Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
Institute of Molecular Oncology, Philipps-University Marburg, Hans-Meerwein-Straße 3, 35043, Marburg, Germany.
J Cancer Res Clin Oncol. 2023 Oct;149(13):11749-11757. doi: 10.1007/s00432-023-05065-7. Epub 2023 Jul 5.
This study investigates the impact of the COVID-19 pandemic on breast cancer (BC) care, analyzing treatment delays and factors associated with them.
This retrospective cross-sectional study analyzed data from the Oncology Dynamics (OD) database. Surveys of 26,933 women with BC performed between January 2021 and December 2022 in Germany, France, Italy, the United Kingdom, and Spain were examined. The study focused on determining the prevalence of treatment delays due to the COVID-19 pandemic, considering factors such as country, age group, treating facility, hormone receptor status, tumor stage, site of metastases, and Eastern Cooperative Oncology Group (ECOG) status. Baseline and clinical characteristics were compared for patients with and without therapy delay using chi-squared tests, and a multivariable logistic regression analysis was conducted to explore the association between demographic and clinical variables and therapy delay.
The present study found that most therapy delays lasted less than 3 months (2.4%). Factors associated with higher risk of delay included being bedridden (OR 3.62; 95% CI 2.51-5.21), receiving neoadjuvant therapy (OR 1.79; 95% CI 1.43-2.24) compared to adjuvant therapy, being treated in Italy (OR 1.58; 95% CI 1.17-2.15) compared to Germany or treatment in general hospitals and non-academic cancer facilities (OR 1.66, 95% CI 1.13-2.44 and OR 1.54; 95% CI 1.14-2.09, respectively) compared to treatment by office-based physicians.
Addressing factors associated with therapy delays, such as patient performance status, treatment settings, and geographic location, can help guide strategies for improved BC care delivery in the future.
本研究旨在调查 COVID-19 大流行对乳腺癌（BC）治疗的影响，分析治疗延迟及其相关因素。
本回顾性横断面研究分析了 Oncology Dynamics（OD）数据库中的数据。对 2021 年 1 月至 2022 年 12 月期间在德国、法国、意大利、英国和西班牙进行的 26933 例 BC 女性的 OD 调查进行了分析。本研究主要关注由于 COVID-19 大流行导致治疗延迟的患病率，考虑了国家、年龄组、治疗机构、激素受体状态、肿瘤分期、转移部位和东部合作肿瘤学组（ECOG）状态等因素。使用卡方检验比较有和无治疗延迟的患者的基线和临床特征，采用多变量逻辑回归分析探讨人口统计学和临床变量与治疗延迟之间的关系。
本研究发现，大多数治疗延迟持续时间不到 3 个月（2.4%）。与延迟相关的风险较高的因素包括卧床不起（OR 3.62；95%CI 2.51-5.21）、接受新辅助治疗（OR 1.79；95%CI 1.43-2.24）而非辅助治疗、与德国相比在意大利治疗（OR 1.58；95%CI 1.17-2.15）、与综合医院和非学术癌症机构相比在普通医院和非学术癌症机构治疗（OR 1.66，95%CI 1.13-2.44 和 OR 1.54；95%CI 1.14-2.09）。
针对与治疗延迟相关的因素，如患者表现状态、治疗环境和地理位置，有助于指导未来改善 BC 治疗的策略。
