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Calapkulu M, Sencar ME, Ozturk Unsal I, Sakiz D, Tekinyildiz M, Ozbek M, Cakal E. The effect of COVID-19 pandemic restrictions on the management of differentiated thyroid cancer in Turkey: a single tertiary centre experience. Eur Arch Otorhinolaryngol 2024; 281:2587-2595. [PMID: 38347198 DOI: 10.1007/s00405-024-08496-1] [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: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 04/18/2024]
Abstract
PURPOSE Many countries have implemented unprecedented health measures since the World Health Organisation declared the novel coronavirus disease 2019 (COVID-19) a global pandemic. These measures have resulted in delays in the diagnosis of differentiated thyroid cancer (DTC). However, there is limited data on the impact of restrictions imposed during the pandemic on DTC management. Thus, the aim of this study is to analyse the clinicopathological and follow-up data of DTC patients diagnosed before and during the COVID-19 outbreak. METHODS This retrospective study included 191 DTC patients that were diagnosed between December 2018 and June 2021. The patients were divided into two groups: patients diagnosed before (December 2018 to February 2020) and during (March 2020 to June 2021) the COVID-19 pandemic. The clinicopathological and follow-up data between the two groups were compared. RESULTS Similar preoperative cytology results were obtained from the two groups. No difference with regard to tumour size, lymphovascular invasion and extrathyroidal invasion was observed between the two groups. While the American Thyroid Association risk stratification was similar between the two groups, radioactive iodine (RAI) therapy was applied less during the COVID-19 period. Although RAI therapy was administered at a lower rate during the COVID-19 period, the recurrence rates among patients after two years of follow-up were similar to those during the pre-COVID-19 period. CONCLUSION Although the COVID-19 pandemic restrictions during the pandemic period caused difficulties in the management of DTC patients, this did not negatively affect their prognosis. These findings can confirm the applicability of active surveillance in DTC patients and may help change the real-life treatment practices in selected low-risk DTC patients.
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Affiliation(s)
- Murat Calapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey.
| | - Muhammed Erkam Sencar
- Department of Endocrinology and Metabolism, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey
| | - Ilknur Ozturk Unsal
- Department of Endocrinology and Metabolism, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey
| | - Davut Sakiz
- Department of Endocrinology and Metabolism, Mardin Training and Research Hospital, Mardin, Turkey
| | - Merve Tekinyildiz
- Department of Internal Medicine, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Mustafa Ozbek
- Department of Endocrinology and Metabolism, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey
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Feier CVI, Muntean C, Faur AM, Vonica RC, Blidari AR, Murariu MS, Olariu S. An Exploratory Assessment of Pre-Treatment Inflammatory Profiles in Gastric Cancer Patients. Diseases 2024; 12:78. [PMID: 38667536 PMCID: PMC11048996 DOI: 10.3390/diseases12040078] [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: 03/19/2024] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
Gastric cancer ranks as the fifth most common cancer, and the assessment of inflammatory biomarkers in these patients holds significant promise in predicting prognosis. Therefore, data from patients undergoing surgical intervention for gastric cancer over a 7-year period were analyzed. This study was retrospective and involved a preoperative investigation of six inflammatory parameters derived from complete blood counts. Statistical analysis revealed a significant increase in the leucocyte-to-monocyte ratio (LMR) (p = 0.048), along with a significant decrease in the number of lymphocytes and monocytes compared to patients with successful discharge. Taking into consideration patients undergoing emergency surgery, a significant increase in the LMR (p = 0.009), neutrophil-to-lymphocyte ratio (NLR) (p = 0.004), Aggregate Index of Systemic Inflammation (AISI) (p = 0.01), and Systemic Immune-Inflammation Index (SII) (p = 0.028) was observed. Regarding relapse, these patients exhibited significant increases in AISI (p = 0.032) and SII (p = 0.047). Inflammatory biomarkers represent a valuable tool in evaluating and predicting the prognosis of patients with gastric cancer.
