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Telisnor G, Lim A, Zhang Z, Lou X, Nassour I, Salloum RG, Rogers SC. Analysis of pancreatic cancer treatment and survival disparities in Florida throughout the Covid-19 pandemic. J Natl Med Assoc 2024; 116:328-337. [PMID: 39107147 DOI: 10.1016/j.jnma.2024.07.004] [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: 08/08/2023] [Revised: 11/27/2023] [Accepted: 07/02/2024] [Indexed: 08/09/2024]
Abstract
INTRODUCTION Pancreatic ductal adenocarcinoma (PDAC) is currently the third-leading cause of cancer-related death in the United States. African Americans (AAs) with PDAC have worse survival in comparison to other racial groups. The COVID-19 pandemic caused significant stress to the healthcare system. We aim to evaluate the pandemic's impact on already known disparities in newly diagnosed patients with PDAC in Florida. METHODS This is a retrospective analysis of newly diagnosed patients with PDAC in the OneFlorida+ Data Trust based upon date of diagnosis: Pre-pandemic (01/01/2017- 09/30/2019), Transition (10/01/2019-02/28/2020), and Pandemic (03/1/2020-10/31/2020). Primary endpoints are time to treatment initiation and rate of surgery and secondary endpoint is survival time. Disparities due to age, sex, race, and income were also evaluated. Chi-squared or Fisher's exact test when necessary, Kruskal-Wallis test, and Kaplan-Meier analysis with log-rank test were performed to compare the differences between the comparative groups for categorical, quantitative, and survival outcomes, respectively. Multivariable regression analyses were conducted to estimate the effects of cofactors. RESULTS 934 patients with a median age of 67 years were included. There were 47.8% females and 52.2% males; 19.4% AA, 70.2% Caucasian, 10.4% Other race; median income was $53,551. While we observed a significant reduction in the diagnosis rate of new PDAC cases during the pandemic, there were no significant differences in demographic distributions among the three cohorts. Time to treatment did not significantly change from the pre-pandemic to the pandemic, and no difference was observed across all demographics. Rate of surgery increased significantly from the pre-pandemic (35.8%) to the pandemic (55.6%). AAs in the pre-pandemic cohort had a significantly lower rate of surgery of 25.0% compared to 41.7% in Caucasians. AAs, patients ≥ 67 years, and income < $53,000 had significantly higher hazards to death and shorter median survival time (mST). CONCLUSIONS While no differences in time to initial treatment are observed among the newly diagnosed PDAC patients, there remain significant disparities in the rate of surgery and overall survival. Observing a significant reduction in diagnosis rate and analyzing disparities can provide insight into the effect of a resource-restricting pandemic for patients with newly diagnosed PDAC.
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Affiliation(s)
- Guettchina Telisnor
- University of Florida, College of Pharmacy, Gainesville, Florida, United States
| | - Alexander Lim
- University of Florida, Department of Medicine, Division of Hematology and Oncology, Gainesville, Florida, United States
| | - Zhongyue Zhang
- Division of Quantitative Science, University of Florida Health Cancer Center, Gainesville, Florida, United States
| | - XiangYang Lou
- University of Florida, Department of Biostatistics, Gainesville, Florida, United States
| | - Ibrahim Nassour
- University of Florida, Department of Surgery, Division of Surgical Oncology, Gainesville, Florida, United States
| | - Ramzi G Salloum
- University of Florida, Department of Health Outcomes and Biomedical Informatics, Gainesville, Florida, United States
| | - Sherise C Rogers
- University of Florida, Department of Medicine, Division of Hematology and Oncology, Gainesville, Florida, United States.
