Alexander Andrea, Fung Stephen, Eichler Martin, Lehwald-Tywuschik Nadja, Uthayakumar Vasuki, Safi Sami-Alexander, Vay Christian, Ashmawy Hany, Kalmuk Sinan, Rehders Alexander, Vaghiri Sascha, Knoefel Wolfram Trudo
Department of General, Visceral and Pediatric Surgery, University Hospital Düsseldorf and Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Duesseldorf, Germany.
Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus Dresden, 01307 Dresden, Germany.
Int J Environ Res Public Health. 2022 Mar 21;19(6):3731. doi: 10.3390/ijerph19063731.
Coronavirus disease 19 (COVID-19) substantially affects cancer patients due to adverse outcomes and disruptions in cancer care. Recent studies have indicated the additional stress and anxiety burden arising from the pandemic and impairing quality of life in this vulnerable group of patients. However, patients with cancer represent a heterogenous group. Therefore, we conducted a study on patients with pancreatic cancer, requiring demanding surgical interventions and chemotherapy regimens due to its aggressive tumor biology, to explore the pandemic's impact on quality of life within this homogenous cohort.
In a descriptive observational study, the quality of life of patients who had undergone pancreatic surgery for tumor resection at our institution between 2014 and the beginning of the pandemic in March 2020 was assessed. For HRQoL measurement, we used the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), comparing their situation before the pandemic and since its beginning. An additional self-developed questionnaire was applied to assess the life circumstances during the pandemic.
Our cohort included 26 patients. Scores from the survey in HRQoL revealed no significant changes over time between before and during the pandemic. A medium deterioration in HRQoL was apparent in social functioning, as well as a small deterioration in role functioning and emotional functioning. Worries concerning a potential impact of COVID-19 on personal health were expressed. Psychological limitations in QoL were mainly attributed to the pandemic, whereas physical limitations in QoL were rather associated with the underlying disease of pancreatic cancer.
The COVID-19 pandemic is causing considerable social and emotional distress among pancreatic cancer patients. These patients will benefit from psychological support during the pandemic and beyond. Long-time survivors of pancreatic cancer, such as those included in our cohort, appear to have improved resilience facing the psychosocial challenges of the pandemic. For pancreatic cancer, surgical care is considered the cornerstone of treatment. Prolonged delays in healthcare cause serious damage to mental and physical health. To date, the longer-term clinical consequences are not known and can only be estimated. The potential tragic outcome for the vulnerable group of pancreatic cancer patients highlights the urgency of timely healthcare decisions to be addressed in the future.
新型冠状病毒肺炎（COVID-19）由于不良后果以及癌症护理中断，对癌症患者产生了重大影响。近期研究表明，疫情带来了额外的压力和焦虑负担，损害了这一弱势群体的生活质量。然而，癌症患者是一个异质性群体。因此，我们对胰腺癌患者进行了一项研究，由于其侵袭性肿瘤生物学特性，胰腺癌患者需要进行高要求的手术干预和化疗方案，以探讨疫情对这一同质队列患者生活质量的影响。
在一项描述性观察研究中，评估了2014年至2020年3月疫情开始期间在我们机构接受胰腺肿瘤切除手术患者的生活质量。对于健康相关生活质量（HRQoL）的测量，我们使用了欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30），比较了疫情前和疫情开始后的情况。还应用了一份额外自行编制的问卷来评估疫情期间的生活状况。
我们的队列包括26名患者。HRQoL调查得分显示，疫情前和疫情期间随时间推移没有显著变化。社会功能方面HRQoL有中度恶化，角色功能和情感功能也有轻度恶化。患者表达了对COVID-19对个人健康潜在影响的担忧。生活质量的心理限制主要归因于疫情，而生活质量的身体限制则更多与胰腺癌基础疾病相关。
COVID-19疫情正在给胰腺癌患者带来相当大的社会和情感困扰。这些患者将在疫情期间及之后受益于心理支持。胰腺癌的长期幸存者，如我们队列中的患者，似乎在面对疫情的心理社会挑战时具有更强的恢复力。对于胰腺癌，手术治疗被认为是治疗的基石。医疗保健的长期延迟会对身心健康造成严重损害。迄今为止，长期临床后果尚不清楚，只能进行估计。胰腺癌弱势群体的潜在悲惨结局凸显了未来及时做出医疗保健决策的紧迫性。