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Affiliation(s)
- Catalin Vladut Ionut Feier
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (M.-S.M.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Calin Muntean
- Medical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Alaviana Monique Faur
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Razvan Constantin Vonica
- Preclinical Department, Discipline of Physiology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania;
| | - Andiana Roxana Blidari
- Oncology, Department IX-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Marius-Sorin Murariu
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (M.-S.M.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Sorin Olariu
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania; (C.V.I.F.); (M.-S.M.); (S.O.)
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
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Fujita M, Yamaguchi K, Nagashima K, Suzuki K, Kasai T, Hashimoto H, Onouchi Y, Sato D, Fujisawa T, Hata A. Impact of the COVID-19 pandemic on gastric surgery in Japan: A nationwide study using interrupted time-series analyses. J Gastroenterol Hepatol 2024. [PMID: 38454806 DOI: 10.1111/jgh.16533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND AIM Changes in the number of surgeries for gastric cancer during the coronavirus disease 2019 (COVID-19) pandemic have been reported, but data are insufficient to understand the impact at the national level. This study aimed to determine the impact of the COVID-19 pandemic on gastric surgery in Japan. METHODS Insurance claims data registered from January 2015 to January 2021 were used. Changes in the number of endoscopic resections and gastrectomies for gastric cancer were estimated using an interrupted time-series analysis. RESULTS The number of endoscopic resections significantly decreased in July 2020 (-1565; 95% confidence interval [CI]: -2022, -1108) and January 2021 (-539; 95% CI: -970, -109), and the number of laparoscopic surgeries significantly decreased in July 2020 (-795; 95% CI: -1097, -492), October 2020 (-313; 95% CI: -606, -19), and January 2021 (-507; 95% CI: -935, -78). Meanwhile, the number of open gastrectomies remained unchanged, and the number of robot-assisted gastrectomies steadily increased since their coverage by public health insurance in April 2018. CONCLUSIONS The decreased number of endoscopic resections and laparoscopic surgeries in Japan suggests a decline in early-stage gastric cancer diagnosis, likely due to the suspension of gastric cancer screening and diagnostic testing during the pandemic. Meanwhile, the number of open and robot-assisted gastrectomies remained unchanged and increased, respectively, indicating that these applications were not affected by the pandemic-related medical crisis. These findings highlight that procedures for cancer diagnosis, including screening, should still be provided during pandemics.
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Affiliation(s)
- Misuzu Fujita
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazuya Yamaguchi
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Kiminori Suzuki
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Tokuzo Kasai
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Hideyuki Hashimoto
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Yoshihiro Onouchi
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Daisuke Sato
- Hospital and Health Administration, Fujita Health University Graduate School of Medicine, Toyoake, Japan
| | - Takehiko Fujisawa
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
| | - Akira Hata
- Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, Chiba, Japan
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Hamilton J, McCarroll K, Kisiel LM, Jagger K, Boulet L. A survey of Canadian specialist anesthesiologists and family practice anesthetists: rural operating room use, a mixed model of care, and mentoring. Can J Anaesth 2024:10.1007/s12630-024-02708-2. [PMID: 38413517 DOI: 10.1007/s12630-024-02708-2] [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: 06/12/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 02/29/2024] Open
Abstract
PURPOSE The aim of this project was to collect data on the delivery of anesthesia in Canada. Specifically, our goal was to increase knowledge by identifying provider demographics and different models of anesthesia delivery, and to explore relationships among specialist anesthesiologists (SAs) and family practice anesthetists (FPAs) with a focus on mentoring. METHODS An online questionnaire was circulated to SAs and FPAs holding membership with the Canadian Anesthesiologists' Society or the Society of Rural Physicians of Canada. A total of 274/2,578 individuals completed the survey (170 SAs and 104 FPAs), providing a response rate of 10.6%. The survey included questions about demographics, anesthesia training, anesthesia resources, models of care, and mentoring relationships. RESULTS Three major themes emerged from the data: 1) FPAs and rural operating rooms are underused resources as 65% (64/98) of FPAs reported having capacity to increase their individual volume of anesthesia services and 41% (40/98) thought capacity existed within their hospital to increase the volume of surgery; 2) 20 hospitals employed a mixed model of anesthesia care whereby SAs and FPAs worked collectively within the same site; providers working within this model reported high levels of satisfaction and independence; 3) most SAs and FPAs perceived a benefit to mentoring and were interested in participating in a mentoring program. CONCLUSION This survey shows perceived capacity to expand surgical services in rural areas, a precedent for a mixed SA-FPA model of anesthesia delivery at the same site, and desire for anesthesia providers to engage in mentoring. Such options should be considered to strengthen the physician-led anesthesiology profession in Canada.