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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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Kasuga N, Sekino Y, Takayanagi T, Ishii K, Nagase H, Kurita Y, Nakajima A. Maintaining early diagnosis of pancreatic adenocarcinoma in Japan: Local resilience against COVID-19. Pancreatology 2023; 23:607-614. [PMID: 37311668 PMCID: PMC10234687 DOI: 10.1016/j.pan.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/05/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS This study evaluated the impact of the coronavirus disease 2019 (COVID-19) pandemic on pancreatic adenocarcinoma (PA) practice in our region and discussed the effects of our institution's regional collaborative system, the "Early Stage Pancreatic Cancer Diagnosis Project," which was originally unrelated to this study's purpose. METHODS We retrospectively investigated 150 patients with PA at Yokohama Rosai Hospital by defining three time periods: before (C0), during the first year (C1), and during the second year (C2) of the COVID-19 pandemic. RESULTS Among the three periods (C0, C1, and C2), there were significantly less patients with stage I PA (14.0%, 0%, and 7.4%, p = 0.032) in C1, and significantly more patients with stage III PA (10.0%, 28.3%, and 9.3%, p = 0.014) in C1. The pandemic significantly prolonged the median durations from disease onset to patients' first visits (28, 49, and 14 days, p = 0.012). In contrast, there was no significant difference in the median durations from referral to first visit to our institution (4, 4, and 6 days, p = 0.391). CONCLUSIONS The pandemic advanced the stage of PA in our region. Although the pancreatic referral network remained functional during the pandemic, there were delays from disease onset to patients' first visit to healthcare providers, including clinics. While the pandemic caused temporary damage to PA practice, the routine regional collaboration provided by our institution's project allowed for early resilience. A notable limitation is that the impact of the pandemic on PA prognosis was not evaluated.
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Affiliation(s)
- Noriki Kasuga
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yusuke Sekino
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan.
| | - Takuya Takayanagi
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Ken Ishii
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yusuke Kurita
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Japan
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Colomer-Lahiguera S, Canella C, Giacomini S, Van KL, Pedrazzani C, Naegele M, Thouvenin L, O'Meara Stern A, Condorelli R, Corbière T, Witt CM, Eicher M, Ribi K. Patient-reported experiences of cancer care related to the COVID-19 pandemic in Switzerland. Support Care Cancer 2023; 31:410. [PMID: 37347278 DOI: 10.1007/s00520-023-07871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE This study aims to describe the experience of Swiss oncological patients during the COVID-19 pandemic. METHODS A national multi-center study including five hospitals covering the three main language regions of Switzerland was conducted between March and July 2021. Patients with melanoma, breast, lung, or colon cancer receiving active systemic anti-cancer treatment at the time of the COVID-19 pandemic were included. We conducted semi-structured telephone or onsite interviews alongside the administration of distress and resilience-validated questionnaires. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. RESULTS Sixty-two cancer patients with a mean age of 61 (SD=14) (58% female) were interviewed. Based on the interviews, we identified that the experience of having cancer during the COVID-19 pandemic was related to five dimensions: psychological, social, support, healthcare, and vaccination. Three themes transverse the five dimensions: (a) needs, (b) positive changes, and (c) phases of the pandemic. In general, patients did not experience delays or disruptions in their cancer treatment nor felt additionally burdened by the pandemic. Lockdown and isolation were reported as mixed experiences (positive and negative), and access to vaccination reassured patients against the risk of infection and instilled hope to return to normalcy. Additionally, we found low distress levels (M=2.9; SD=2.5) and high resilience scores (M=7; SD=1.3) in these patients. CONCLUSION Swiss patients with cancer did not express major needs or disruptions in their care during this period of the COVID-19 pandemic. Results identify the mixed experiences of patients and highlight the high resilience levels.
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Affiliation(s)
- Sara Colomer-Lahiguera
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland.
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Stellio Giacomini
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Kim Lê Van
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Carla Pedrazzani
- Department of Economics, Health and Social Sciences, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Matthias Naegele
- Cantonal Hospital St. Gallen, Department of Development and Quality Management in Nursing, Network Oncology, St. Gallen, Switzerland
- Comprehensive Cancer Center Zurich, University Hospital Zurich, Zürich, Switzerland
| | - Laure Thouvenin
- Department of Oncology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Alix O'Meara Stern
- Department of Medical Oncology, Réseau Hospitalier Neuchatelois, Neuchâtel, Switzerland
| | - Rosaria Condorelli
- Department of Medical Oncology, EOC - Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Tourane Corbière
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Manuela Eicher
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Karin Ribi
- Department Health, Kalaidos University of Applied Sciences, Zürich, Switzerland
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Correia de Sá T, Rocha M. The Pancreas in Coronavirus Disease 2019 Infection. Gastroenterol Clin North Am 2023; 52:37-48. [PMID: 36813429 PMCID: PMC9744682 DOI: 10.1016/j.gtc.2022.12.002] [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] [Indexed: 12/15/2022]
Abstract
An association between acute pancreatitis (AP) and coronavirus disease 2019 (COVID-19) has been proposed but the mechanisms of pancreatic injury of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the implicative role on the development of AP are not yet fully understood. COVID-19 also imposed major challenges on pancreatic cancer management. We conducted an analysis on the mechanisms of pancreatic injury by SARS-CoV-2 and reviewed published case reports of AP attributed to COVID-19. We also examined the pandemic effect on pancreatic cancer diagnosis and management, including pancreatic surgery.
