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系统评价和荟萃分析确定实施的 COVID-19 指南对肿瘤外科学量和临床结果的影响。

Systematic review and meta-analysis determining the effect of implemented COVID-19 guidelines on surgical oncology volumes and clinical outcomes.

机构信息

Department of Surgery, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.

Department of Surgery, Cancer Center, University Medical Center Utrecht, Utrecht, the Netherlands.

出版信息

Surg Oncol. 2022 Dec;45:101859. doi: 10.1016/j.suronc.2022.101859. Epub 2022 Oct 4.


DOI:10.1016/j.suronc.2022.101859
PMID:36242979
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9529677/
Abstract

BACKGROUND: To provide for Coronavirus Disease 2019 (COVID-19) healthcare capacity, (surgical oncology) guidelines were established, forcing to alter the timing of performing surgical procedures. It is essential to determine whether these guidelines have led to disease progression. This study aims to give an insight into the number of surgical oncology procedures performed during the pandemic and provide information on short-term clinical outcomes. MATERIALS AND METHODS: A systematic literature search was performed on all COVID-19 articles including operated patients, published before March 21, 2022. Meta-analysis was performed to visualize the number of performed surgical oncology procedures during the pandemic compared to the pre-pandemic period. Random effects models were used for evaluating short-term clinical outcomes. RESULTS: Twenty-four studies containing 6762 patients who underwent a surgical oncology procedure during the pandemic were included. The number of performed surgical procedures for an oncological pathology decreased (-26.4%) during the pandemic. The number of performed surgical procedures for breast cancer remained stable (+0.3%). Moreover, no difference was identified in the number of ≥T2 (OR 1.00, P = 0.989), ≥T3 (OR 0.95, P = 0.778), ≥N1 (OR 1.01, P = 0.964) and major postoperative complications (OR 1.55, P = 0.134) during the pandemic. CONCLUSION: The number of performed surgical oncology procedures during the COVID-19 pandemic decreased. In addition, the number of performed surgical breast cancer procedures remained stable. Oncological staging and major postoperative complications showed no significant difference compared to pre-pandemic practice. During future pandemics, the performed surgical oncology practice during the first wave of the COVID-19 pandemic seems appropriate for short-term results.

摘要

背景:为了应对 2019 年冠状病毒病(COVID-19)的医疗保健能力,制定了(肿瘤外科)指南,这迫使手术程序的时间发生改变。确定这些指南是否导致疾病进展至关重要。本研究旨在深入了解大流行期间进行的肿瘤外科手术数量,并提供有关短期临床结果的信息。

材料和方法:对所有包括手术患者的 COVID-19 文章进行了系统的文献检索,这些文章发表于 2022 年 3 月 21 日之前。进行荟萃分析以可视化大流行期间与大流行前相比进行的肿瘤外科手术数量。使用随机效应模型评估短期临床结果。

结果:纳入了 24 项研究,共包含 6762 名在大流行期间接受肿瘤外科手术的患者。大流行期间进行的肿瘤外科手术数量减少了(-26.4%)。乳腺癌手术数量保持稳定(+0.3%)。此外,≥T2(OR 1.00,P=0.989)、≥T3(OR 0.95,P=0.778)、≥N1(OR 1.01,P=0.964)和主要术后并发症(OR 1.55,P=0.134)的数量在大流行期间没有差异。

结论:COVID-19 大流行期间进行的肿瘤外科手术数量减少。此外,乳腺癌手术数量保持稳定。与大流行前的实践相比,肿瘤分期和主要术后并发症没有显著差异。在未来的大流行中,COVID-19 大流行第一波期间进行的肿瘤外科手术实践似乎对短期结果是合适的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/70a2b5c1df59/gr3d_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/b2925428b93b/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/ad8834c9467b/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/51fd3f85ab3f/gr3a_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/008381766676/gr3b_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/29d502593dc6/gr3c_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/70a2b5c1df59/gr3d_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/b2925428b93b/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/ad8834c9467b/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/51fd3f85ab3f/gr3a_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/008381766676/gr3b_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/29d502593dc6/gr3c_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/9529677/70a2b5c1df59/gr3d_lrg.jpg

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[8]
Association between COVID-19 and Postoperative Neurological Complications and Antipsychotic Medication Use after Cancer Surgery: A Retrospective Study.

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本文引用的文献

[1]
Impact of COVID-19 and suspension of colorectal cancer screening on incidence and stage distribution of colorectal cancers in the Netherlands.

Eur J Cancer. 2022-1

[2]
Collateral damage of COVID-19 pandemic: The impact on a gynecologic surgery department.

J Gynecol Obstet Hum Reprod. 2022-1

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Oral Oncol. 2021-11

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N Engl J Med. 2021-11-4

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ANZ J Surg. 2021-7

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JAMA Netw Open. 2021-5-3

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Care as Usual: An Acceptable Strategy to Apply During the COVID-19 Pandemic in a French Tertiary Gynecologic Oncology Department.

Front Oncol. 2021-4-21

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Delay to surgical treatment in lung cancer patients and its impact on survival in a video-assisted thoracoscopic lobectomy cohort.

Sci Rep. 2021-3-1

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