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Affiliation(s)
- Jordan Hamilton
- Shuswap Lake General Hospital, 601 10th Street NE, Salmon Arm, BC, V1E 4A7, Canada.
| | | | - Luz Maria Kisiel
- Department of Physician Quality Improvement and Department of Medical Imaging, Interior Health Authority, Kelowna, BC, Canada
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Barker CS, Chung CW, Mukherjee R, Siegel JB, Cole DJ, Lockett MA, Klauber-DeMore N, Abbott AM. The impact of nurse navigation on timeliness to treatment for benign high-risk breast pathology. Breast Cancer Res Treat 2023; 202:129-137. [PMID: 37584883 DOI: 10.1007/s10549-023-07049-0] [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: 10/04/2022] [Accepted: 07/13/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE High-risk breast pathology is a breast cancer risk factor for which timely treatment is crucial. Nurse navigation programs have been implemented to minimize delays in patient care. This study evaluated nurse navigation in terms of timeliness to surgery for patients with high-risk breast pathology. METHODS This was a single-institution, retrospective review of patients with identified high-risk breast pathology undergoing lumpectomy between January 2017 and June 2019. Patients were stratified into cohorts based on periods with and without nurse navigation. Preoperative and postoperative time to care as well as demographic and tumor characteristics were compared using univariate and multivariate analysis. RESULTS 100 patients had assigned nurse navigators and 29 patients did not. Nurse navigation was associated with reduced time from referral to date of surgery (DOS) by 16.9 days (p = 0.003). Patients > 75 years had a shorter time to first appointment (p = 0.03), and patients with Medicare insurance had a reduced time from referral to DOS (p = 0.005). 20% of all patients were upstaged to cancer on final surgical pathology. CONCLUSION Nurse navigation was significantly associated with decreased time to care for patients with high-risk breast pathology undergoing lumpectomy. We recommend nurse navigation programs as part of a comprehensive approach for patients with high-risk breast pathology.
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Affiliation(s)
- Catherine S Barker
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Catherine W Chung
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Rupak Mukherjee
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Julie B Siegel
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
| | - David J Cole
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Mark A Lockett
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Nancy Klauber-DeMore
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Andrea M Abbott
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
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Manzella A, Eskander MF, Grandhi MS, In H, Langan RC, Kennedy T, August D, Alexander HR, Beninato T, Pitt HA. COVID-19 Effect on Surgery for Gastrointestinal Malignancies: Have Operative Volumes Recovered? J Gastrointest Surg 2023; 27:2538-2546. [PMID: 37749458 DOI: 10.1007/s11605-023-05838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND COVID-19 disrupted elective operations, cancer screening, and routine medical care while simultaneously overwhelming hospital staff and supplies. Operations for gastrointestinal (GI) malignancies rely on endoscopic screening, staging, and neoadjuvant therapy (NAT), each of which was disrupted by the pandemic. The aim was to evaluate the effect of the COVID-19 pandemic on the US national rates of gastrointestinal oncologic operations. METHODS The Vizient Clinical Data Base® was queried for oncologic operations for esophageal, gastric, and colorectal malignancies with and without NAT from March 2019 to March 2022. Control chart analysis examined operative volume over time while Wilcoxon rank sum tests were used to compare mean monthly volume before and during the pandemic. RESULTS A total of 95,912 patients were identified over 36 months; 5.8% esophageal, 6.3% gastric, 77.5% colonic, and 10.4% rectal operations. Esophageal operative volume decreased for 9 months during the pandemic and was significantly lower during than before the pandemic (p=0.002). Gastric operations decreased for 10 months early in the pandemic, but rebounded so that after 2 years volumes were unchanged (p=0.49). Colonic operations experienced a sharp decrease for 4 months at the beginning of the pandemic, but volumes quickly increased and overall were unchanged (p=0.29). Rectal operations decreased for 13 months and were significantly lower during than before the pandemic (p=0.018). Oncologic operations for patients receiving NAT varied. CONCLUSION COVID-19 significantly disrupted the volume of gastrointestinal oncologic operations in the USA. Esophageal and rectal oncologic operations experienced prolonged and significant reductions while gastric and colonic oncologic operations transiently decreased but rebounded during the pandemic.