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Affiliation(s)
- Tiago Correia de Sá
- General Surgery Department, Centro Hospitalar do Tâmega e Sousa, Avenida do Hospital Padre Américo 210, 4564-007 Penafiel, Portugal.
| | - Mónica Rocha
- Hepato-Pancreato-Biliary Unit, General Surgery Department, Centro Hospitalar do Tâmega e Sousa, Avenida do Hospital Padre Américo 210, 4564-007 Penafiel, Portugal
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Parray AM, Chaudhari VA, Bhandare MS, Madhabananda K, Muduly DK, Sudhindran S, Mathews J, Pradeep R, Thammineedi SR, Amal K, Chaudhary D, Jitender R, Pandey D, Amar P, Penumadu P, Kalayarasan R, Elamurugan TP, Kantharia C, Pujari S, Ramesh H, Somashekhar SP, Fernandes A, Sexena R, Singh RK, Lattoo MR, Shah OJ, Jeswanth S, Roy M, Thambudorai R, Shrikhande SV. Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey. Langenbecks Arch Surg 2022; 407:3735-3745. [PMID: 36098808 PMCID: PMC9469820 DOI: 10.1007/s00423-022-02675-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
Purpose To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. Methods A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. Results There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. Conclusion
Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s00423-022-02675-6.
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Affiliation(s)
- Amir M Parray
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | | | | | - K Madhabananda
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Dilip K Muduly
- All India Institute of Medical Sciences, Bhubaneshwar, India
| | - S Sudhindran
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - Johns Mathews
- Amrita Institute of Medical Sciences and Research Institute, Kochi, India
| | - R Pradeep
- Asian Institute of Gastroenterology, Hyderabad, India
| | | | - K Amal
- Dr B Borooah Cancer Institute, Gauhati, India
| | | | - R Jitender
- Homi Bhabha Cancer Hospital (TMC), Sangrur, India
| | - Durgatosh Pandey
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - P Amar
- Mahamana Pandit Madan Mohan Malaviya Cancer Centre & Homi Bhabha Cancer Hospital (TMC), Varanasi, India
| | - Prasanth Penumadu
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Raja Kalayarasan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - T P Elamurugan
- Jawahar Lal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - H Ramesh
- Lakeshore Hospital and Research Centre, Kochi, India
| | | | | | - Rajan Sexena
- Sanjay Gandhi PGI of Medical Sciences, Lucknow, India
| | | | - Mohd R Lattoo
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Omar J Shah
- Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | | | | | - Shailesh V Shrikhande
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India. .,Department of Gastrointestinal and Hepato-Pancreato-Biliary, Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, Maharashtra, 400012, India.
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7
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Ilic I, Ilic M. International patterns in incidence and mortality trends of pancreatic cancer in the last three decades: A joinpoint regression analysis. World J Gastroenterol 2022; 28:4698-4715. [PMID: 36157927 PMCID: PMC9476884 DOI: 10.3748/wjg.v28.i32.4698] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/05/2022] [Accepted: 06/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic cancer, as the one of most fatal malignancies, remains a critical issue in the global burden of disease.
AIM To estimate trends in pancreatic cancer incidence and mortality worldwide in the last three decades.
METHODS A descriptive epidemiological study was done. Pancreatic cancer incidence and mortality data were obtained from the database of the World Health Organization. Analysis of pancreatic cancer incidence and mortality during 2020 was performed. The age-standardized rates (ASRs, expressed per 100000) were presented. To estimate trends of incidence and mortality of pancreatic cancer, joinpoint regression analysis was used: the average annual percent change (AAPC) with the corresponding 95% confidence interval (95%CI) was calculated. Additionally, analysis was performed by sex and age. In this paper, the trend analysis included only countries with high and medium data quality.
