Department of Medical Oncology, JIPMER, Dhanvantri Nagar, Puducherry, 605006, India.
Department of Clinical Pharmacology, JIPMER, Puducherry, India.
Med Oncol. 2021 Sep 28;38(11):137. doi: 10.1007/s12032-021-01588-6.
The covid-19 pandemic has impacted the management of non-covid-19 illnesses. Epithelial ovarian cancer (EOC) requires long-duration multidisciplinary treatment. Teleconsultation and shared care are suggested solutions to mitigate the consequences of the pandemic. However, these may be challenging to implement among patients who come from the lower economic strata. We report the disastrous impact of the pandemic on the care of EOC by comparing patients who were treated during the pandemic with those treated in the previous year. We collected the following data from newly diagnosed patients with EOC: time from diagnosis to treatment, time for completion of planned chemotherapy, and proportion of patients completing various components of therapy (surgery and chemotherapy). Patients treated between January 2019 and September 2019 (Group 1: Pre-covid) were compared with those treated between January 2020 and December 2020 (Group 2: During covid pandemic). A total of 82 patients were registered [Group 1: 43(51%) Group 2: 39(49)]. The median time from diagnosis to start of treatment was longer in group 2 when compared to group 1 [31(23-58) days versus 17(11-30) days (p = 0.03)]. The proportion of patients who had surgery in group 2 was lower in comparison to group 1 [33(77%) versus 21(54%) (p = 0.02)]. Proportion of patients who underwent neoadjuvant (NACT) and surgery were fewer in group 2 in comparison to group 1 [9(33%) versus 18(64%) p = 0.002]. Among patients planned for adjuvant chemotherapy, the median time from diagnosis to treatment was longer in group 2 [28(17-45) days, group 1 versus 49(26-78) days, group 2 (p = 0.04)]. The treatment of patients with EOC was adversely impacted due to the COVID-19 pandemic. There was a compromise in the proportion of patients completing planned therapy. Even among those who completed the treatment, there were considerable delays when compared with the pre-covid period. The impact of these compromises on the outcomes will be known with longer follow-up.
新冠疫情对非新冠疾病的管理产生了影响。上皮性卵巢癌（EOC）需要长期的多学科治疗。远程咨询和共享护理被认为是减轻疫情影响的解决方案。然而，对于来自较低经济阶层的患者来说，这些方案可能难以实施。我们通过比较在疫情期间和前一年接受治疗的患者，报告了疫情对 EOC 治疗的灾难性影响。我们从新诊断为 EOC 的患者中收集了以下数据：从诊断到治疗的时间、完成计划化疗的时间以及完成治疗各个部分（手术和化疗）的患者比例。2019 年 1 月至 2019 年 9 月期间接受治疗的患者（第 1 组：新冠前）与 2020 年 1 月至 2020 年 12 月期间接受治疗的患者（第 2 组：新冠期间）进行了比较。共登记了 82 名患者[第 1 组：43（51%），第 2 组：39（49%）]。与第 1 组相比，第 2 组从诊断到开始治疗的时间中位数更长[31（23-58）天比 17（11-30）天（p=0.03）]。第 2 组接受手术的患者比例低于第 1 组[33（77%）比 21（54%）（p=0.02）]。与第 1 组相比，第 2 组接受新辅助化疗（NACT）和手术的患者比例更少[9（33%）比 18（64%），p=0.002]。在计划接受辅助化疗的患者中，第 2 组从诊断到治疗的中位时间更长[28（17-45）天，第 1 组比 49（26-78）天，第 2 组（p=0.04）]。由于新冠疫情，EOC 患者的治疗受到了不利影响。计划治疗完成比例降低。即使是那些完成治疗的患者，与新冠前相比，也存在相当长的延迟。随着随访时间的延长，这些妥协对结果的影响将会显现。