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Affiliation(s)
- Alexander Manzella
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Mariam F Eskander
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Miral S Grandhi
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Haejin In
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Russell C Langan
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Timothy Kennedy
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - David August
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - H Richard Alexander
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Toni Beninato
- Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA
| | - Henry A Pitt
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, ET834, New Brunswick, NJ, 08901, USA.
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Popa O, Barna RA, Borlea A, Cornianu M, Dema A, Stoian D. The impact of the COVID-19 pandemic on thyroid nodular disease: a retrospective study in a single center in the western part of Romania. Front Endocrinol (Lausanne) 2023; 14:1221795. [PMID: 37497351 PMCID: PMC10368367 DOI: 10.3389/fendo.2023.1221795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/23/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The COVID-19 pandemic had a significant impact on the healthcare system, leading to a prioritization of hospital admissions in many countries. Romania was no exception, and it had to restrict patient access to medical services in hospitals with chronic diseases and oncological pathology, including thyroid cancer. This study aimed to compare the clinical and pathological factors of patients with nodular thyroid disease diagnosed and surgically treated during the two years before and after the COVID-19 pandemic, in a single medical institution. Methods The retrospective study included 1505 patients who were diagnosed and operated on for nodular thyroid disease between January 2018 and December 2021. The patients were divided into two groups: the "PRECOVID" group (January 2018 to February 2020), and the "POSTCOVID" group (March 2020 to December 2021). The analyzed parameters included patients' gender, age, preoperative diagnosis, type of surgical intervention, and pathological diagnosis. Results A significant decrease was observed in the number of surgeries performed for thyroid nodular disease during the COVID-19 pandemic period (450 versus 1055 cases, p<0.00001). There was a significant decrease in the number of surgical reinterventions (0.9% in the POSTCOVID group versus 2.9% in the PRECOVID group, p=0.01) and a significant increase in the number of total thyroidectomies (84.9% in the POSTCOVID group versus 80.1% in the PRECOVID group, p=0.02). We also observed a higher incidence of malignant/borderline tumors in the POSTCOVID group compared to the PRECOVID group (p=0.04) and a significantly higher frequency of aggressive forms of thyroid cancer in the POSTCOVID group (p=0.0006). Discussion The COVID-19 pandemic had a significant impact on the surgical management of nodular thyroid disease, resulting in a decrease in surgeries and a change in the type of surgical interventions performed. The higher incidence of malignant/borderline tumors diagnosed during the pandemic highlights the importance of timely diagnosis and treatment of thyroid nodules to prevent cancer progression.
