age (P=0.988), body mass index (P=0.504), and tumor, node, metastasis (TNM) stage (P=0.932). The Group A patients were more likely to receive single perforator DIEP flap transplantation than the Group B patients (n=28, 22.8% vs. n=3, 5.8%, P=0.007). There was a numerical decrease in the mean operating time of Group A patients compared to Group B patients (9.82 vs. 10.12 hours, P=0.172). The mean length of stay after the surgery was significantly shorter after the pandemic than before the pandemic (11.2 vs. 14.3 days, P<0.001). The complication rates between the two groups were similar. Conclusions This study provides evidence that resuming DIEP reconstruction is safe in the post-COVID-19 era.
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Affiliation(s)
- Weiqi Gao
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yujie Lu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ou Huang
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaosong Chen
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianrong He
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiguo Chen
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yafen Li
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayi Wu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kunwei Shen
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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22
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Sobhani N, Mondani G, Roviello G, Catalano M, Sirico M, D'Angelo A, Scaggiante B, Generali D. Cancer management during the COVID-19 world pandemic. Cancer Immunol Immunother 2023; 72:3427-3444. [PMID: 37642709 DOI: 10.1007/s00262-023-03524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
Since 2019, the world has been experiencing an outbreak of a novel beta-coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV)-2. The worldwide spread of this virus has been a severe challenge for public health, and the World Health Organization declared the outbreak a public health emergency of international concern. As of June 8, 2023, the virus' rapid spread had caused over 767 million infections and more than 6.94 million deaths worldwide. Unlike previous SARS-CoV-1 and Middle East respiratory syndrome coronavirus outbreaks, the COVID-19 outbreak has led to a high death rate in infected patients; this has been caused by multiorgan failure, which might be due to the widespread presence of angiotensin-converting enzyme 2 (ACE2) receptors-functional receptors of SARS-CoV-2-in multiple organs. Patients with cancer may be particularly susceptible to COVID-19 because cancer treatments (e.g., chemotherapy, immunotherapy) suppress the immune system. Thus, patients with cancer and COVID-19 may have a poor prognosis. Knowing how to manage the treatment of patients with cancer who may be infected with SARS-CoV-2 is essential. Treatment decisions must be made on a case-by-case basis, and patient stratification is necessary during COVID-19 outbreaks. Here, we review the management of COVID-19 in patients with cancer and focus on the measures that should be adopted for these patients on the basis of the organs or tissues affected by cancer and by the tumor stage.
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Affiliation(s)
- Navid Sobhani
- Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
| | - Giuseppina Mondani
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Martina Catalano
- Royal Infirmary Hospital, Foresterhill Health Campus, Foresterhill Rd, Aberdeen, AB25 2ZN, UK
| | - Marianna Sirico
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Via P. Maroncelli 40, 47014, Meldola, Italy
| | - Alberto D'Angelo
- Department of Biology and Biochemistry, University of Bath, Bath, BA2 7AX, UK
| | - Bruna Scaggiante
- Department of Life Sciences, University of Trieste, 34127, Trieste, Italy
| | - Daniele Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127, Trieste, Italy
- Multidisciplinary Unit of Breast Pathology and Translational Research, Cremona Hospital, 26100, Cremona, Italy
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23
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Janczewski LM, Cotler J, Merkow RP, Palis B, Nelson H, Mullett T, Boffa DJ. Alterations in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US. JAMA Netw Open 2023; 6:e2340148. [PMID: 37902756 PMCID: PMC10616721 DOI: 10.1001/jamanetworkopen.2023.40148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Importance The COVID-19 pandemic created challenges to the evaluation and treatment of cancer, and abrupt resource diversion toward patients with COVID-19 put cancer treatment on hold for many patients. Previous reports have shown substantial declines in cancer screening and diagnoses in 2020; however, the extent to which the delivery of cancer care was altered remains unclear. Objective To assess alterations in cancer treatment in the US during the first year of the COVID-19 pandemic. Design, Setting, and Participants This retrospective cohort study used data from the National Cancer Database (NCDB) on patients older than 18 years with newly diagnosed cancer from January 1, 2018, to December 31, 2020. Main Outcomes and Measures The main outcomes were accessibility (time to treatment, travel distance, and multi-institutional care), availability (proportional changes in cancer treatment between years), and utilization (reductions by treatment modality, hospital type) of cancer treatment in 2020 compared with 2018 to 2019. Autoregressive models forecasted expected findings for 2020 based on observations from prior years. Results Of 1 229 654 patients identified in the NCDB in 2020, 1 074 225 were treated for cancer, representing a 16.8% reduction from what was expected. Patients were predominately female (53.8%), with a median age of 66 years (IQR, 57-74 years), similar to demographics in 2018 and 2019. Median time between diagnosis and treatment was 26 days (IQR, 0-36 days) in 2020, and median travel distance for care was 11.1 miles (IQR, 5.0-25.3 miles), similar to 2018 and 2019. In 2020, fewer patients traveled longer distances (20.2% reduction of patients traveling >35 miles). The proportions of patients treated with chemotherapy (32.0%), radiation (29.5%), and surgery (57.1%) were similar to those in 2018 and 2019. Overall, 146 805 fewer patients than expected underwent surgery, 80 480 fewer received radiation, and 68 014 fewer received chemotherapy. Academic hospitals experienced the greatest reduction in cancer surgery and treatment, with a decrease of approximately 484 patients (-19.0%) per hospital compared with 99 patients (-12.6%) at community hospitals and 110 patients (-12.8%) at integrated networks. Conclusions and Relevance This study found that among patients diagnosed with cancer in 2020, access and availability of treatment remained intact; however, reductions in treated patients varied across treatment modalities and were greater at academic hospitals than at community hospitals and integrated networks compared with expected values. These results suggest the resilience of cancer service lines and frame the economic losses from reductions in cancer treatment during the pandemic.
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Affiliation(s)
- Lauren M. Janczewski
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Joseph Cotler
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Ryan P. Merkow
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- American College of Surgeons Cancer Programs, Chicago, Illinois
- Department of Surgery, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Bryan Palis
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Heidi Nelson
- American College of Surgeons Cancer Programs, Chicago, Illinois
| | - Timothy Mullett
- Department of Surgery, University of Kentucky College of Medicine, Lexington
| | - Daniel J. Boffa
- Section of Thoracic Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
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24
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Shih KK, Arechiga AB, Chen X, Urbauer DL, De Moraes AR, Rodriguez AJ, Thomas L, Stanton PA, Bruera E, Hui D. Postvaccine Era COVID-19 Pandemic-Related Distress in Palliative Care Patients With Advanced Cancer. J Pain Symptom Manage 2023; 66:328-337.e2. [PMID: 37394198 DOI: 10.1016/j.jpainsymman.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
CONTEXT The COVID-19 pandemic represents a source of distress in patients with advanced cancer; however, few studies have examined the extent of pandemic-related distress in the postvaccine era. OBJECTIVES We conducted a cross-sectional survey to examine pandemic-related distress among patients seen by palliative care after vaccine availability. METHODS Patients at our palliative care clinic were surveyed from April 2021 to March 2022 regarding 1) pandemic-related distress level, 2) potential contributors to pandemic-related distress, 3) coping strategies, 4) demographic factors and symptom burden. Univariate and multivariate analyses identified factors associated with pandemic-related distress. RESULTS A total of 200 patients completed the survey. Of 79 (40%, 95% confidence interval [CI]: 33%, 46%) reported worse pandemic-related distress. Patients who reported greater distress were more likely to report worse social isolation (67 [86%] vs. 52 [43%]), staying home more often (75 [95%] vs. 95 [79%]), more negative experience staying at home (26 [33%] vs. 11 [9%]), worse stress with child-care duties (14 [19%] vs. 4 [3%]), less seeing family/friends (63 [81%] vs. 72 [60%]), and more difficulty traveling to medical appointments (27 [35%] vs. 20 [17%]). Thirty-seven patients (19%) reported more difficulty getting medical appointments. In multivariable analysis, younger age (odds ratio [OR], 0.97; 95% CI, 0.92-0.99; P = 0.01), worse isolation status (OR, 6.87; 95% CI, 2.76-17.12; P < 0.001), and more negative attitude towards staying home (OR, 4.49; 95% CI, 1.6-12.57; P = 0.004) were associated with pandemic-related distress. CONCLUSIONS Patients with advanced cancer continued to experience pandemic-related distress in the postvaccine era. Our findings highlight potential opportunities to support patients.
