Delayed surgery during the Covid-19 pandemic did not affect long-term outcomes of pancreatic adenocarcinoma.

Autor: Hamadalnile A; Department of HPB Surgery, King's College Hospital, London, UK., Mariathasan M; Department of HPB Surgery, King's College Hospital, London, UK., Riad M; Department of General Surgery, Maidstone and Tunbridge Wells Hospitals, Maidstone, UK., Patel AG; Department of HPB Surgery, King's College Hospital, London, UK., Atkinson S; Department of HPB Surgery, King's College Hospital, London, UK., Prachalias AA; Department of HPB Surgery, King's College Hospital, London, UK., Srinivasan P; Department of HPB Surgery, King's College Hospital, London, UK., Jiao L; Department of HPB Surgery, Royal Marsden Hospital, London, UK., Bhogal RH; Department of HPB Surgery, Royal Marsden Hospital, London, UK., Menon K; Department of HPB Surgery, King's College Hospital, London, UK., Schneider C; Department of HPB Surgery, King's College Hospital, London, UK; Department of HPB Surgery, Royal Marsden Hospital, London, UK. Electronic address: crispin.schneider@nhs.net.
Jazyk: angličtina
Zdroj: Surgical oncology [Surg Oncol] 2024 Nov 23; Vol. 58, pp. 102169. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1016/j.suronc.2024.102169
Abstrakt: Background: During the Covid-19 pandemic cancer surgery was severely affected due to relocation of healthcare resources and the resulting restructuring of cancer pathways. Although this potentially affected rapidly progressing malignancies like pancreatic cancer the most, little is known about long-term outcomes following pancreatectomy.
Materials and Methods: Survival data from two pancreatic surgery centres in the UK was analysed with patients being compared across pre-pandemic (C19-) and intra-pandemic (C19+) groups. Demographic, pathological and surgical pathway parameters were evaluated with multivariate analysis and propensity score matching.
Results: Out of 123 patients, 60 had surgery during the pandemic. The main strategy to reduce disruptions to pancreatic surgery was relocation of services to private sector facilities without emergency medicine departments. Although time to surgery was delayed by almost 20 days during the pandemic, there were no significant differences in overall survival at 22 months vs. 24 months or disease free survival at 15 months vs. 16 months for the C19+ and C19- groups, respectively. Adjuvant chemotherapy, Charlson comorbidity score, tumour stage and resection margin status were found to be independent predictors for overall survival whereas only adjuvant chemotherapy and Charlson comorbidity score were predictive of disease free survival.
Conclusion: This article provides a template for the effective restructuring of pancreatectomy pathways during a pandemic with associated lockdowns and provides the first evidence that the quality of outcomes can be maintained in this difficult environment. It is hoped that these results will provide a framework for addressing surgical oncology challenges in future pandemics.
Competing Interests: Conflict of interest statement Albasheer Hamadalnile, Michael Mariathanasan, Mahmud Riad, Ameet Patel, Simon Atkinson, Andreas Prachalias, Parthiban Srinivasan, Long Jiao, Ricky Bhogal, Krishna Menon and Crispin Schneider have no conflicts of interest or financial ties to disclose.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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