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Affiliation(s)
- Oana Popa
- Endocrinology Department, Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Robert Alexandru Barna
- Discipline of Morphopathology, Department of Microscopic Morphology, ANAPATMOL Research Centre, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Andreea Borlea
- Endocrinology Department, Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Marioara Cornianu
- Discipline of Morphopathology, Department of Microscopic Morphology, ANAPATMOL Research Centre, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Alis Dema
- Discipline of Morphopathology, Department of Microscopic Morphology, ANAPATMOL Research Centre, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Dana Stoian
- Endocrinology Department, Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
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Grani G, Ciotti L, Del Gatto V, Montesano T, Biffoni M, Giacomelli L, Sponziello M, Pecce V, Lucia P, Verrienti A, Filetti S, Durante C. The COVID-19 outbreak and de-escalation of thyroid cancer diagnosis and treatment. Endocrine 2022; 78:387-391. [PMID: 35802229 PMCID: PMC9264748 DOI: 10.1007/s12020-022-03131-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/27/2022] [Indexed: 12/28/2022]
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
| | - Piernatale Lucia
- 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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Impact of COVID-19 Pandemic on Thyroid Surgery in a University Hospital in South Korea. Cancers (Basel) 2022; 14:cancers14174338. [PMID: 36077872 PMCID: PMC9454546 DOI: 10.3390/cancers14174338] [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] [Received: 07/18/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has changed healthcare systems around the world. Medical personnel concentrated on infectious disease management and treatments for non-emergency diseases and scheduled surgeries were delayed. We aimed to investigate the change in the severity of thyroid cancer before and after the outbreak of COVID-19 in Korea. We collected three years of data (2019, 2020, and 2021) on patients who received thyroid surgery in a university hospital in South Korea and grouped them as "Before COVID-19", "After COVID-19 1-year" and "After COVID-19 2-years". The total number of annual outpatients declined significantly after the outbreak of COVID-19 in both new (1303, 939, and 1098 patients) and follow-up patients (5584, 4609, and 4739 patients). Clinical characteristics, including age, sex, BMI, preoperative cytology results, surgical extent, and final pathologic diagnosis, were not significantly changed after the outbreak of COVID-19. However, the number of days from the first visit to surgery was significantly increased (38.3 ± 32.2, 58.3 ± 105.2, 47.8 ± 124.7 days, p = 0.027). Papillary thyroid carcinoma (PTC) patients showed increased proportions of extrathyroidal extension, lymphatic invasion, vascular invasion, and cervical lymph node metastasis. Increased tumor size was observed in patients with follicular tumor (3.5 ± 2.2, 4.0 ± 1.9, 4.3 ± 2.3 cm, p = 0.019). After the COVID-19 outbreak, poor prognostic factors for thyroid cancer increased, and an increase in the size of follicular tumors was observed. Due to our study being confined to a single tertiary institution in Incheon city, Korea, nationwide studies that include primary clinics should be required to identify the actual impact of COVID-19 on thyroid disease treatment.
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10
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Frio GS, Russo LX, de Albuquerque CP, da Mota LMH, Barros-Areal AF, Oliveira APRA, Firmino-Machado J, da Silva EN. The disruption of elective procedures due to COVID-19 in Brazil in 2020. Sci Rep 2022; 12:10942. [PMID: 35768482 PMCID: PMC9243075 DOI: 10.1038/s41598-022-13746-5] [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: 09/28/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Elective procedures were temporarily suspended several times over the course of the pandemic of COVID-19. Monthly data from the Unified Health System (SUS) were used for the period between January 2008 and December 2020 and the interrupted time series method was used to estimate the effect of the pandemic on the number of elective surgeries and elective procedures that were not performed. Considering a 9-month period, a reduction of 46% in the number of elective procedures carried out in the SUS could be attributed to COVID-19, corresponding to about 828,429 elective procedures cancelled, ranging from 549,921 to 1,106,936. To a full recovery of pre-pandemic performance, SUS would need to increase about 21,362 hospital beds, ranging from 12,370 to 36,392 hospital beds during a 6 month-period. This effort would represent an increase of 8.48% (ranging from 4.91 to 14.45%) in relation to the total number of SUS’s hospital beds in 2019. As a result, the pandemic will leave a large number of elective procedures to be carried out, which will require efforts by health agencies to meet this demand.
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Affiliation(s)
- Gustavo Saraiva Frio
- Graduate Program in Collective Health, Faculty of Health Science, University of Brasilia, Brasília, Brazil.,Catholic University of Pelotas, Pelotas, Brazil
| | - Letícia Xander Russo
- Department of Economics, Federal University of Grande Dourados, Dourados, Brazil.