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Affiliation(s)
- Kaoswi K Shih
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Adrienne B Arechiga
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xi Chen
- Department of Biostatistics (X.C., D.L.U.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana L Urbauer
- Department of Biostatistics (X.C., D.L.U.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aline Rozman De Moraes
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ashley J Rodriguez
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lisa Thomas
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Penny A Stanton
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - David Hui
- Department of Palliative (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
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25
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Hardy N, Vegivinti CTR, Mehta M, Thurnham J, Mebane A, Pederson JM, Tarchand R, Shivakumar J, Olaniran P, Gadodia R, Ganguly A, Kelagere Y, Nallabolu RR, Gaddam M, Keesari PR, Pulakurthi YS, Reddy R, Kallmes K, Musunuru TN. Mortality of COVID-19 in patients with hematological malignancies versus solid tumors: a systematic literature review and meta-analysis. Clin Exp Med 2023; 23:1945-1959. [PMID: 36795239 PMCID: PMC9933827 DOI: 10.1007/s10238-023-01004-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023]
Abstract
Cancer patients are more vulnerable to COVID-19 compared to the general population, but it remains unclear which types of cancer have the highest risk of COVID-19-related mortality. This study examines mortality rates for those with hematological malignancies (Hem) versus solid tumors (Tumor). PubMed and Embase were systematically searched for relevant articles using Nested Knowledge software (Nested Knowledge, St Paul, MN). Articles were eligible for inclusion if they reported mortality for Hem or Tumor patients with COVID-19. Articles were excluded if they were not published in English, non-clinical studies, had insufficient population/outcomes reporting, or were irrelevant. Baseline characteristics collected included age, sex, and comorbidities. Primary outcomes were all-cause and COVID-19-related in-hospital mortality. Secondary outcomes included rates of invasive mechanical ventilation (IMV) and intensive care unit (ICU) admission. Effect sizes from each study were computed as logarithmically transformed odds ratios (ORs) with random-effects, Mantel-Haenszel weighting. The between-study variance component of random-effects models was computed using restricted effects maximum likelihood estimation, and 95% confidence intervals (CIs) around pooled effect sizes were calculated using Hartung-Knapp adjustments. In total, 12,057 patients were included in the analysis, with 2,714 (22.5%) patients in the Hem group and 9,343 (77.5%) patients in the Tumor group. The overall unadjusted odds of all-cause mortality were 1.64 times higher in the Hem group compared to the Tumor group (95% CI: 1.30-2.09). This finding was consistent with multivariable models presented in moderate- and high-quality cohort studies, suggestive of a causal effect of cancer type on in-hospital mortality. Additionally, the Hem group had increased odds of COVID-19-related mortality compared to the Tumor group (OR = 1.86 [95% CI: 1.38-2.49]). There was no significant difference in odds of IMV or ICU admission between cancer groups (OR = 1.13 [95% CI: 0.64-2.00] and OR = 1.59 [95% CI: 0.95-2.66], respectively). Cancer is a serious comorbidity associated with severe outcomes in COVID-19 patients, with especially alarming mortality rates in patients with hematological malignancies, which are typically higher compared to patients with solid tumors. A meta-analysis of individual patient data is needed to better assess the impact of specific cancer types on patient outcomes and to identify optimal treatment strategies.
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Affiliation(s)
| | | | - Mansi Mehta
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - John M Pederson
- Nested Knowledge, Inc, St Paul, MN, USA
- Superior Medical Experts, St. Paul, MN, USA
| | | | - Jeevan Shivakumar
- Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA
| | | | - Ritika Gadodia
- Medstar Washington Hospital Center/Georgetown University, Washington, DC, USA
| | - Arup Ganguly
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Yashaswini Kelagere
- Department of Pediatrics, Saint Peter's University Hospital, New Brunswick, NJ, USA
| | | | | | - Praneeth R Keesari
- Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | | | - Rohit Reddy
- Department of Medical Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | | - Tejo N Musunuru
- Department of Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA.
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26
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Pietroluongo E, De Placido P, Tortora M, Martinelli C, Viggiano A, Saponaro MR, Caltavituro A, Buonaiuto R, Morra R, Ottaviano M, Del Deo V, Cernera G, Gelzo M, Malfitano AM, Di Tolla MF, De Angelis C, Arpino G, Terracciano D, Bianco R, Veneziani BM, Formisano P, Castaldo G, Palmieri G, De Placido S, Giuliano M. Impaired Seroconversion After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccine in Patients With Thymic Epithelial Tumors. J Thorac Oncol 2023; 18:1399-1407. [PMID: 37390981 PMCID: PMC10303630 DOI: 10.1016/j.jtho.2023.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/29/2023] [Accepted: 06/10/2023] [Indexed: 07/02/2023]
Abstract
INTRODUCTION Thymic epithelial tumors (TETs) are rare malignancies associated with dysregulation of the immune system and humoral- and cell-mediated immunity abnormalities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine is effective in preventing coronavirus disease 2019 morbidity and mortality. The aim of this study was to evaluate the seroconversion in patients with TET after two doses of mRNA vaccine. METHODS This is a prospective study in which consecutive patients with TET were enrolled before receiving the first dose of SARS-CoV-2 mRNA vaccine (BNT162b2 by Pfizer-BioNTech). SARS-CoV-2 spike-binding immunoglobulin (Ig)G antibody serologic levels were analyzed at different time points, including before first vaccine dose (T0), 1 month after the second dose (T2), and 3 months after the second dose (T3). RESULTS Overall, 39 patients were included in the analysis. All patients had negative antibody titer results at T0. There were 19 patients (48.7%) in the follow-up with no residual tumor lesion/s (referred as no evidence of disease), and 20 (51.3%) had evidence of disease (ED) and were receiving systemic treatment. Dysregulations of the immune system were diagnosed in 29 patients (74.4%) with Good syndrome (GS) being the most frequent immune disorder (48.7%). At univariate analysis, lack of seroconversion at T2 was significantly associated with ED (p < 0.001) and with GS (p = 0.043). A significant association with impaired seroconversion was confirmed at multivariate analysis for ED (p = 0.00101) but not for GS (p = 0.625). CONCLUSIONS Our data revealed that patients with TET with ED had substantially higher probability of impaired seroconversion after SARS-CoV-2 mRNA vaccine as compared with patients with no evidence of disease.
