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COVID-19 大流行期间头颈部癌症患者就诊延迟。

Delayed presentation of head and neck cancer patients during COVID-19 pandemic.

机构信息

Cerrahpasa Medical Faculty, Otorhinolaryngology-Head and Neck Surgery Department, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2021 Dec;278(12):5081-5085. doi: 10.1007/s00405-021-06728-2. Epub 2021 Mar 6.

Abstract

PURPOSE

Impact of COVID-19 pandemic on healthcare is huge. We intended to demonstrate how COVID-19 pandemic affected primary head and neck oncology patient's referral and admission to a tertiary center by comparing the retrospective patient data in March-September 2020 and the same period in 2019.

METHODS

In this cross-sectional study, from March 15th, 2020 to September 15th, 2020, medical records of 61 patients (Group 1) diagnosed and scheduled for surgery for head and neck cancer in our tertiary care center were revised and compared with 64 head and neck cancer patients treated in the same institution in the same time period of the previous year (Group2). Surgical site, TNM stages, need for reconstruction with flap, time from first symptom occurrence to first admission to our institution, and time to surgery were noted.

RESULTS

In Group 1, out of 56 patients, 26 were diagnosed with T1-2 tumor, while 30 had T3-4 tumor. In Group 2, 43 of 60 patients had T1-2 tumor, while only 17 of them were diagnosed with T3-4 tumor. The rate of T3-4 tumors had significantly increased in 2020 when compared to 2019 (p = 0.049). In oral cavity cancer patients, N stage was significantly increased in Group 1 when compared to Group 2 (p = 0.024). Need for reconstruction with regional or free flaps were significantly increased in oral cavity cancer patients (p = 0,022). The mean time from the beginning of the first symptom to the admission was 19.01 ± 4.6 weeks (ranging between 11 and 32 weeks) in Group 1, while it was 16.6 ± 5.9 weeks in Group 2 (ranging between 6 and18 weeks); with significant increase (p = 0,02). The time to surgery from first admission was 3.4 ± 2.5 and 2.9 ± 1.2 weeks in Group 1 and 2, respectively, with no statistically significant difference (p = 0.06).

CONCLUSION

The COVID-19 pandemic has caused delay in the diagnosis and treatment of many diseases as such in head and neck cancers. Admission with advanced stage disease and the need for more complex reconstructive procedures were increased. During the pandemic, the management of other diseases that cause mortality and morbidity should not be neglected and priorities should be determined.

摘要

目的

新冠疫情对医疗保健的影响巨大。我们旨在通过比较 2020 年 3 月至 9 月和 2019 年同期三级中心原发性头颈部肿瘤患者的转诊和入院情况,展示新冠疫情对原发性头颈部肿瘤患者的影响。

方法

在这项回顾性研究中,我们从 2020 年 3 月 15 日至 2020 年 9 月 15 日,对 61 例在我院接受头颈部癌症诊断和手术治疗的患者(第 1 组)的病历进行了修订,并与 64 例在同一时期在同一机构接受治疗的头颈部癌症患者(第 2 组)进行了比较。记录了手术部位、TNM 分期、是否需要皮瓣重建、从首发症状到首次入院就诊的时间以及手术时间。

结果

第 1 组中,56 例患者中有 26 例诊断为 T1-2 期肿瘤,30 例诊断为 T3-4 期肿瘤。第 2 组中,60 例患者中有 43 例诊断为 T1-2 期肿瘤,而只有 17 例诊断为 T3-4 期肿瘤。与 2019 年相比,2020 年 T3-4 期肿瘤的比例显著增加(p=0.049)。在口腔癌患者中,第 1 组 N 分期明显高于第 2 组(p=0.024)。口腔癌患者需要进行区域性或游离皮瓣重建的比例明显增加(p=0.022)。第 1 组患者从首发症状到入院的平均时间为 19.01±4.6 周(11-32 周),第 2 组为 16.6±5.9 周(6-18 周);差异有统计学意义(p=0.02)。第 1 组和第 2 组患者从首次入院到手术的时间分别为 3.4±2.5 周和 2.9±1.2 周,差异无统计学意义(p=0.06)。

结论

新冠疫情导致许多疾病(包括头颈部癌症)的诊断和治疗延迟。晚期疾病入院和更复杂的重建手术需求增加。在大流行期间,不应忽视其他导致死亡率和发病率的疾病的治疗,应确定优先事项。

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