| | - Cleandro Pires de Albuquerque
- Graduate Program in Medical Science, Faculty of Medicine, University Hospital of Brasília, University of Brasilia, Brasília, Brazil
| | | | - Adriana Ferreira Barros-Areal
- Graduate Program in Medical Science, Health Department of the Federal District (SES/DF), Faculty of Medicine, University of Brasilia, Brasília, Brazil
| | | | - João Firmino-Machado
- Faculty of Medicine, Institute of Public Health (ISPUP), University of Porto, Porto, Portugal
| | - Everton Nunes da Silva
- Graduate Program in Collective Health, Faculty of Health Science, Faculty of Ceilândia, University of Brasilia, Brasília, Brazil
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Prodromidou A, Koulakmanidis AM, Haidopoulos D, Nelson G, Rodolakis A, Thomakos N. Where Enhanced Recovery after Surgery (ERAS) Protocols Meet the Three Major Current Pandemics: COVID-19, Obesity and Malignancy. Cancers (Basel) 2022; 14:cancers14071660. [PMID: 35406432 PMCID: PMC8996966 DOI: 10.3390/cancers14071660] [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: 02/06/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary The SARS-CoV-2 (COVID-19) pandemic has significantly modified the medical services provided for patients that receive care either for COVID-19 or for those that need care for benign diseases, including obesity, or for malignant ones, such as gynecological cancer. We sought to investigate the association among three major worldwide health issues (COVID-19, obesity, and malignancy) and how ERAS protocols can potentially provide optimal management of patients with obesity and malignancy during the COVID-19 pandemic, with special attention to patients who required surgery for gynecologic oncology. We strongly believe that the application of ERAS protocols could play a key role during these unprecedented COVID-19 times. Abstract The outbreak of the SARS-CoV-2 (COVID-19) pandemic has transformed the provision of medical services for both patients that receive care for COVID-19 and for those that need care either for benign diseases, including obesity, or for malignancies, such as gynecological cancer. In this perspective article, we focus on the association among three major worldwide health issues and how ERAS protocols can potentially provide optimal management of patients with obesity and malignancy during the COVID-19 pandemic, with special attention to patients who required surgery for gynecologic oncology. A thorough search of the literature on the respective topics was performed. Patients with malignancy and obesity presented with increased vulnerability to COVID-19 infection. However, the management of their disease should not be withheld. Protective measures should be established to reduce exposure of patients with oncological diseases to SARS-CoV-2 while simultaneously enabling their access to vaccination. Since ERAS protocols have proved to be efficient in many surgical fields, including gynecologic oncology, general surgery, and orthopedics, we strongly believe that ERAS protocols may play a significant role in this effort. The end of the COVID-19 pandemic cannot be accurately predicted. Nevertheless, we have to ensure the appropriate and efficient management of certain groups of patients.
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Affiliation(s)
- Anastasia Prodromidou
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
- Correspondence: ; Tel.: +30-6972751000
| | - Aristotelis-Marios Koulakmanidis
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Dimitrios Haidopoulos
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Alexandros Rodolakis
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
| | - Nikolaos Thomakos
- Gynaecologic Oncology Unit, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.-M.K.); (D.H.); (A.R.); (N.T.)
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12
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Breast reconstruction during the COVID-19 pandemic: Single institution experience from the pandemic's epicenter in the United States. J Plast Reconstr Aesthet Surg 2022; 75:2236-2241. [PMID: 35317981 PMCID: PMC8866163 DOI: 10.1016/j.bjps.2022.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/23/2021] [Accepted: 02/12/2022] [Indexed: 12/02/2022]
Abstract
Introduction The coronavirus disease-19 (COVID-19) pandemic dramatically changed the delivery of breast cancer care. The objective of this study was to quantify the effect of the pandemic on breast cancer screening, treatment, and reconstruction at a single institution in New York City. Methods A retrospective chart review was conducted to determine the number of mammograms, lumpectomies, mastectomies, and breast reconstruction operations performed between January 1, 2019 and June 30, 2021. Outcomes analyzed included changes in mammography, oncologic surgery, and breast reconstruction surgery volume before, during and after the start of the pandemic. Results Mammography volume declined by 11% in March–May of 2020. Oncologic breast surgeries and reconstructive surgeries similarly declined by 6.8% and 11%, respectively, in 2020 compared with 2019, reaching their lowest levels in April 2020. The volume of all procedures increased during the summer of 2020. Mammography volumes in June and July 2020 were found to be at pre-COVID levels, and in October–December 2020 were 15% higher than in 2019. Oncologic breast surgeries saw a similar rebound in May 2020, with 24.6% more cases performed compared with May 2019. Breast reconstruction volumes increased, though changes in the types of reconstruction were noted. Oncoplastic closures were more common during the pandemic, while two-stage implant reconstruction and immediate autologous reconstruction decreased by 27% and 43%, respectively. All procedures are on track to increase in volume in 2021 compared to that in 2020. Conclusion The COVID-19 pandemic reduced the volume of breast cancer surveillance, surgical treatment, and reconstruction procedures. While it is reassuring that volumes have rebounded in 2021, efforts must be made to emphasize screening and treatment procedures in the face of subsequent surges, such as that recently attributable to the Delta and Omicron variants.
