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评估2019冠状病毒病对外科肿瘤学实践的直接影响:来自美国东北部一家美国国立癌症研究所指定的综合癌症中心的经验。

Assessing the immediate impact of COVID-19 on surgical oncology practice: Experience from an NCI-designated Comprehensive Cancer Center in the Northeastern United States.

作者信息

Gazivoda Victor, Greenbaum Alissa, Roshal Joshua, Lee Jenna, Reddy Lekha, Rehman Shahyan, Kangas-Dick Aaron, Gregory Stephanie, Kowzun Maria, Stephenson Ruth, Laird Amanda, Alexander H R, Berger Adam C

机构信息

Department of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.

Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

出版信息

J Surg Oncol. 2021 Jul;124(1):7-15. doi: 10.1002/jso.26475. Epub 2021 Mar 25.

Abstract

BACKGROUND

The effects of the coronavirus disease 2019 (COVID-19) pandemic on surgical oncology practice are not yet quantified. The aim of this study was to measure the immediate impact of COVID-19 on surgical oncology practice volume.

METHODS

A retrospective study of patients treated at an NCI-Comprehensive Cancer Center was performed. "Pre-COVID" era was defined as January-February 2020 and "COVID" as March-April 2020. Primary outcomes were clinic visits and operative volume by surgical oncology subspecialty.

RESULTS

Abouyt 907 new patient visits, 3897 follow-up visits, and 644 operations occurred during the study period. All subspecialties experienced significant decreases in new patient visits during COVID, though soft tissue oncology (Mel/Sarc), gynecologic oncology (Gyn/Onc), and endocrine were disproportionately affected. Telehealth visits increased to 11.4% of all visits by April. Mel/Sarc, Gyn/Onc, and Breast experienced significant operative volume decreases during COVID (25.8%, p = 0.012, 43.6% p < 0.001, and 41.9%, p < 0.001, respectively), while endocrine had no change and gastrointestinal oncology had a slight increase (p = 0.823) in the number of cases performed.

CONCLUSIONS

The effects of the COVID-19 pandemic are wide-ranging within surgical oncology subspecialties. The addition of telehealth is a viable avenue for cancer patient care and should be considered in surgical oncology practice.

摘要

背景

2019年冠状病毒病(COVID-19)大流行对外科肿瘤学实践的影响尚未得到量化。本研究的目的是衡量COVID-19对外科肿瘤学业务量的直接影响。

方法

对在一家美国国立癌症研究所综合癌症中心接受治疗的患者进行了一项回顾性研究。“COVID前”时代定义为2020年1月至2月,“COVID”时代定义为2020年3月至4月。主要结局是外科肿瘤学亚专业的门诊量和手术量。

结果

在研究期间,共进行了约907次新患者就诊、3897次随访就诊和644台手术。在COVID期间,所有亚专业的新患者就诊量均显著下降,尽管软组织肿瘤学(黑色素瘤/肉瘤)、妇科肿瘤学(妇科/肿瘤)和内分泌科受到的影响尤为严重。到4月,远程医疗就诊量增加到所有就诊量的11.4%。在COVID期间,黑色素瘤/肉瘤、妇科/肿瘤和乳腺科的手术量显著下降(分别为25.8%,p = 0.012;43.6%,p < 0.001;41.9%,p < 0.001),而内分泌科没有变化,胃肠肿瘤学的手术例数略有增加(p = 0.823)。

结论

COVID-19大流行对外科肿瘤学亚专业的影响广泛。增加远程医疗是癌症患者护理的一条可行途径,应在外科肿瘤学实践中予以考虑。

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Safety of Surgical Telehealth in the Outpatient and Inpatient Setting.外科远程医疗在门诊和住院环境中的安全性。
Surg Clin North Am. 2021 Feb;101(1):109-119. doi: 10.1016/j.suc.2020.09.003. Epub 2020 Nov 2.

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