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Affiliation(s)
- Erica Pietroluongo
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Marianna Tortora
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Claudia Martinelli
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Angela Viggiano
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | | | - Aldo Caltavituro
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Roberto Buonaiuto
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Rocco Morra
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Margaret Ottaviano
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy; Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Italian National Cancer Institute- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Pascale Foundation, Naples, Italy
| | - Vitantonio Del Deo
- Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Gustavo Cernera
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Monica Gelzo
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Anna Maria Malfitano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | | | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Bianca Maria Veneziani
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II," Naples, Italy
| | - Pietro Formisano
- Department of Translational Medical Sciences, University "Federico II," Naples, Italy
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy; Rare Tumors Coordinating Center of Campania Region (CRCTR), Naples, Italy
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27
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Aryanian Z, Balighi K, Goodarzi A, Sadeghi Nia A, Afshar ZM, Hatami P. The impact of the COVID-19 pandemic on the diagnosis and treatment of skin cancers, a mini review. Cancer Rep (Hoboken) 2023; 6:e1854. [PMID: 37434543 PMCID: PMC10480421 DOI: 10.1002/cnr2.1854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND The SARS-Cov-2 pandemic has caused dermatologists around the world to adapt their practice in the aim of protecting patients with special clinical conditions such as those having skin cancers or premalignant conditions and some diagnostic or therapeutic programs would be suspended due to being infected to SARS-CoV-2. We focused the existing data in this regard through searching on PubMed, Google Scholar, and Scopus and tried to summarize recommendations for treating this group of patients in COVID era to provide a practical guide for clinicians. RECENT FINDINGS The number of diagnosed skin cancers dropped significantly since the beginning of the pandemic, specially in the peaks of various variants of the SARS-CoV-2 infection. The new guidelines allowed even a 3-month delay in excision and recommended surgery for non-melanoma growing skin cancers. CONCLUSION Dermatologists should perform a careful, individualized risk-benefit assessment for their patients and consider some changes in routine protocols such as having a delayed diagnostic or therapeutic intervention.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center, School of MedicineIran University of Medical SciencesTehranIran
- Skin and Stem Cell Research CenterTehran University of Medical SciencesTehranIran
| | - Ali Sadeghi Nia
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Behayand Cancer TeamTehranIran
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28
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Martinez-Perez D, Viñal D, Peña-Lopez J, Jimenez-Bou D, Ruiz-Gutierrez I, Martinez-Recio S, Alameda-Guijarro M, Rueda-Lara A, Martin-Montalvo G, Ghanem I, Custodio AB, Trilla-Fuertes L, Gamez-Pozo A, Barbachano A, Rodriguez-Cobos J, Bustamante-Madrid P, Fernandez-Barral A, Burgos A, Prieto-Nieto MI, Pastrian LG, González-Sancho JM, Muñoz A, Feliu J, Rodríguez-Salas N. Clinico-Pathological Features, Outcomes and Impacts of COVID-19 Pandemic on Patients with Early-Onset Colorectal Cancer: A Single-Institution Experience. Cancers (Basel) 2023; 15:4242. [PMID: 37686518 PMCID: PMC10487095 DOI: 10.3390/cancers15174242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND The rising incidence of colorectal cancer (CRC) among young patients is alarming. We aim to characterize the clinico-pathological features and outcomes of patients with early-onset CRC (EOCRC), as well as the impacts of COVID-19 pandemic. METHODS We included all patients with pathologically confirmed diagnoses of CRC at Hospital Universitario La Paz from October 2016 to December 2021. The EOCRC cut-off age was 50 years old. RESULTS A total of 1475 patients diagnosed with CRC were included, eighty (5.4%) of whom had EOCRC. Significant differences were found between EOCRC and later-onset patients regarding T, N stage and metastatic presentation at diagnosis; perineural invasion; tumor budding; high-grade tumors; and signet ring cell histology, with all issues having higher prevalence in the early-onset group. More EOCRC patients had the RAS/ BRAF wild type. Chemotherapy was administered more frequently to patients with EOCRC. In the metastatic setting, the EOCRC group presented a significantly longer median OS. Regarding the COVID-19 pandemic, more patients with COVID-19 were diagnosed with metastatic disease (61%) in the year after the lockdown (14 March 2020) than in the pre-pandemic EOCRC group (29%). CONCLUSIONS EOCRC is diagnosed at a more advanced stage and with worse survival features in localized patients. More patients with EOCRC were diagnosed with metastatic disease in the year after the COVID-19 pandemic lockdown. The long-term consequences of COVID-19 are yet to be determined.
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Affiliation(s)
- Daniel Martinez-Perez
- Department of Medical Oncology, Central University Hospital of Asturias, 33011 Oviedo, Spain; (D.M.-P.); (J.F.); (N.R.-S.)
| | - David Viñal
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Jesús Peña-Lopez
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Diego Jimenez-Bou
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Iciar Ruiz-Gutierrez
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Sergio Martinez-Recio
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain;
| | - María Alameda-Guijarro
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Antonio Rueda-Lara
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Gema Martin-Montalvo
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
| | - Ana Belén Custodio
- Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain; (J.P.-L.); (D.J.-B.); (I.R.-G.); (M.A.-G.); (A.R.-L.); (G.M.-M.); (I.G.); (A.B.C.)
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
| | - Lucia Trilla-Fuertes
- Molecular Oncology and Pathology Lab, Institute of Medical and Molecular Genetics-INGEMM, Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain; (L.T.-F.); (A.G.-P.)
| | - Angelo Gamez-Pozo
- Molecular Oncology and Pathology Lab, Institute of Medical and Molecular Genetics-INGEMM, Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain; (L.T.-F.); (A.G.-P.)
| | - Antonio Barbachano
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Javier Rodriguez-Cobos
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Pilar Bustamante-Madrid
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Asuncion Fernandez-Barral
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Aurora Burgos
- Department of Gastroenterology, Hospital Universitario La Paz, 28046 Madrid, Spain;
| | - Maria Isabel Prieto-Nieto
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Department of Surgery, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Laura Guerra Pastrian
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
- Department of Pathology, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - José Manuel González-Sancho
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Alberto Muñoz
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
| | - Jaime Feliu
- Department of Medical Oncology, Central University Hospital of Asturias, 33011 Oviedo, Spain; (D.M.-P.); (J.F.); (N.R.-S.)
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
- Catedra UAM-AMGEN, 28046 Madrid, Spain
| | - Nuria Rodríguez-Salas
- Department of Medical Oncology, Central University Hospital of Asturias, 33011 Oviedo, Spain; (D.M.-P.); (J.F.); (N.R.-S.)
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), 28046 Madrid, Spain; (A.B.); (J.R.-C.); (P.B.-M.); (A.F.-B.); (M.I.P.-N.); (J.M.G.-S.); (A.M.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain;
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Nebelung H, Radosa CG, Schön F, Blum SFU, Böhme C, Hoffmann RT, Plodeck V. Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital. ROFO-FORTSCHR RONTG 2023; 195:707-712. [PMID: 37224865 DOI: 10.1055/a-2081-4012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The COVID-19 pandemic led to the implementation of severe restrictions on public life in Germany and a reduction in the number of non-COVID patients presenting for care. The aim of this study was to measure the impact on the number of therapeutic interventional oncology procedures in relation to diagnostic imaging studies at a high-volume radiology department. MATERIALS AND METHODS The numbers of therapeutic interventional oncology procedures and diagnostic CT/MRI examinations for the years 2010 to 2021 were extracted using the hospital information system. Monthly data from January 2010 to December 2019 were used to build forecasting models for the timeframe from January 2020 to December 2021. Real procedure numbers were compared with predicted numbers to calculate residual differences, which were considered statistically significant if the real number was outside the 95 % confidence interval (p < 0.05). RESULTS During the first German lockdown (March/April 2020), the number of outpatient CT/MRI examinations decreased significantly, with a less pronounced decrease of overall CT/MRI numbers. The second German lockdown (January-May 2021) led to lower than predicted outpatient CT numbers, whereas outpatient MRI numbers in part even exceeded predicted numbers and overall CT/MRI numbers stayed within confidence limits. The lockdowns had a more pronounced negative effect on the number of oncological MRI examinations compared to CT examinations. The number of therapeutic interventional oncology procedures showed no significant decrease during both lockdowns. CONCLUSION Lockdown measures had minor impact on the number of therapeutic interventional oncology procedures, possibly due to a shift from more resource-intensive therapies like surgery towards interventional oncology. The overall numbers of diagnostic imaging decreased during the first lockdown, while the second lockdown had less negative impact. The number of oncological MRI examinations was affected most severely. To avoid adverse outcomes, specific protocols for patient management during future pandemic outbreaks should be implemented and continuously adapted. KEY POINTS · COVID-19 lockdowns had minor effect on therapeutic interventional oncology procedures.. · Numbers of diagnostic outpatient imaging procedures dropped markedly, especially during the first lockdown.. · The number of oncological MRI examinations showed a significant decrease during both lockdowns.. CITATION FORMAT · Nebelung H, Radosa CG, Schön F et al. Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital. Fortschr Röntgenstr 2023; 195: 707 - 712.