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Chen R, Yang J, Zhao X, Fu Z, Wang Z, Qiu C, Wu Y, Yang R, Liu W, Huang Y, Chen J. Pattern of Time-to-Surgery in Patients With Breast Cancer at Different Stages of the COVID-19 Pandemic. Front Oncol 2022; 11:820638. [PMID: 35096625 PMCID: PMC8790243 DOI: 10.3389/fonc.2021.820638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 02/05/2023] Open
Abstract
Background The management of cancer surgeries is under unprecedented challenges during the COVID-19 pandemic, and the breast cancer patients may face a time-delay in the treatment. This retrospective study aimed to present the pattern of time-to-surgery (TTS) and analyze the features of breast cancer patients under the different stages of the COVID-19 pandemic. Methods Patients who received surgeries for breast cancers at West China Hospital between February 15, 2020 and April 30, 2020 (the outbreak and post-peak stages), and between March 10, 2021 and May 25, 2021 (the normalization stage) were included. TTS was calculated as the time interval between the pathological diagnosis and surgical treatment of breast cancer patients. And the pandemic was divided into three stages based on the time when the patients were pathologically diagnosed and the severity of pandemic at that time point. TTS, demographic and clinicopathological features were collected from medical records. Results A total of 367 patients were included. As for demographic features, it demonstrated statistically significant differences in insurance type (p<0.001) and regular screening (p<0.001), as well as age (p=0.013) and menstrual status (p=0.004). As for clinicopathological features, axillary involvement (p=0.019) was a factor that differed among three stages. The overall TTS was 23.56 ± 21.39 days. TTS for patients who were diagnosed during the outbreak of COVID-19 were longer than those diagnosed during pandemic post-peak and normalization stage (p<0.001). Pandemic stage (p<0.001) and excision biopsy before surgery (OR, 6.459; 95% CI, 2.225-18.755; p=0.001) were markedly correlated with the TTS of patients. Conclusions TTS of breast cancer patients significantly varied in different stages of the COVID-19 pandemic. And breast cancer patients’ daily lives and disease treatments were affected by the pandemic in many aspects, such as health insurance access, physical screening and change of therapeutic schedules. As the time-delay may cause negative influences on patients’ disease, we should minimize the occurrence of such time-delay. It is vital to come up with comprehensive measures to deal with unexpected situations in case the pandemic occurs.
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Affiliation(s)
- Ruixian Chen
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jiqiao Yang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Zhao
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhoukai Fu
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhu Wang
- Laboratory of Molecular Diagnosis of Cancer, West China Hospital, Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yunhao Wu
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ruoning Yang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Weijing Liu
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ya Huang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Chen
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
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14
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Pramesh CS, Badwe RA. The COVID-19 Pandemic and Cancer Surgery. Indian J Surg Oncol 2021; 12:229-231. [PMID: 34751206 PMCID: PMC8566655 DOI: 10.1007/s13193-021-01461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- C. S. Pramesh
- Tata Memorial Centre, Homi Bhabha National Institute, Dr Ernest Borges Marg, Parel, Mumbai 400012 India
| | - Rajendra Achyut Badwe
- Tata Memorial Centre, Homi Bhabha National Institute, Dr Ernest Borges Marg, Parel, Mumbai 400012 India
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