Report on lung cancer surgery during COVID-19 pandemic at a high volume US institution

医学 2019年冠状病毒病(COVID-19) 肺癌 阶段(地层学) 回顾性队列研究 大流行 癌症 严重急性呼吸综合征冠状病毒2型(SARS-CoV-2) 外科 疾病 内科学 传染病(医学专业) 生物 古生物学
作者
Daniel P. Dolan,Daniel N. Lee,Emily Polhemus,Suden Kucukak,Luis E. De León,Daniel Wiener,Michael T. Jaklitsch,Scott J. Swanson,Augustus A. White
出处
期刊:Journal of Thoracic Disease [AME Publishing Company]
卷期号:14 (8): 2874-2879 被引量:9
标识
DOI:10.21037/jtd-22-5
摘要

The impact of COVID-19 has been felt in every field of medicine. We sought to understand how lung cancer surgery was affected at a high volume institution. We hypothesized that patients would wait longer for surgery, have more advanced tumors, and experience more complications during the COVID-19 crisis.A retrospective review was conducted, comparing pathologically confirmed non-small cell lung cancer (NSCLC) surgical cases performed in 2019 to cases performed from March to May 2020, during the height of the COVID-19 crisis. Clinical and pathologic stage, tumor size, time to surgery, follow up time, and complications were evaluated.A total of 375 cases were performed in 2019 vs. 58 cases in March to May 2020. Overall, there were no differences in the distribution of clinical stages or in the distribution of median wait times to surgery between groups (COVID-19 16.5 days vs. pre-COVID-19 17 days, P=0.54), nor were there differences when subdivided into Stage I-II and Stage III-IV. Case volume was lowest in April 2020 with 6 cases vs. 37 in April 2019, P<0.01. Tumor size was clinically larger in the COVID-19 group (median 2.1 vs. 1.9 cm, P=0.05) but not at final pathology. No differences in complications were observed between groups (COVID-19 31.0% vs. pre-COVID-19 30.9%, P=1.00). No patients from the COVID-19 group tested positive for the disease during their hospital stay or by the median 15 days to first follow-up.Surgical wait time, pathologic tumor size, and complications were not different among patients undergoing surgery before vs. during the pandemic. Importantly, no patients became infected as a result of their hospital stay. The significant decrease in surgical cases is concerning for untreated cancers that may progress without proper treatment.
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