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Affiliation(s)
- Heiner Nebelung
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christoph Georg Radosa
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Felix Schön
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Sophia Freya Ulrike Blum
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Böhme
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Ralf-Thorsten Hoffmann
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Verena Plodeck
- Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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Hall LA, McKay SC, Halle-Smith J, Soane J, Osei-Bordom DC, Goodburn L, Magill L, Pinkney T, Radhakrishna G, Valle JW, Corrie P, Roberts KJ. The impact of the COVID-19 pandemic upon pancreatic cancer treatment (CONTACT Study): a UK national observational cohort study. Br J Cancer 2023; 128:1922-1932. [PMID: 36959376 PMCID: PMC10035482 DOI: 10.1038/s41416-023-02220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/06/2023] [Accepted: 02/24/2023] [Indexed: 03/25/2023] Open
Abstract
INTRODUCTION CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). METHODS The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic ('COVID' cohort, 16/03/2020-10/05/2020), with 12-month follow-up. RESULTS Among 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8-4.1) vs. 4.4 (IQR 3.6-5.2) months, p = 0.093). CONCLUSION Pathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.
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Affiliation(s)
- Lewis A Hall
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England.
| | - Siobhan C McKay
- Queen Elizabeth Hospital, Birmingham, England
- Department of Academic Surgery, University of Birmingham, Birmingham, England
| | | | - Joshua Soane
- Southend University Hospital, Southend-on-Sea, England
| | | | | | - Laura Magill
- Birmingham Surgical Trials Consortium, University of Birmingham, Birmingham, England
| | - Thomas Pinkney
- Birmingham Surgical Trials Consortium, University of Birmingham, Birmingham, England
| | | | - Juan W Valle
- The Christie NHS Foundation Trust, Manchester, England
| | - Pippa Corrie
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Keith J Roberts
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
- Queen Elizabeth Hospital, Birmingham, England
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Ge R. Key points of anti-tumor treatment in breast cancer patients with SARS-CoV-2 infection. TRANSLATIONAL BREAST CANCER RESEARCH : A JOURNAL FOCUSING ON TRANSLATIONAL RESEARCH IN BREAST CANCER 2023; 4:13. [PMID: 38751467 PMCID: PMC11093019 DOI: 10.21037/tbcr-23-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/15/2023] [Indexed: 05/18/2024]
Abstract
Internationally, the outbreak of coronavirus disease 2019 (COVID-19) has become the most serious public health emergency. With the adjustment of the prevention and control policies, China downgraded the management of COVID-19 from Class A to Class B, causing new challenges in the clinical management of patients with breast cancer. It is necessary to formulate clinical strategies for timely and reasonable anti-tumor treatment after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. By combing the relevant evidence and summarizing the anti-tumor treatment experience for breast cancer patients with SARS-CoV-2 infection in various regions, the expert panel of the Breast Cancer Professional Committee of the Chinese Society of Clinical Oncology (CSCO-BC) discussed and voted on hot and difficult issues of this situation timely. Based on the vote results, combined with domestic and foreign guidelines and consensus, the key points of treatment and management of breast cancer patients who were infected with COVID-19 have been established to provide suggestions and recommendations for clinical practice, such as restart time of anti-tumor treatment, application of anti-tumor drugs and other considerations. In the formulation of this key point, we mainly focus on mild to moderate and asymptomatic infection patients who account for the largest proportion of COVID-19 patients, and propose diagnosis and treatment recommendations for breast cancer patients with different infections and after SARS-CoV-2 infection, aiming to provide a reference for clinical diagnosis and treatment.
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Affiliation(s)
- Rui Ge
- Department of General Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, China
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Addabbo F, Giotta M, Mincuzzi A, Minerba AS, Prato R, Fortunato F, Bartolomeo N, Trerotoli P. No Excess of Mortality from Lung Cancer during the COVID-19 Pandemic in an Area at Environmental Risk: Results of an Explorative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085522. [PMID: 37107804 PMCID: PMC10138515 DOI: 10.3390/ijerph20085522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The COVID-19 pandemic and the restrictive measures associated with it placed enormous pressure on health facilities and may have caused delays in the treatment of other diseases, leading to increases in mortality compared to the expected rates. Areas with high levels of air pollution already have a high risk of death from cancer, so we aimed to evaluate the possible indirect effects of the pandemic on mortality from lung cancer compared to the pre-pandemic period in the province of Taranto, a polluted site of national interest for environmental risk in the south of Italy. METHODS We carried out a retrospective observational study on lung cancer data (ICD-10: C34) from the Registry of Mortality (ReMo) for municipalities in Taranto Province over the period of 1 January 2011 to 31 December 2021. Seasonal exponential smoothing, Holt-Winters additive, Holt-Winters multiplicative, and auto-regressive integrated moving average (ARIMA) models were used to forecast the number of deaths during the pandemic period. Data were standardized by sex and age via an indirect method and shown as monthly mortality rates (MRs), standardized mortality ratios (SMRs), and adjusted mortality rates (AMRs). RESULTS In Taranto Province, 3108 deaths from lung cancer were recorded between 2011 and 2021. In the province of Taranto, almost all of the adjusted monthly mortality rates during the pandemic were within the confidence interval of the predicted rates, with the exception of significant excesses in March (+1.82, 95% CI 0.11-3.08) and August 2020 (+2.09, 95% CI 0.20-3.44). In the municipality of Taranto, the only significant excess rate was in August 2020 (+3.51, 95% CI 0.33-6.69). However, in total, in 2020 and 2021, the excess deaths from lung cancer were not significant both for the province of Taranto (+30 (95% CI -77; +106) for 2020 and +28 (95% CI -130; +133) for 2021) and for the municipality of Taranto alone (+14 (95% CI -47; +74) for 2020 and -2 (95% CI -86; +76) for 2021). CONCLUSIONS This study shows that there was no excess mortality from lung cancer as a result of the COVID-19 pandemic in the province of Taranto. The strategies applied by the local oncological services during the pandemic were probably effective in minimizing the possible interruption of cancer treatment. Strategies for accessing care in future health emergencies should take into account the results of continuous monitoring of disease trends.
