Dolan Daniel P, Lee Daniel N, Polhemus Emily, Kucukak Suden, De León Luis E, Wiener Daniel, Jaklitsch Michael T, Swanson Scott J, White Abby
Division of Thoracic and Cardiac Surgery, Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
J Thorac Dis. 2022 Aug;14(8):2874-2879. doi: 10.21037/jtd-22-5.
The impact of COVID-19 has been felt in every field of medicine. We sought to understand how lung cancer surgery was affected at a high volume institution. We hypothesized that patients would wait longer for surgery, have more advanced tumors, and experience more complications during the COVID-19 crisis.
A retrospective review was conducted, comparing pathologically confirmed non-small cell lung cancer (NSCLC) surgical cases performed in 2019 to cases performed from March to May 2020, during the height of the COVID-19 crisis. Clinical and pathologic stage, tumor size, time to surgery, follow up time, and complications were evaluated.
A total of 375 cases were performed in 2019 58 cases in March to May 2020. Overall, there were no differences in the distribution of clinical stages or in the distribution of median wait times to surgery between groups (COVID-19 16.5 days pre-COVID-19 17 days, P=0.54), nor were there differences when subdivided into Stage I-II and Stage III-IV. Case volume was lowest in April 2020 with 6 cases 37 in April 2019, P<0.01. Tumor size was clinically larger in the COVID-19 group (median 2.1 1.9 cm, P=0.05) but not at final pathology. No differences in complications were observed between groups (COVID-19 31.0% pre-COVID-19 30.9%, P=1.00). No patients from the COVID-19 group tested positive for the disease during their hospital stay or by the median 15 days to first follow-up.
Surgical wait time, pathologic tumor size, and complications were not different among patients undergoing surgery before during the pandemic. Importantly, no patients became infected as a result of their hospital stay. The significant decrease in surgical cases is concerning for untreated cancers that may progress without proper treatment.
新型冠状病毒肺炎（COVID-19）的影响已在医学的各个领域显现。我们试图了解一家大型医疗机构的肺癌手术受到了怎样的影响。我们推测，在COVID-19危机期间，患者等待手术的时间会更长，肿瘤会更晚期，并且会经历更多并发症。
进行了一项回顾性研究，比较2019年进行的经病理证实的非小细胞肺癌（NSCLC）手术病例与2020年3月至5月COVID-19危机高峰期进行的病例。评估了临床和病理分期、肿瘤大小、手术时间、随访时间和并发症。
2019年共进行了375例手术，2020年3月至5月进行了58例手术。总体而言，两组之间临床分期的分布或手术中位等待时间的分布没有差异（COVID-19组为16.5天，COVID-19前组为17天，P = 0.54），分为Ⅰ-Ⅱ期和Ⅲ-Ⅳ期时也没有差异。2020年4月的病例数最少，为6例，2019年4月为37例，P < 0.01。COVID-19组的肿瘤临床大小更大（中位值2.1对1.9 cm，P = 0.05），但最终病理结果并非如此。两组之间并发症无差异（COVID-19组为31.0%，COVID-19前组为30.9%，P = 1.00）。COVID-19组的患者在住院期间或至首次随访的中位15天内均未检测出该疾病呈阳性。
在大流行之前和期间接受手术的患者，手术等待时间、病理肿瘤大小和并发症没有差异。重要的是，没有患者因住院而感染。手术病例的显著减少令人担忧，因为未经治疗的癌症可能会在没有适当治疗的情况下进展。
