Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
PET/CT Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Eur J Nucl Med Mol Imaging. 2022 Apr;49(5):1623-1629. doi: 10.1007/s00259-021-05629-0. Epub 2021 Dec 8.
To investigate whether the COVID-19 pandemic and national lockdown had an impact on the extent of cancer disease at FDG PET/CT staging as surrogate marker.
Retrospective observational study including cancer patients submitted to FDG PET/CT staging from June 1 to October 31, 2020, and June 1 to October 31, 2019, respectively. Data regarding primary tumour, nodal (N) status and number of involved nodal stations, and presence and number of distant metastases (M) were collected. Each scan was classified in limited vs advanced status. Data were aggregated across the study population and tumour type. Bi-weekly frequencies of the observed events were analysed.
Six hundred eleven patients were included (240 in 2019 vs 371 in 2020, respectively). A significant increase of advanced disease patients (rate 1.56, P < 0.001), N + or M + patients (rate 1.84 and 2.09, respectively, P < 0.001), and patients with a greater number of involved N stations or M (rate 2.01 and 2.06, respectively, P < 0.001) were found in 2020 compared with data of 2019. Analysis by tumour type showed a significant increase of advanced disease in lymphoma and lung cancer in 2020 compared with 2019 (P < 0.001). In addition, a significant increase of nodal involvement was found in lung, gastro-intestinal, and breast cancers, as well as in lymphoma patients (P < 0.02). A significant increase of distant metastases was found in lung cancers (P = 0.002).
Cancer patients with advanced disease at FDG PET/CT staging increased in 2020 compared with 2019, following the national lockdown due to the COVID-19 pandemic, 1.5-fold with a significant increase of patients with N or M involvement. Targeted health interventions are needed to mitigate the effects of the pandemic on patient outcome.
研究 COVID-19 大流行和全国封锁是否对 FDG PET/CT 分期作为替代标志物的癌症疾病程度产生影响。
回顾性观察性研究，纳入分别于 2020 年 6 月 1 日至 10 月 31 日和 2019 年 6 月 1 日至 10 月 31 日接受 FDG PET/CT 分期的癌症患者。收集原发肿瘤、淋巴结（N）状态和受累淋巴结站数，以及远处转移（M）的存在和数量等数据。每一次扫描都分为局限性和进展性。将数据汇总到研究人群和肿瘤类型中。分析观察到的事件的两周频率。
共纳入 611 例患者（2019 年 240 例，2020 年 371 例）。与 2019 年相比，2020 年进展性疾病患者（发生率 1.56，P<0.001）、N+或 M+患者（发生率 1.84 和 2.09，P<0.001）和存在更多受累淋巴结站或转移的患者（发生率 2.01 和 2.06，P<0.001）显著增加。按肿瘤类型分析，2020 年淋巴瘤和肺癌的进展性疾病显著增加（P<0.001）。此外，肺癌、胃肠道癌和乳腺癌以及淋巴瘤患者的淋巴结受累显著增加（P<0.02）。肺癌远处转移显著增加（P=0.002）。
与 2019 年相比，由于 COVID-19 大流行而实行的全国封锁后，2020 年 FDG PET/CT 分期的癌症患者中进展性疾病患者增加了 1.5 倍，且 N 或 M 受累患者显著增加。需要采取有针对性的卫生干预措施，减轻大流行对患者结局的影响。