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Affiliation(s)
- Francesco Addabbo
- School of Medical Statistics and Biometry, University of Bari Aldo Moro, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy;
| | - Massimo Giotta
- School of Medical Statistics and Biometry, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Antonia Mincuzzi
- Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy
| | - Aldo Sante Minerba
- Unit of Statistics and Epidemiology, Azienda Sanitaria Locale Taranto, 74121 Taranto, Italy
| | - Rosa Prato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Francesca Fortunato
- Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Nicola Bartolomeo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-080-547-8479
| | - Paolo Trerotoli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy;
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Afolabi BL, Mazhindu T, Zedias C, Borok M, Ndlovu N, Masimirembwa C. Pharmacogenetics and Adverse Events in the Use of Fluoropyrimidine in a Cohort of Cancer Patients on Standard of Care Treatment in Zimbabwe. J Pers Med 2023; 13:jpm13040588. [PMID: 37108974 PMCID: PMC10141018 DOI: 10.3390/jpm13040588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Fluoropyrimidines are commonly used in the treatment of colorectal cancer. They are, however, associated with adverse events (AEs), of which gastrointestinal, myelosuppression and palmar-plantar erythrodysesthesia are the most common. Clinical guidelines are used for fluoropyrimidine dosing based on dihydropyrimidine dehydrogenase (DPYD) genetic polymorphism and have been shown to reduce these AEs in patients of European ancestry. This study aimed to evaluate, for the first time, the clinical applicability of these guidelines in a cohort of cancer patients on fluoropyrimidine standard of care treatment in Zimbabwe. DNA was extracted from whole blood and used for DPYD genotyping. Adverse events were monitored for six months using the Common Terminology Criteria for AEs (CTCAE) v.5.0. None of the 150 genotyped patients was a carrier of any of the pathogenic variants (DPYD*2A, DPYD*13, rs67376798, or rs75017182). However, severe AEs were high (36%) compared to those reported in the literature from other populations. There was a statistically significant association between BSA (p = 0.0074) and BMI (p = 0.0001) with severe global AEs. This study has shown the absence of the currently known actionable DPYD variants in the Zimbabwean cancer patient cohort. Therefore, the current pathogenic variants in the guidelines might not be feasible for all populations hence the call for modification of the current DPYD guidelines to include minority populations for the benefit of all diverse patients.
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Morton C, Sullivan R, Sarker D, Posner J, Spicer J. Revitalising cancer trials post-pandemic: time for reform. Br J Cancer 2023; 128:1409-1414. [PMID: 36959378 PMCID: PMC10035974 DOI: 10.1038/s41416-023-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
The COVID-19 pandemic posed significant risk to the health of cancer patients, compromised standard cancer care and interrupted clinical cancer trials, prompting dramatic streamlining of services. From this health crisis has emerged the opportunity to carry forward an unexpected legacy of positive reforms to clinical cancer research, where conventionally convoluted approvals processes, inefficient trial design, procedures and data gathering could benefit from the lessons in rationalisation learned during the pandemic.
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Affiliation(s)
- Cienne Morton
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK.
| | | | - Debashis Sarker
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - John Posner
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - James Spicer
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
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Dalamaga M, Nasiri-Ansari N, Spyrou N. Perspectives and Challenges of COVID-19 with Obesity-Related Cancers. Cancers (Basel) 2023; 15:cancers15061771. [PMID: 36980657 PMCID: PMC10046880 DOI: 10.3390/cancers15061771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
The emergence of COVID-19 has created an unprecedented threat worldwide, involving overwhelmed health-care systems in the majority of countries [...]
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Affiliation(s)
- Maria Dalamaga
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
- Correspondence:
| | - Narjes Nasiri-Ansari
- Department of Biological Chemistry, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
| | - Nikolaos Spyrou
- Tisch Cancer Institute Icahn School of Medicine at Mount Sinai, 1190 One Gustave L. Levy Place, New York, NY 10029, USA
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Clemente F, Antonacci A, Giardi MT, Frisulli V, Tambaro FP, Scognamiglio V. Last Trends in Point-of-Care (POC) Diagnostics for the Management of Hematological Indices in Home Care Patients. BIOSENSORS 2023; 13:345. [PMID: 36979557 PMCID: PMC10046198 DOI: 10.3390/bios13030345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Today, complete blood count (CBC) analyses are highly automated and allow for high throughput and accurate and reliable results. However, new analytical tools are in great demand to provide simple, rapid and cost-effective management of hematological indices in home care patients. Chronic disease monitoring at home has become a benefit for patients who are finding cost savings in programs designed to monitor/treat patients in offsite locations. This review reports the latest trends in point-of-care (POC) diagnostics useful for home testing of key hematological counts that may be affected during home therapy treatment.
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Affiliation(s)
- Fabrizio Clemente
- Department of Chemical Sciences and Materials Technologies, Institute of Crystallography (IC-CNR), Via Salaria Km 29.300, 00015 Monterotondo, Italy
- Institute of Crystallography (IC-CNR), Department of Chemical Sciences and Materials Technologies, URT Naples c/o Azienda Ospedialiera di Rilievo Nazionale (AORN) Santobono-Pausilipon Via Teresa Ravaschieri 8, 80112 Naples, Italy
| | - Amina Antonacci
- Department of Chemical Sciences and Materials Technologies, Institute of Crystallography (IC-CNR), Via Salaria Km 29.300, 00015 Monterotondo, Italy
| | - Maria Teresa Giardi
- Department of Chemical Sciences and Materials Technologies, Institute of Crystallography (IC-CNR), Via Salaria Km 29.300, 00015 Monterotondo, Italy
| | - Valeria Frisulli
- Department of Chemical Sciences and Materials Technologies, Institute of Crystallography (IC-CNR), Via Salaria Km 29.300, 00015 Monterotondo, Italy
| | - Francesco Paolo Tambaro
- Struttura Semplice Dipartimentale Trapianto di Midollo Osseo-Azienda Ospedialiera di Rilievo Nazionale (AORN), Santobono-Pausilipon, 80129 Napoli, Italy
| | - Viviana Scognamiglio
- Department of Chemical Sciences and Materials Technologies, Institute of Crystallography (IC-CNR), Via Salaria Km 29.300, 00015 Monterotondo, Italy
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Amaadour L, Lahrch I, Siyouri O, Oualla K, Benbrahim Z, Arifi S, Aarab C, El Fakir S, Mellas N. SARS-CoV2 et cancer : quel impact psychologique ? PSYCHO-ONCOLOGIE 2023. [DOI: 10.3166/pson-2022-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Introduction : La Covid-19 constitue une cause de plusieurs affections mentales, notamment chez les patients atteints de cancer qui sont déjà considérés comme une population vulnérable. Ainsi, l’objectif de la présente étude était d’évaluer les troubles psychologiques des patients suivis pour une maladie tumorale maligne, sous traitement médical systémique, ayant eu une infection au SARS-CoV2 ; ainsi que les conséquences que ces troubles psychologiques peuvent avoir sur l’adhésion aux soins oncologiques.
Méthode : Il s’agit d’une étude transversale sur une période de quatre mois (pic de la pandémie) menée au département d’oncologie médicale du centre hospitalier universitaire Hassan-II de Fès, Maroc. Les symptômes anxieux/dépressifs et le stress post-traumatique ont été évalués avec les échelles HADS, PCL-5. L’échelle mini-MAC était utilisée afin d’évaluer l’ajustement psychologique des patients atteints de cancer dans le contexte d’infection à la Covid-19.
Résultats : Au total, 53 patients ont été rencontrés : 45,2 % des patients présentaient des symptômes significatifs de stress post-traumatique et 20,7 % une symptomatologie dépressive. Une symptomatologie anxieuse importante était objectivée chez 69,8 % des patients. L’âge inférieur à 65 ans, le sexe féminin et la stratégie thérapeutique envisagée (curative versus palliative) étaient des facteurs prédictifs de survenue de troubles anxieux. Tous les patients sont revenus pour reprendre leurs soins oncologiques après l’épisode infectieux.
Conclusion : Les troubles anxieux et le stress posttraumatique sont très fréquents chez les patients atteints de cancer et positifs à la Covid-19 par rapport à la population générale. Nos résultats suggèrent la nécessité de mettre en place des soins de support psycho-oncologiques personnalisés durant le contexte pandémique.