RESULTS A total of 495773 (262865 male and 232908 female) new cases and 466003 (246840 male and 219163 female) deaths from pancreatic cancer were reported worldwide in 2020. In both sexes, most of the new cases (191348; 38.6% of the total) and deaths (182074; 39.1% of the total) occurred in the Western Pacific Region. In both sexes, the highest ASRs were found in the European Region, while the lowest rates were reported in the South-East Asia Region. The general pattern of rising pancreatic cancer incidence and mortality was seen across countries worldwide in observed period. Out of all countries with an increase in pancreatic cancer incidence, females in France and India showed the most marked rise in incidence rates (AAPC = +3.9% and AAPC = +3.7%, respectively). Decreasing incidence trends for pancreatic cancer were observed in some countries, but without significance. Out of all countries with an increase in pancreatic cancer mortality rates, Turkmenistan showed the most marked rise both in males (AAPC = +10.0%, 95%CI: 7.4–12.5) and females (AAPC = +6.4%, 95%CI: 3.5–9.5). The mortality trends of pancreatic cancer were decreasing in both sexes only in Canada and Mexico.
CONCLUSION Further research is needed to explain the cause of large international differences in incidence and mortality trends of pancreatic cancer in last three decades.
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Affiliation(s)
- Irena Ilic
- Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
| | - Milena Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
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Sinagra E, Shahini E, Crispino F, Macaione I, Guarnotta V, Marasà M, Testai S, Pallio S, Albano D, Facciorusso A, Maida M. COVID-19 and the Pancreas: A Narrative Review. Life (Basel) 2022; 12:life12091292. [PMID: 36143329 PMCID: PMC9504204 DOI: 10.3390/life12091292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
The outbreak of COVID-19, initially developed in China in early December 2019, has rapidly spread to other countries and represents a public health emergency of international concern. COVID-19 has caused great concern about respiratory symptoms, but it is worth noting that it can also affect the gastrointestinal tract. However, the data on pancreatic involvement during SARS-CoV-2 infection are limited. The prevalence and severity of pancreatic damage and acute pancreatitis, as well as its pathophysiology, are still under debate. Moreover, the possible implication of pancreatic damage as an apparent adverse effect of COVID-19 therapies or vaccines are issues that need to be addressed. Finally, the COVID-19 pandemic has generated delays and organizational consequences for pancreatic surgery, an element that represent indirect damage from COVID-19. This narrative review aims to summarize and analyze all the aspects of pancreatic involvement in COVID-19 patients, trying to establish the possible underlying mechanisms and scientific evidence supporting the association between COVID-19 and pancreatic disease.
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Affiliation(s)
- Emanuele Sinagra
- Gastroenterology and Endoscopy Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
- Correspondence: ; Tel.: +39-921920712; Fax: +39-921920406
| | - Endrit Shahini
- Division of Gastroenterology, National Institute of Research “Saverio De Bellis”, Via Turi, 27, Castellana Grotte, 70013 Bari, Italy
| | - Federica Crispino
- Department of Health Promotion Sciences Maternal and Infant Care, Section of Gastroenterology & Hepatology, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90133 Palermo, Italy
| | - Ina Macaione
- Surgery Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Valentina Guarnotta
- Section of Endocrinology, Department of Health Promotion Sciences, Maternal-Infant Care, Internal Medicine and Specialties of Excellence “G.D’Alessandro” (PROMISE), University Hospital P. Giaccone, University of Palermo, Piazza Delle Cliniche 2, 90133 Palermo, Italy
| | - Marta Marasà
- Radiology Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Sergio Testai
- Radiology Unit, Fondazione Istituto G. Giglio, Contrada Pietra Pollastra Pisciotto, 90015 Cefalù, Italy
| | - Socrate Pallio
- Endoscopy Unit, Department of Clinical and Experimental Medicine, University of Messina, AOUP Policlinico G. Martino, 98122 Messina, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Antonio Facciorusso
- Gastroenterology Unit, Department of Medical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Marcello Maida
- Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, 93100 Caltanissetta, Italy
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Abramczyk U, Nowaczyński M, Słomczyński A, Wojnicz P, Zatyka P, Kuzan A. Consequences of COVID-19 for the Pancreas. Int J Mol Sci 2022; 23:864. [PMID: 35055050 PMCID: PMC8776154 DOI: 10.3390/ijms23020864] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Although coronavirus disease 2019 (COVID-19)-related major health consequences involve the lungs, a growing body of evidence indicates that COVID-19 is not inert to the pancreas either. This review presents a summary of the molecular mechanisms involved in the development of pancreatic dysfunction during the course of COVID-19, the comparison of the effects of non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pancreatic function, and a summary of how drugs used in COVID-19 treatment may affect this organ. It appears that diabetes is not only a condition that predisposes a patient to suffer from more severe COVID-19, but it may also develop as a consequence of infection with this virus. Some SARS-CoV-2 inpatients experience acute pancreatitis due to direct infection of the tissue with the virus or due to systemic multiple organ dysfunction syndrome (MODS) accompanied by elevated levels of amylase and lipase. There are also reports that reveal a relationship between the development and treatment of pancreatic cancer and SARS-CoV-2 infection. It has been postulated that evaluation of pancreatic function should be increased in post-COVID-19 patients, both adults and children.
