Madge Oliver, Brodey Alexandra, Bowen Jordan, Nicholson George, Sivakumar Shivan, Bottomley Matthew J
Ambulatory Assessment Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.
Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.
J Clin Med. 2022 May 4;11(9):2574. doi: 10.3390/jcm11092574.
The COVID-19 pandemic has hugely disrupted healthcare provision, including oncology services. To evaluate the effects of the pandemic on referral routes leading to diagnosis, treatments, and prognosis in patients with pancreatic ductal adenocarcinoma, we performed a retrospective cohort study at a single tertiary centre in the UK. The patients were identified from the weekly hepatopancreatobiliary multidisciplinary team meetings between February 2018 and March 2021. The demographic, referral, and treatment data for each patient and date of death, where applicable, were extracted from the electronic patient record. The patients ( = 203) were divided into "pre-pandemic" and "pandemic" cohorts based on a referral date cut-off of 23rd March 2020. The median survival was 7.4 months [4.9-9.3] in the "pre-pandemic" cohort ( = 125), halving to 3.3 months [2.2-6.0], ( = 0.015) in the "pandemic" cohort ( = 78). There was no significant difference in patient characteristics between the two cohorts. There was a trend toward increased emergency presentations at diagnosis and reduced use of surgical resection in the "pandemic" cohort. This small-scale study suggested that the COVID-19 pandemic is associated with a halving of median survival in pancreatic ductal adenocarcinoma. Urgent further studies are required to confirm these findings and examine corresponding effects in other cancer types.
新冠疫情极大地扰乱了医疗服务的提供，包括肿瘤学服务。为了评估疫情对胰腺导管腺癌患者诊断、治疗及预后的转诊途径的影响，我们在英国一家单一的三级医疗中心进行了一项回顾性队列研究。研究对象是从2018年2月至2021年3月期间每周的肝胆胰多学科团队会议中确定的。从电子病历中提取了每位患者的人口统计学、转诊及治疗数据，以及适用情况下的死亡日期。根据2020年3月23日的转诊日期截止点，将203例患者分为“疫情前”和“疫情期间”队列。“疫情前”队列（n = 125）的中位生存期为7.4个月[4.9 - 9.3]，而“疫情期间”队列（n = 78）的中位生存期减半至3.3个月[2.2 - 6.0]，（P = 0.015）。两个队列的患者特征无显著差异。“疫情期间”队列在诊断时急诊就诊有增加趋势，手术切除的使用减少。这项小规模研究表明，新冠疫情与胰腺导管腺癌患者的中位生存期减半有关。需要进一步进行紧急研究以证实这些发现，并研究对其他癌症类型的相应影响。