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The Mental Health Burden of Patients with Colorectal Cancer Receiving Care during the COVID-19 Pandemic: Results of the PICO-SM Study. Cancers (Basel) 2023; 15:cancers15041226. [PMID: 36831568 PMCID: PMC9954113 DOI: 10.3390/cancers15041226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
The COVID-19 pandemic has resulted in unprecedented changes to the lives of patients with cancer. To evaluate the impact of the COVID-19 pandemic on the mental health and well-being of patients with colorectal cancer, we conducted a prospective longitudinal questionnaire study at a UK tertiary cancer centre. In total, 216 participants were included: mean age 65 years, 57% (n = 122) male, 92% (n = 198) of white ethnicity. Amongst participants who completed the screening psychometric questionnaire, 24% (n = 48/203) reported anxiety (GAD-7 ≥ 5), 15% (n = 31/204) depressive symptoms (PHQ-9 ≥ 10), 3% (n = 5/190) probable post-traumatic stress disorder (PC-PTSD-5 ≥ 4), and 31% (n = 66/213) poor well-being (WHO-5 < 50). In the subgroup (n = 95/216, 44%) who consented to and completed a follow-up survey 6 months later, there was a significant increase in the number of participants at risk of depression (4% vs. 13%, p = 0.021). Self-reported concern about the COVID-19 pandemic impacting one's mental health is associated with increased likelihood of anxiety, depression, and poor well-being, in respective multivariate analyses. In conclusion, screening for the mental health impact of the COVID-19 pandemic is essential to ensure timely action from all key stakeholders and to avoid potentially longer-term detrimental consequences.
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Mahajan A, Chakrabarty N, Majithia J, Ahuja A, Agarwal U, Suryavanshi S, Biradar M, Sharma P, Raghavan B, Arafath R, Shukla S. Multisystem Imaging Recommendations/Guidelines: In the Pursuit of Precision Oncology. Indian J Med Paediatr Oncol 2023. [DOI: 10.1055/s-0043-1761266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
AbstractWith an increasing rate of cancers in almost all age groups and advanced screening techniques leading to an early diagnosis and longer longevity of patients with cancers, it is of utmost importance that radiologists assigned with cancer imaging should be prepared to deal with specific expected and unexpected circumstances that may arise during the lifetime of these patients. Tailored integration of preventive and curative interventions with current health plans and global escalation of efforts for timely diagnosis of cancers will pave the path for a cancer-free world. The commonly encountered circumstances in the current era, complicating cancer imaging, include coronavirus disease 2019 infection, pregnancy and lactation, immunocompromised states, bone marrow transplant, and screening of cancers in the relevant population. In this article, we discuss the imaging recommendations pertaining to cancer screening and diagnosis in the aforementioned clinical circumstances.
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Affiliation(s)
- Abhishek Mahajan
- Department of Radiology, The Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Nivedita Chakrabarty
- Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Jinita Majithia
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | | | - Ujjwal Agarwal
- Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Shubham Suryavanshi
- Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Mahesh Biradar
- Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Prerit Sharma
- Radiodiagnosis, Sharma Diagnostic Centre, Wardha, India
| | | | | | - Shreya Shukla
- Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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Della Corte L, Cafasso V, Boccia D, Morra I, De Angelis C, De Placido S, Giampaolino P, Di Carlo C, Bifulco G. How SARS-CoV-2 Infection Impacts the Management of Patients with Vulvar Cancer: Experience in a Third-Level Hospital of Southern Italy. J Pers Med 2023; 13:jpm13020240. [PMID: 36836474 PMCID: PMC9967907 DOI: 10.3390/jpm13020240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/21/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Background: Since February 2020, the spread of Coronavirus Disease 2019 (COVID-19) in Italy has induced the government to call for lockdown of any activity apart from primary needs, and changing the lives of each of us. All that has dramatically impacted the management of patients affected by cancer. Patients with vulvar cancer (VC) represent a particularly frail population because they are elderly and affected by multiple comorbidities. The aim of this study is to evaluate the clinical impact of the SARS-CoV-2 infection on VC patients in terms of delay or impossibility of carrying out the scheduled treatment. Methods: The medical records of patients affected by vulvar tumors, referred to "DAI Materno-Infantile" of AOU Federico II of Naples between February 2020 and January 2022 were retrospectively analyzed. The presence of a positive reverse transcription-polymerase chain reaction (RT-PCR) in nasopharyngeal swab defined the positivity to SARS-CoV-2. Results: Twenty-four patients with VC were analyzed and scheduled for treatment. The median age was 70.7 years (range: 59-80). Seven (29.2%) patients were diagnosed with SARS-CoV-2 infection: In three (42.8%) patients, the treatment was delayed with no apparent consequences, in four (57.2%), the treatment was delayed or changed due to cancer progression and, of these four, one died due to respiratory complications of COVID-19, and one died due to oncologic disease progression. Conclusion: COVID-19 caused, in most cases, significant delays in oncologic treatments and high mortality in our series of patients affected by VC.
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Affiliation(s)
- Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 84014 Naples, Italy
- Correspondence:
| | - Valeria Cafasso
- Department of Public Health, School of Medicine, University of Naples Federico II, 84014 Napoli, Italy
| | - Dominga Boccia
- Department of Public Health, School of Medicine, University of Naples Federico II, 84014 Napoli, Italy
| | - Ilaria Morra
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 84014 Naples, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 84014 Naples, Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 84014 Naples, Italy
| | - Pierluigi Giampaolino
- Department of Public Health, School of Medicine, University of Naples Federico II, 84014 Napoli, Italy
| | - Costantino Di Carlo
- Department of Public Health, School of Medicine, University of Naples Federico II, 84014 Napoli, Italy
| | - Giuseppe Bifulco
- Department of Public Health, School of Medicine, University of Naples Federico II, 84014 Napoli, Italy
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Laffi A, Gervaso L, D’Ecclesiis O, Gandini S, Riva A, Passerini R, Spada F, Pellicori S, Rubino M, Cella CA, Ravenda PS, Zampino MG, Fazio N. Observational Study on Antibody Response to COVID-19 Vaccines in PAtients with Gastro-Entero-PanCreatic Cancers and NeuroendocrIne NeoplAsms on Systemic TreatmEnts (VACCINATE). Biomedicines 2023; 11:biomedicines11020336. [PMID: 36830873 PMCID: PMC9953014 DOI: 10.3390/biomedicines11020336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
The coronavirus disease-19 (COVID-19) pandemic dramatically impacted oncological patients' care. Since the introduction of vaccines and the demonstration of their benefit on frail patients, COVID-19 vaccinations were indicated to also be beneficial to oncological population. However, data about the impact of anticancer-treatments and the timing between vaccinations and systemic therapy delivery were not available. We aimed to evaluate potential factors influencing the outcome of the COVID-19 vaccination in cancer patients. We prospectively collected data of patients undergoing the COVID-19 vaccination with gastro-entero-pancreatic and neuroendocrine neoplasms, treated at our institute, between 03/2021 and 12/2021. We enrolled 46 patients, 63.1% males; at the time of data collection, 86.9% had received two-doses of Pfizer-BioNTech and the rest had received the Moderna vaccine. All patients obtained a subsequent immune-response. Chemotherapy seems to determinate a significantly lower antibody response after vaccination compared to the other anti-cancer agents (p = 0.004). No significant effect on immune-response was reported for both vaccinations performed ≤7 vs. >7 days from the last systemic treatment (p = 0.77) and lymphocytes count (p = 0.11). The findings suggest that the optimal timing for COVID-19 vaccination and lymphocytes count are not the issue, but rather that the quality of the subset of lymphocytes before the vaccination determine the efficacy level of immune-response in this population.
