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奥密克戎大流行和新冠疫苗接种对胰腺腺癌患者的影响。

The impact of Omicron pandemic and COVID-19 vaccination on the pancreatic adenocarcinoma patients.

作者信息

Fu Ningzhen, Jiang Yu, Xu Zhiwei, Yang Meng, Peng Chenghong, Deng Xiaxing, Zhao Shulin, Shen Baiyong

机构信息

Department of General Surgery Pancreatic Disease Center Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai China.

Research Institute of Pancreatic Disease Shanghai Jiaotong University School of Medicine Shanghai China.

出版信息

Aging Cancer. 2022 Sep-Dec;3(3-4):161-168. doi: 10.1002/aac2.12056. Epub 2022 Dec 8.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic resulted in enormous medical and economic burden worldwide during the past 3 years. The vaccination was deemed the effective option to prevent the severe symptoms, and especially recommended among cancer patients. Shanghai experienced the first lockdown during the recent Omicron pandemic since 2019. How patients with pancreatic adenocarcinoma (PAC) suffered from the pandemic and how vaccination influenced their oncological outcomes were unexplored yet.

METHOD

The retrospective study was carried out in a high-volume referral center including 1157 consecutively enrolled patients with PAC experiencing the COVID-19 pandemic. The primary outcome was the overall survival (OS).

RESULTS

Limited postoperative patients (9.21%) received the vaccination. The lockdown in Shanghai (April to May, 2022) was not observed impacting the survival prognoses of patients with PAC. Though vaccination was not significantly associated with OS itself (adjusted hazard ratio (aHR): 2.032 [0.940-4.391], 0.071), it was discovered to synergistically improve the chemotherapy effect in the multivariate analyses (interaction 0.023).

CONCLUSION

The vaccination itself did not influence the survival prognoses of patients with PAC. A potential positive interaction was observed between chemotherapy and vaccination despite the limited follow-up time. The postoperative patients should consider the vaccination more. The patients with PAC did not suffer worse prognostic outcomes from the strict sanitary policy during the wave of COVID-19 pandemic in Shanghai.

摘要

背景

2019年冠状病毒病(COVID-19)大流行在过去3年给全球带来了巨大的医疗和经济负担。疫苗接种被认为是预防严重症状的有效选择,尤其在癌症患者中被推荐。上海在2019年以来最近一次奥密克戎大流行期间经历了首次封控。胰腺腺癌(PAC)患者在大流行中如何患病以及疫苗接种如何影响他们的肿瘤学结局尚未得到探索。

方法

在一家大型转诊中心对1157例连续入组的经历COVID-19大流行的PAC患者进行了回顾性研究。主要结局是总生存期(OS)。

结果

仅有少数术后患者(9.21%)接种了疫苗。未观察到上海的封控(2022年4月至5月)对PAC患者的生存预后产生影响。尽管疫苗接种本身与OS无显著关联(调整后风险比(aHR):2.032 [0.940 - 4.391],P = 0.071),但在多变量分析中发现它能协同改善化疗效果(交互作用P = 0.023)。

结论

疫苗接种本身并未影响PAC患者的生存预后。尽管随访时间有限,但观察到化疗与疫苗接种之间存在潜在的积极交互作用。术后患者应更多地考虑接种疫苗。在上海COVID-19大流行期间的严格卫生政策下,PAC患者并未出现更差的预后结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45cd/9878165/83467daf7eaf/AAC2-3-161-g002.jpg

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