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COVID-19 之前及期间头颈部癌的诊断、分期和治疗时间

Times to Diagnosis, Staging, and Treatment of Head and Neck Cancer Before and During COVID-19.

作者信息

Yao Peter, Cooley Victoria, Kuhel William, Tassler Andrew, Banuchi Victoria, Long Sallie, Savenkov Oleksandr, Kutler David Ivan

机构信息

Weill Cornell Medical College, Weill Cornell Medicine, New York, New York, USA.

Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA.

出版信息

OTO Open. 2021 Nov 22;5(4):2473974X211059429. doi: 10.1177/2473974X211059429. eCollection 2021 Oct-Dec.

Abstract

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic has reduced the demand for, and supply of, head and neck cancer services. This study compares the times to diagnosis, staging, and treatment of head and neck cancers before and during the COVID-19 pandemic.

STUDY DESIGN

Retrospective cohort study.

SETTING

Tertiary academic medical center in New York City (NYC).

METHODS

The times to diagnosis, staging, and treatment of head and neck cancer for patients presenting to the clinics of 4 head and neck oncology surgeons with newly diagnosed head and neck cancers were compared between pre-COVID-19 and COVID-19 periods.

RESULTS

Sixty-eight patients in the pre-COVID-19 period and 26 patients in the COVID-19 period presented with newly diagnosed head and neck cancer. Patients in the COVID-19 group had a significantly longer time to diagnosis than the pre-COVID-19 group after adjustment for age and cancer diagnosis ( = .02; hazard ratio [HR], 0.54; 95% CI, 0.32-0.92). Patients in the pre-COVID-19 and COVID-19 groups had no statistically significant differences in time to staging ( > .9; HR, 1.01; 95% CI, 0.58-1.74) or time to treatment ( = .12; HR, 1.55; 95% CI, 0.89-2.72).

CONCLUSION

This study found that time to diagnosis for head and neck cancers was delayed during a COVID-19 period compared to a pre-COVID-19 period. However, there was no evidence of delays in time to staging and time to treatment during the COVID-19 period. Our results prompt further investigations into the factors contributing to diagnostic delays but provide reassurance that despite COVID-19, patients were receiving timely staging and treatment for head and neck cancers.

摘要

目的

2019年冠状病毒病(COVID-19)大流行减少了头颈癌服务的需求和供给。本研究比较了COVID-19大流行之前和期间头颈癌的诊断、分期和治疗时间。

研究设计

回顾性队列研究。

研究地点

纽约市的三级学术医疗中心。

方法

比较了在COVID-19之前和期间,4名头颈肿瘤外科医生诊所中,新诊断出头颈癌的患者的头颈癌诊断、分期和治疗时间。

结果

COVID-19之前时期有68例患者,COVID-19时期有26例患者新诊断出头颈癌。在对年龄和癌症诊断进行调整后,COVID-19组患者的诊断时间明显长于COVID-19之前组(P = 0.02;风险比[HR],0.54;95%可信区间[CI],0.32 - 0.92)。COVID-19之前组和COVID-19组患者在分期时间(P > 0.9;HR,1.01;95% CI,0.58 - 1.74)或治疗时间(P = 0.12;HR,1.55;95% CI,0.89 - 2.72)上没有统计学显著差异。

结论

本研究发现,与COVID-19之前时期相比,COVID-19时期头颈癌的诊断时间有所延迟。然而,没有证据表明COVID-19时期在分期时间和治疗时间上有延迟。我们的结果促使进一步调查导致诊断延迟的因素,但也让人放心,尽管有COVID-19,患者仍能及时接受头颈癌的分期和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c570/8637711/c3eef66f2699/10.1177_2473974X211059429-fig1.jpg

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