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Affiliation(s)
- Alice Laffi
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Correspondence: (A.L.); (L.G.)
| | - Lorenzo Gervaso
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
- Correspondence: (A.L.); (L.G.)
| | - Oriana D’Ecclesiis
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Agostino Riva
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy
| | - Rita Passerini
- Division of Laboratory Medicine, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Francesca Spada
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Stefania Pellicori
- Oncologic Department, ASST Lodi Hospital, Piazza Ospitale 10, 26900 Lodi, Italy
| | - Manila Rubino
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Chiara Alessandra Cella
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Paola Simona Ravenda
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Maria Giulia Zampino
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
| | - Nicola Fazio
- Division of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology (IEO), IRCCS, Via Ripamonti 435, 20141 Milan, Italy
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Linjawi M, Shakoor H, Hilary S, Ali HI, Al-Dhaheri AS, Ismail LC, Apostolopoulos V, Stojanovska L. Cancer Patients during COVID-19 Pandemic: A Mini-Review. Healthcare (Basel) 2023; 11:healthcare11020248. [PMID: 36673615 PMCID: PMC9859465 DOI: 10.3390/healthcare11020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Since its emergence, coronavirus disease 2019 (COVID-19) has affected the entire world and all commerce and industries, including healthcare systems. COVID-19 adversely affects cancer patients because they are immunocompromised. Increased COVID-19 infection and shortage of medical supplies, beds and healthcare workers in hospitals affect cancer care. This paper includes a description of the existing research that shows the impact of COVID-19 on the management of cancer patients. Aged people with various chronic conditions such as cancer and comorbidities face more challenges as they have a greater risk of disease severity. COVID-19 has affected care delivery, including patient management, and has been responsible for increased mortality among cancer patients. Cancer patients with severe symptoms require regular therapies and treatment; therefore, they have a higher risk of exposure. Due to the risk of transmission, various steps were taken to combat this disease; however, they have affected the existing operational efficiency. Herein, we present the changing priorities during COVID-19, which also affected cancer care, including delayed diagnosis, treatment, and surgeries.
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Affiliation(s)
- Maryam Linjawi
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Hira Shakoor
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Serene Hilary
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence: (S.H.); (L.S.)
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ayesha S. Al-Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Correspondence: (S.H.); (L.S.)
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Thiagarajan S, Poojari V, Tuljapurkar V, Ghosh-Laskar S, Fatehi K, Babu S, Penumadu P, Patil A, Joshi A, Kumar S, Chaukar D, Kannan R, Pramesh CS. National Cancer Grid Virtual Tumor Boards of Head and Neck Cancers: An Innovative Approach to Multidisciplinary Care. JCO Glob Oncol 2023; 9:e2200348. [PMID: 36706349 PMCID: PMC10166436 DOI: 10.1200/go.22.00348] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Virtual tumor board (VTB) via videoconference facility involving multiple specialists in the decision making for various tumors is well accepted, especially in high-income countries. Information on virtual tumor boards for head and neck cancers especially from low- and middle-income countries is sparse. In this study, we have audited the findings of the National Cancer Grid VTBs performed for head and neck cancers. METHODS All patients discussed in the head and neck VTBs at our center between December 2016 and February 2022 were included in the study. Details such as the type of institute sending patients for discussion, its location, subsites within the head and neck region, histopathology, treatment setting or question for the VTB, and availability of guidelines for such patient scenarios were assessed. Also, a survey was sent to assess the usefulness of the VTBs. RESULTS A total of 208 patients were discussed in 54 VTB sessions. The most common head and neck sites discussed in the VTBs were the oral cavity (n = 64, 30.7%) followed by skull base/nose and paranasal sinuses/eyelid-orbit tumors (n = 49, 23.5%). Nonsquamous cell carcinoma was the most common histopathology discussed; recurrent cancers/residual diseases were the most common treatment settings (n = 134, 64.4%) for which there were no existing guidelines. Survey results showed that most VTB decisions were implementable, and respondents felt that VTBs were a useful educational tool as well. CONCLUSION Our study affirms the feasibility of VTBs in low- and middle-income countries' health care systems for managing uncommon malignancies and clinical situations, which act as an important educational platform.
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Affiliation(s)
- Shivakumar Thiagarajan
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - Vidisha Tuljapurkar
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sarbani Ghosh-Laskar
- Department of Radiation Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | | | | | - Asawari Patil
- Department of Pathology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Suman Kumar
- Department of Radiology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Devendra Chaukar
- Department of Head and Neck Oncology, Tata Memorial Centre and Homi Bhabha National Institute (HBNI), Mumbai, India
| | | | - C S Pramesh
- Tata Memorial Hospital, Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India
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Grani G, Ciotti L, Del Gatto V, Montesano T, Biffoni M, Giacomelli L, Sponziello M, Pecce V, Verrienti A, Filetti S, Durante C. The legacy of the COVID-19 pandemics for thyroid cancer patients: towards the application of clinical practice recommendations. Endocrine 2023; 79:45-48. [PMID: 35857273 PMCID: PMC9298162 DOI: 10.1007/s12020-022-03132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/30/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Giorgio Grani
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Ciotti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Del Gatto
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Teresa Montesano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Valeria Pecce
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Sebastiano Filetti
- School of Health, UNITELMA Sapienza University of Rome, Piazza Sassari, 4, 00161, Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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Feeney L, Hamilton A, Lavery A, O’Neill C, Walls G, Taylor K, Turkington RC. Real world outcomes in cancer patients with COVID-19 infection: Northern Ireland experience. THE ULSTER MEDICAL JOURNAL 2023; 92:29-37. [PMID: 36762131 PMCID: PMC9899036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Background Cancer has been assumed to be associated with a high-risk of morbidity and mortality from COVID-19. Protective measures have incorporated modifications in cancer treatments. There are conflicting data about the impact of COVID-19 infection and outcomes in cancer patients. We aim to describe the impact of demographic and clinical characteristics on COVID-19 outcomes in patients with cancer in Northern Ireland reported within the UK Coronavirus Cancer Monitoring Project (UKCCMP). Method Prospective data collection including demographics, cancer stage and type, treatment and outcomes occurred for all Northern Irish patients enrolled in the UKCCMP. The primary endpoint was all-cause mortality. Descriptive statistics and logistic regression analysis were performed using SPSSv25. Results Between March 2020 and March 2021, 110 cases were registered. Median age was 63 years (range 27 to 87). Seventy patients (63.6%) were >60 years and 59 (53.8%) were females. Co-morbidities were reported in 83 patients (72.7%). Most patients had metastatic disease (64, 58.2%). Sixty-seven patients (60.9%) received anticancer treatment in the 4 weeks prior to COVID-19 infection. Of those patients, 35 (52.2%) received chemotherapy. Thirty-nine patients (58.2%) continued treatment as planned; 24 (36.9%) stopped treatment due to SARS-CoV-2 infection. The majority of patients were asymptomatic or experienced mild symptoms (67, 60.9%). Fifty-one (46.3%%) were admitted to hospital for COVID-19. Risk of severe/critical COVID-19 disease was significantly associated with age (OR 1.07 [95% CI 1.03-1.11); p=0.004), pre-existing hypertension (OR 3.29 [95% CI 1.42-7.62]; p=0.02) and thoracic primary malignancy (OR 4.41 [95% CI 1.52-12.74]; p=0.042). Twenty-nine patients (26.3%) died of whom 15 (57.7%) died of COVID-19 and 13 (44.8%) died due to cancer. Risk of death was significantly associated with age (OR 1.05 [95% CI 1.01-1.09]; p=0.014), male sex (OR 3.76 [95% CI 1.51-9.34]; p=0.008) and thoracic primary malignancy (OR 5.35 [95% CI 1.88-15.25]; p=0.014). When corrected for age, gender and co-morbidities, chemotherapy within the past 4 weeks was not significantly associated with mortality (OR 0.65 [95% CI 0.20-2.11]; p=0.476). Conclusion Age and thoracic cancer diagnosis correlated with survival. Comparison of performance during the pandemic with national benchmarks can inform how regional services should be adapted in preparation for future healthcare crises.
