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2019年冠状病毒病大流行对公共医疗背景下肿瘤PET/CT分期成像及患者预后的影响:大流行头两年的概述与随访

Impact of the COVID-19 Pandemic on Staging Oncologic PET/CT Imaging and Patient Outcome in a Public Healthcare Context: Overview and Follow Up of the First Two Years of the Pandemic.

作者信息

Kohan Andres, Menon Sumesh, Murad Vanessa, Mirshahvalad Seyed Ali, Kulanthaivelu Roshini, Farag Adam, Ortega Claudia, Metser Ur, Veit-Haibach Patrick

机构信息

Toronto Joint Department Medical Imaging, University Health Network, Sinai Health System, Women's College Hospital, University Medical Imaging Toronto, Toronto, ON M5T 1W7, Canada.

出版信息

Cancers (Basel). 2023 Nov 10;15(22):5358. doi: 10.3390/cancers15225358.

Abstract

To assess the impact of the COVID-19 pandemic on the diagnosis, staging and outcome of a selected population throughout the first two years of the pandemic, we evaluated oncology patients undergoing PET/CT at our institution. A retrospective population of lung cancer, melanoma, lymphoma and head and neck cancer patients staged using PET/CT during the first 6 months of the years 2019, 2020 and 2021 were included for analysis. The year in which the PET was performed was our exposure variable, and our two main outcomes were stage at the time of the PET/CT and overall survival (OS). A total of 1572 PET/CTs were performed for staging purposes during the first 6 months of 2019, 2020 and 2021. The median age was 66 (IQR 16), and 915 (58%) were males. The most prevalent staged cancer was lung cancer (643, 41%). The univariate analysis of staging at PET/CT and OS by year of PET/CT were not significantly different. The multivariate Cox regression of non-COVID-19 significantly different variables at univariate analysis and the year of PET/CT determined that lung cancer (HR 1.76 CI95 1.23-2.53, < 0.05), stage III (HR 3.63 CI95 2.21-5.98, < 0.05), stage IV (HR 11.06 CI95 7.04-17.36, < 0.05) and age at diagnosis (HR 1.04 CI95 1.02-1.05, < 0.05) had increased risks of death. We did not find significantly higher stages or reduced OS when assessing the year PET/CT was performed. Furthermore, OS was not significantly modified by the year patients were staged, even when controlled for non-COVID-19 significant variables (age, type of cancer, stage and gender).

摘要

为评估2019冠状病毒病大流行头两年对特定人群的诊断、分期及预后的影响,我们对在本机构接受正电子发射断层扫描/计算机断层扫描(PET/CT)的肿瘤患者进行了评估。纳入分析的是2019年、2020年和2021年头6个月期间使用PET/CT进行分期的肺癌、黑色素瘤、淋巴瘤及头颈癌患者的回顾性队列。进行PET检查的年份是我们的暴露变量,我们的两个主要结局是PET/CT检查时的分期和总生存期(OS)。2019年、2020年和2021年头6个月期间,共进行了1572次用于分期目的的PET/CT检查。中位年龄为66岁(四分位间距16岁),915例(58%)为男性。最常见的分期癌症是肺癌(643例,41%)。按PET/CT年份对PET/CT分期和OS进行的单因素分析无显著差异。对单因素分析中无COVID-19显著差异的变量及PET/CT年份进行多因素Cox回归分析,结果显示肺癌(风险比[HR]1.76,95%置信区间[CI]1.23 - 2.53,P<0.05)、III期(HR 3.63,CI95 2.21 - 5.98,P<0.05)、IV期(HR 11.06,CI95 7.04 - 17.36,P<0.05)及诊断时年龄(HR 1.04,CI95 1.02 - 1.05,P<0.05)的死亡风险增加。在评估进行PET/CT的年份时,我们未发现分期显著升高或总生存期缩短。此外,即使对非COVID-19显著变量(年龄、癌症类型、分期和性别)进行控制,患者分期年份对总生存期也无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8177/10670509/7f5fc005719d/cancers-15-05358-g001.jpg

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