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COVID-19 封锁措施对肿瘤外科活动的影响:对意大利西北部一家三级转诊医院外科病理学病例的分析。

Impact of COVID-19 lockdown measures on oncological surgical activity: Analysis of the surgical pathology caseload of a tertiary referral hospital in Northwestern Italy.

机构信息

Pathology Unit, Department of Medical Sciences, "Città della Salute e della Scienza di Torino" University Hospital, University of Turin, Turin, Italy.

Obstetrics, and Gynecology Unit, Department of Surgical Sciences, Sant'Anna Hospital, "Città della Salute e della Scienza di Torino" University Hospital, University of Turin, Turin, Italy.

出版信息

J Surg Oncol. 2021 Jan;123(1):24-31. doi: 10.1002/jso.26256. Epub 2020 Oct 20.

Abstract

BACKGROUND AND OBJECTIVES

Italy was severely affected by the severe acute respiratory syndrome coronavirus 2 pandemic. Our Institution, Piedmont's largest tertiary referral center, was designated as a non-COVID-19 hospital and activities were reorganized to prioritize critical services like oncological care. The aim of this study was to investigate the efficacy in preserving the oncological surgical practice at our Institution during the most critical months of the COVID-19 epidemic by analyzing the surgical pathology activity.

METHODS

The number of oncological surgical resections submitted to histopathological examination from 9th March 2020 to 8th May 2020 were collected as well staging/grading data and compared with the previous three pre-COVID-19 years (2017-2019).

RESULTS

Overall, no decrease was observed for most tumor sites (5/9) while breast resections showed the largest drop (109 vs. 160; -31.9%), although a full recovery was already noticed during the second half of the period. Conversely, the selected control benchmarks showed a sharp decrease (-80.4%). Distribution of pathological TNM stages (or tumor grades for central nervous system tumors) showed no significant differences during the lockdown compared with previous years (p > .05).

CONCLUSIONS

The present data suggest the possibility of preserving this cornerstone oncological activity during an evolving public health emergency thanks to a prompt workflow reorganization.

摘要

背景与目的

意大利深受严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)大流行的影响。我们机构作为皮埃蒙特最大的三级转诊中心,被指定为非 COVID-19 医院,并重新组织了活动,以优先考虑肿瘤治疗等关键服务。本研究旨在通过分析外科病理学活动,调查在 COVID-19 大流行期间,我们机构在肿瘤外科实践方面保持疗效的情况。

方法

收集 2020 年 3 月 9 日至 5 月 8 日期间提交给组织病理学检查的肿瘤外科切除数量,以及分期/分级数据,并与 COVID-19 前 3 年(2017-2019 年)进行比较。

结果

总体而言,大多数肿瘤部位(5/9)未见减少,而乳房切除术减少最多(109 例比 160 例,减少 31.9%),尽管在该时期的下半年已经出现全面恢复。相比之下,所选的对照组基准显示出急剧下降(-80.4%)。与前几年相比,封锁期间的病理 TNM 分期(或中枢神经系统肿瘤的肿瘤分级)分布无显著差异(p>.05)。

结论

目前的数据表明,由于及时的工作流程重组,有可能在不断发展的公共卫生紧急情况下保持这一重要的肿瘤活动。

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