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Affiliation(s)
- Laura Feeney
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK,Correspondence to: Laura Feeney,
| | - Ashleigh Hamilton
- Northern Ireland Cancer Centre, Belfast, UK,Centre For Public Health, Queens University Belfast, Belfast, UK
| | - Anita Lavery
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
| | - Conor O’Neill
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Centre For Public Health, Queens University Belfast, Belfast, UK
| | - Gerard Walls
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
| | | | - Richard C Turkington
- Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK,Northern Ireland Cancer Centre, Belfast, UK
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Martínez-Pérez C, Turnbull AK, Kay C, Dixon JM. Neoadjuvant endocrine therapy in postmenopausal women with HR+/HER2- breast cancer. Expert Rev Anticancer Ther 2023; 23:67-86. [PMID: 36633402 DOI: 10.1080/14737140.2023.2162043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023]
Abstract
INTRODUCTION While endocrine therapy is the standard-of-care adjuvant treatment for hormone receptor-positive (HR+) breast cancers, there is also extensive evidence for the role of pre-operative (or neoadjuvant) endocrine therapy (NET) in HR+ postmenopausal women. AREAS COVERED We conducted a thorough review of the published literature, to summarize the evidence to date, including studies of how NET compares to neoadjuvant chemotherapy, which NET agents are preferable, and the optimal duration of NET. We describe the importance of on-treatment assessment of response, the different predictors available (including Ki67, PEPI score, and molecular signatures) and the research opportunities the pre-operative setting offers. We also summarize recent combination trials and discuss how the COVID-19 pandemic led to increases in NET use for safe management of cases with deferred surgery and adjuvant treatments. EXPERT OPINION NET represents a safe and effective tool for the management of postmenopausal women with HR+/HER2- breast cancer, enabling disease downstaging and a wider range of surgical options. Aromatase inhibitors are the preferred NET, with evidence suggesting that longer regimens might yield optimal results. However, NET remains currently underutilised in many territories and institutions. Further validation of predictors for treatment response and benefit is needed to help standardise and fully exploit the potential of NET in the clinic.
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Affiliation(s)
- Carlos Martínez-Pérez
- Translational Oncology Research Group, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
- Edinburgh Breast Cancer Now Research Team, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
| | - Arran K Turnbull
- Translational Oncology Research Group, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
- Edinburgh Breast Cancer Now Research Team, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
| | - Charlene Kay
- Translational Oncology Research Group, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
- Edinburgh Breast Cancer Now Research Team, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
| | - J Michael Dixon
- Translational Oncology Research Group, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
- Edinburgh Breast Cancer Now Research Team, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
- Edinburgh Breast Unit, Western General Hospital, Edinburgh, Scotland
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Amaoui B, Lahlou L, Safini F, Semghouli S. Teleconsultation use and satisfaction among cancerologists during the COVID-19 pandemic in Morocco. Pan Afr Med J 2023; 44:89. [PMID: 37193104 PMCID: PMC10182389 DOI: 10.11604/pamj.2023.44.89.35081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 02/04/2023] [Indexed: 05/18/2023] Open
Abstract
Introduction health care benefits have undergone major changes during the COVID-19 pandemic. This has led to an explosive growth in teleconsultation services mainly for cancer patients. The purpose of this study was to assess the perception and experience of Moroccan oncologists with the use of teleconsultation during the COVID-19 pandemic. Methods a 17-question anonymous cross-sectional survey was conducted on Google forms and emailed to all Moroccan oncologists. Statistical analysis was performed using the statistical software Jamovi (version 2.2). Results out of a total of 500 oncologists who received the questionnaire, 126 responded, with a response rate of 25%. During the pandemic, only 59.5% of oncologists used teleconsultation, with no significant differences among the three groups (radiation oncologists, medical oncologists and cancer surgeons (p=0.294)). Most participants were satisfied with being able to explain medical diagnosis, provide assessment results, and provide treatment recommendations during teleconsultation. Finally, 47.2% of participants were willing to continue conducting teleconsultations after the COVID-19 pandemic, with no significant differences among the three groups. Conclusion oncology physicians were satisfied with their experiences with teleconsultation and agreed that it is likely to be part of their long-term practice. Future studies are needed to assess patient satisfaction with teleconsultation and to improve patient care through this virtual technology.
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Affiliation(s)
- Bouchra Amaoui
- Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco
- Corresponding author: Bouchra Amaoui, Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco.
| | - Laila Lahlou
- Faculty of Medicine and Pharmacy, University Ibn Zohr, Agadir, Morocco
| | | | - Slimane Semghouli
- Higher Institute of Nursing Professions and Health Techniques, Agadir, Morocco
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Simão D, Sardinha M, Reis AF, Spencer AS, Luz R, Oliveira S. What Has Changed During the COVID-19 Pandemic? - The Effect on an Academic Breast Department in Portugal. Eur J Breast Health 2022; 18:74-78. [DOI: 10.4274/ejbh.galenos.2021.2021-11-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/11/2021] [Indexed: 12/01/2022]
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Welti M, Cheng PF, Mangana J, Levesque MP, Dummer R, Imhof L. Impact of Covid-19 on the management of patients with metastatic melanoma. Oncotarget 2022; 13:1370-1379. [PMID: 36580495 PMCID: PMC9799324 DOI: 10.18632/oncotarget.28333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The Covid-19 pandemic created new uncertainties in the management of metastatic melanoma patients. In particular, the impact of immunotherapy, targeted therapy, or chemotherapy on the risk of Sars-CoV-2 infection and severity was debated. In this study, we analyzed all patients with metastatic melanoma receiving therapy who developed Covid-19 between February 2020 and February 2022. We retrospectively collected demographic data, cancer-specific parameters, melanoma treatment regimen, comorbidities and Covid-19-specific parameters in these patients. Of the 350 patients with metastatic melanoma, 25 had Covid-19. The median age at the time of Covid-19 diagnosis was 66 years (range 36-86), 10 patients were female, and 15 patients were male. The treatment regimen during infection was immunotherapy in 12 cases, followed by targeted therapy (n = 8), chemotherapy (n = 2), and TVEC injections, follow-up and palliative therapy in 1 case each. The severity was mild in 17 patients and 8 had a moderate to critical course. Patients with a severe Covid-19 course were often older and had more comorbidities than patients with a mild infection. Many of the patients had a mild Covid-19 course despite having metastatic melanoma and systemic therapy. We therefore recommend continuing systemic therapy whenever possible, even in such exceptional situations as the Covid-19 pandemic.
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Affiliation(s)
- Michèle Welti
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland,Correspondence to:Michèle Welti, email:
| | - Phil F. Cheng
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland
| | - Joanna Mangana
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland
| | - Mitchell P. Levesque
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland
| | - Reinhard Dummer
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland
| | - Laurence Imhof
- 1Department of Dermatology, University Hospital Zurich (USZ), Zurich 8091, Switzerland,2Faculty of Medicine, University of Zurich (UZH), Zurich 8032, Switzerland,3Institute for Biomedical Engineering, ETH Zurich, Zurich 8092, Switzerland
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