Department of Thoracic Surgery, University Hospital Zurich, Switzerland.
Faculty of Medicine, University of Zurich, Switzerland.
Swiss Med Wkly. 2022 Feb 7;152:w30109. doi: 10.4414/smw.2022.w30109. eCollection 2022 Jan 31.
The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on oncological and thoracic surgical practice worldwide. In many hospitals, the care of COVID-19 patients required a reduction of elective surgery, to avoid viral transmission within the hospital, and to save and preserve personnel and material resources. Cancer patients are more susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and are at an increased risk of a severe course of disease. In many patients with lung cancer, this risk is further increased owing to comorbidities, older age and a pre-existing lung disease. Surgical resection is an important part of the treatment in patients with early stage or locally advanced non-small cell lung cancer, but the treatment of these patients during the COVID-19 pandemic becomes a challenging balance between the risk of patient exposure to SARS-CoV-2 and the need to provide timely and adequate cancer treatment despite limited hospital capacities. This manuscript aims to provide an overview of the surgical treatment of lung cancer patients during the COVID-19 pandemic including the triage and prioritisation as well as the surgical approach, and our own experience with cancer surgery during the first pandemic wave. We furthermore aim to highlight the risk and potential consequences of delayed lung cancer treatment due to the deferral of surgery, screening appointments and follow-up visits. With much attention being diverted to COVID-19, it is important to retain awareness of cancer patients, maintain oncological surgery and avoid treatment delay during the pandemic.
新型冠状病毒病 2019（COVID-19）大流行对全球肿瘤学和胸外科实践产生了严重影响。在许多医院，为避免医院内病毒传播，节省和保护人员和物资资源，需要减少 COVID-19 患者的择期手术。癌症患者更容易感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2），并且疾病严重程度的风险增加。在许多肺癌患者中，由于合并症、年龄较大和先前存在的肺部疾病，这种风险进一步增加。手术切除是早期或局部晚期非小细胞肺癌患者治疗的重要组成部分，但在 COVID-19 大流行期间，这些患者的治疗成为患者暴露于 SARS-CoV-2 的风险与尽管医院容量有限但仍需要及时提供充分癌症治疗之间的具有挑战性的平衡。本文旨在概述 COVID-19 大流行期间肺癌患者的手术治疗，包括分诊和优先排序以及手术方法，以及我们在第一波大流行期间进行癌症手术的经验。我们还旨在强调由于手术、筛查预约和随访的推迟而导致的肺癌治疗延迟的风险和潜在后果。由于对 COVID-19 的关注较多，因此重要的是要意识到癌症患者的存在，保持肿瘤外科手术并避免大流行期间的治疗延误。
