1
|
Solaini L, Bencivenga M, Rosa F, D’ignazio A, Marino E, Ministrini S, Sofia S, Sacco M, Mura G, Rausa E, Prizio MD, Graziosi L, Degiuli M, Tiberio GAM, Alfieri S, Marrelli D, Morgagni P, Ercolani G. Consequences of the COVID-19 pandemic on the diagnosis and treatment of gastric cancer in referral centers in Italy. TUMORI JOURNAL 2023; 109:121-128. [PMID: 35152794 PMCID: PMC9895277 DOI: 10.1177/03008916211072586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The coronavirus pandemic had a major impact in Italy. The Italian health system's re-organization to face the emergency may have led to significant consequences especially in the diagnosis and treatment of malignancies. This study aimed to assess the impact of the pandemic in the diagnosis and treatment of gastric cancer in nine Gruppo Italiano RIcerca Cancro Gastrico (GIRCG) centers. METHODS All patients assessed for gastric adenocarcinoma at nine GIRCG centers between January 2019 and November 2020 were included. Patients were grouped according to the date of "patient 1's" diagnosis in Italy: preCOVID versus COVID. Clinico-pathological and outcome differences between the two groups were analyzed. RESULTS A total of 632 patients were included in the analysis (205 in the COVID group). The cT4 weighted ratios were higher in 2020 from April to September, with the greatest differences in May, August and September. The cM+ weighted ratio was significantly higher in July 2020. The mean number of gastrectomies had the greatest reduction in March and May 2020 compared with 2019. The median times from diagnosis to chemotherapy, to complete diagnostic work-up or to operation were longer in 2019. The median time from the end of chemotherapy to surgery was 17 days longer in the preCOVID group. CONCLUSIONS A greater number of advanced or metastatic cases were diagnosed after the spread of SARS-CoV-2 infection, especially after the "full lockdown" periods. During the pandemic, once gastric cancer patients were referred to one of the centers, a shorter time to complete the diagnostic work-up or to address them to the best treatment option was required.
Collapse
Affiliation(s)
- Leonardo Solaini
- Department of Medical and Surgical
Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy,Department of Surgery,
Morgagni-Pierantoni Hospital, Forlì, Italy,Leonardo Solaini, Department of Medical and
Surgical Sciences, University of Bologna, Via Carlo Forlanini 34,
Morgagni-Pierantoni Hospital, Forlì, 47121, Italy.
| | - Maria Bencivenga
- General and Upper GI Surgery Division,
University of Verona, Verona, Italy
| | - Fausto Rosa
- Digestive Surgery, Fondazione
Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore,
Rome, Italy
| | - Alessia D’ignazio
- Department of Surgery, Policlinico le
Scotte- University of Siena, Siena, Italy
| | - Elisabetta Marino
- Department of Surgery, Santa Maria
della Misericordia Hospital, University of Perugia, Perugia, Italy
| | | | - Silvia Sofia
- Surgical Oncology and Digestive
Surgery, Department of Oncology, University of Turin, San Luigi University Hospital,
Orbassano, Turin, Italy
| | - Michele Sacco
- General and Upper GI Surgery Division,
University of Verona, Verona, Italy
| | - Gianni Mura
- Department of Surgery, Azienda USl
Toscana SudEst- Arezzo, Arezzo, Italy
| | - Emanuele Rausa
- General Surgery 1, ASST Papa Giovanni
XXIII, Bergamo, Italy
| | - Marco De Prizio
- Department of Surgery, Azienda USl
Toscana SudEst- Arezzo, Arezzo, Italy
| | - Luigina Graziosi
- Department of Surgery, Santa Maria
della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Maurizio Degiuli
- Surgical Oncology and Digestive
Surgery, Department of Oncology, University of Turin, San Luigi University Hospital,
Orbassano, Turin, Italy
| | | | - Sergio Alfieri
- Digestive Surgery, Fondazione
Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore,
Rome, Italy
| | - Daniele Marrelli
- Department of Surgery, Policlinico le
Scotte- University of Siena, Siena, Italy
| | - Paolo Morgagni
- Department of Surgery,
Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Giorgio Ercolani
- Department of Medical and Surgical
Sciences, University of Bologna, Morgagni-Pierantoni Hospital, Forlì, Italy,Department of Surgery,
Morgagni-Pierantoni Hospital, Forlì, Italy
| |
Collapse
|
2
|
[Impact of COVID-19 on oncological surgery of the upper gastrointestinal tract]. Chirurg 2021; 92:929-935. [PMID: 34448904 PMCID: PMC8391856 DOI: 10.1007/s00104-021-01489-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND The outbreak of the coronavirus disease 2019 (COVID-19) pandemic imposed limitations for elective surgery, impacting the associated hospital standards worldwide. As certain treatment windows must be adhered to in oncological surgery, the limited intensive care unit (ICU) capacity had to be critically distributed in order to do justice to both acutely ill and oncology patients. This manuscript summarizes the impact of COVID-19 on the management of oncological surgery of the upper gastrointestinal tract and particularly esophageal surgery in German medical centers. MATERIAL AND METHODS A survey of German centers for esophageal surgery was performed on the impact of COVID-19 on operative management for esophageal surgery during the first lockdown. After inspection, assessment, critical analysis and interpretation, the results were compared to the international literature. RESULTS AND DISCUSSION Initial recommendations of international societies warned for caution and restraint regarding interventions of the upper gastrointestinal tract that were not absolutely necessary. Oncological surgery should be performed under strict restrictions, especially only after negative testing for COVID-19 and only with sufficiently available personal protective equipment for the personnel. Furthermore, minimally invasive procedures were preferably not recommended. In diseases with alternative treatment options, such as definitive chemoradiotherapy of esophageal squamous cell carcinoma, these should be given priority when possible. In the further development of the pandemic, it was shown that due to a high standardization of preoperative management, postoperative results comparable to pre-pandemic times could be achieved particularly with respect to the diagnostics of infections.
Collapse
|
3
|
Mehtsun W, Tanabe K. Don't Let a Crisis Go to Waste. Ann Surg Oncol 2021; 28:4759-4761. [PMID: 34132949 PMCID: PMC8207811 DOI: 10.1245/s10434-021-10166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Winta Mehtsun
- Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Kenneth Tanabe
- Division of Gastrointestinal and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
| |
Collapse
|
4
|
Alkhaffaf B, Alasmar M. Major Complex and Minimally Invasive Cancer Surgery Can Be Delivered Safely During the COVID-19 Pandemic. Ann Surg Oncol 2021; 28:4827-4828. [PMID: 33796998 PMCID: PMC8015926 DOI: 10.1245/s10434-021-09888-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Bilal Alkhaffaf
- Department of Oesophago-Gastric Surgery, Salford Royal Foundation Trust, Salford Royal Hospital, Manchester, UK. .,Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| | - Mohamed Alasmar
- Department of Oesophago-Gastric Surgery, Salford Royal Foundation Trust, Salford Royal Hospital, Manchester, UK.,Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|