Division of Colorectal Oncology, Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
J Surg Oncol. 2020 Dec;122(7):1271-1275. doi: 10.1002/jso.26193. Epub 2020 Sep 3.
The COVID-19 pandemic has wreaked havoc in the healthcare infrastructure. While we change our surgical practice, cancer care will take a toll on unprecedented long-term outcomes. We elucidate our experience that has unfolded during this period.
This study included retrospective data of patients being treated for colorectal cancer and peritoneal surface malignancy between January and May 2020. We compared the treatment changes before and after the national emergency was declared.
There was a 65% decrease in outpatients with a 90% drop in endoscopy procedures. Treatment protocols were changed with a 200% increase in short course radiation in rectal cancer. Colon cancer and anal melanoma were triaged to undergo 'essential' surgery. No robotic or exenteration procedures were performed in April and May. Patients with a low peritoneal cancer index underwent surgery alone. The relative number of emergency surgeries were unchanged.
There is no standard approach to deliver cancer care during the COVID-19 pandemic. Treatment decisions were made based on the state of affairs that COVID-19 had created during that cross-section of time and protocols were redrawn to strike a balance between the risk of death from colorectal cancer and the risk of death from COVID-19 infection.
COVID-19 大流行对医疗基础设施造成了严重破坏。虽然我们改变了手术实践，但癌症治疗将对前所未有的长期结果造成影响。我们阐述了在此期间所积累的经验。
本研究纳入了 2020 年 1 月至 5 月期间接受结直肠癌和腹膜表面恶性肿瘤治疗的患者的回顾性数据。我们比较了在宣布国家紧急状态前后的治疗变化。
门诊患者减少了 65%，内窥镜检查减少了 90%。治疗方案发生改变，直肠癌的短程放疗增加了 200%。结肠癌和肛门黑色素瘤被分诊为进行“必要”手术。4 月和 5 月没有进行机器人手术或切除术。腹膜癌指数低的患者仅接受手术。急诊手术的相对数量保持不变。
在 COVID-19 大流行期间，没有标准的方法来提供癌症治疗。治疗决策是基于 COVID-19 在该时间点造成的情况做出的，并且重新制定了方案，以平衡结直肠癌死亡风险和 COVID-19 感染死亡风险。