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Affiliation(s)
- Urszula Abramczyk
- Department of Medical Biochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Maciej Nowaczyński
- Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.N.); (A.S.); (P.W.); (P.Z.)
| | - Adam Słomczyński
- Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.N.); (A.S.); (P.W.); (P.Z.)
| | - Piotr Wojnicz
- Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.N.); (A.S.); (P.W.); (P.Z.)
| | - Piotr Zatyka
- Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.N.); (A.S.); (P.W.); (P.Z.)
| | - Aleksandra Kuzan
- Department of Medical Biochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland;
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Marchegiani G, Perri G, Bianchi B, Esposito A, Landoni L, Casetti L, Tuveri M, Malleo G, Paiella S, Fontana M, Pea A, De Pastena M, Salvia R, Bassi C. Pancreatic surgery during COVID-19 pandemic: major activity disruption of a third-level referral center during 2020. Updates Surg 2021; 74:953-961. [PMID: 34689316 PMCID: PMC8541802 DOI: 10.1007/s13304-021-01197-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/18/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has severely limited the access to cancer surgery, but it is not known to what extent referral centers for pancreatic diseases were affected by its outbreak. The aim of this study is to describe the effect of COVID-19 pandemic on a third-level referral center for pancreatic surgery in Italy. METHODS The 2020 activity of The Pancreas Institute of the University of Verona was reviewed, comparing different phases of the COVID-19 pandemic outbreaks using the pre-COVID era as a control. Endpoints were the overall caseload of pancreatic resections, surgical waiting list, administration of preoperative therapy, major morbidity and mortality, residents' training; number of inpatients beds, outpatient visits/procedures/diagnostics. RESULTS In 2020, there was an overall significant reduction of pancreatic resections performed (394 vs. 506 in 2019), particularly during the first (March-May) and second (October-December) COVID-19 outbreaks, with an all-time-low of 16 resections/months in April (compared to 43 average resection/month in 2019). The rates of major morbidity (Clavien-Dindo ≥ 3) and mortality were similar to 2019 (16 vs 12%, p = 0.11 and 3 vs 2%, p = 0.29, respectively). During the first and second outbreaks resident's training, inpatient beds, outpatient visits, diagnostics, and procedures were severely impaired, while the waiting list for up-front cancer resections and the use of preoperative chemotherapy concomitantly raised. CONCLUSION The COVID-19 pandemic has severely disrupted the activity of a third-level referral center for pancreatic surgery, affecting the access to cancer surgical procedures and raising concerns regarding the solidity of the current centralization model.
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Affiliation(s)
- Giovanni Marchegiani
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy.
| | - Giampaolo Perri
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Beatrice Bianchi
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Alessandro Esposito
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Luca Landoni
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Luca Casetti
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Massimiliano Tuveri
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Giuseppe Malleo
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Salvatore Paiella
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Martina Fontana
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Antonio Pea
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Matteo De Pastena
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Roberto Salvia
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
| | - Claudio Bassi
- Department of General and Pancreatic Surgery-The Pancreas Institute, Verona University Hospital Trust, Piazzale Scuro 10, 37134, Verona, Italy
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