Carré Julia, Herzog Beatrice, Reil Daniela, Schneider Constanze, Pflüger Maren, Löbel Madlen, Herzog Michael
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Deutschland.
Klinisch-epidemiologisches Krebsregister Brandenburg-Berlin gGmbH, Dreifertstr. 12, 03044, Cottbus, Deutschland.
HNO. 2024 Feb;72(2):90-101. doi: 10.1007/s00106-023-01396-6. Epub 2023 Dec 20.
The impact of the COVID-19 pandemic on potential limitations to the diagnosis and treatment of patients with head and neck tumours has not yet been adequately investigated. There are contradictory data on this subject. Data from larger patient collectives do not exist for Germany so far.
The aim of the survey was to clarify in a large cohort whether the COVID-19 pandemic had an influence on the diagnosis and treatment of patients with head and neck tumours.
A retrospective data analysis of the reporting data of the Clinical and Epidemiological Cancer Registry of Brandenburg and Berlin (Klinisch-epidemiologischen Krebsregisters Brandenburg-Berlin, KKRBB) of 4831 cases with head and neck tumours from 2018 to 2020 was performed. The period before April 01, 2020, was evaluated as a prepandemic cohort and compared with the cases of the pandemic cohort from April 1, 2020, until December 31, 2020, in terms of patient-related baseline data, tumour location, tumour stage, tumour board and treatments administered.
No differences were observed between the prepandemic and pandemic cohorts with regard to patient-related baseline data, tumour localisation and tumour stage. Likewise, no temporal delay in diagnosis, tumour board and treatment was evident during the pandemic period. On the contrary, the time interval between diagnosis and start of therapy was shortened by an average of 2.7 days in the pandemic phase. Tumours with T4 stage were more frequently treated surgically during the pandemic compared to the period before (20.8% vs. 29.6%), whereas primary radio(chemo)therapy decreased during the pandemic (53.3% vs. 40.4%). For all other tumour stages and entities, there were no differences in treatment.
Contrary to initial speculation that the COVID-19 pandemic may have led to a decrease in tumour cases, larger tumour stages at initial presentation and a delay in diagnosis and treatment, the cohort studied for Brandenburg and Berlin showed neither a delay in tumour treatment nor an increase in tumour size and stage at initial presentation. The treatments performed, however, were subject to a change in favour of surgery and it remains to be seen whether this trend will be maintained in the long term.
新型冠状病毒肺炎(COVID-19)大流行对头颈肿瘤患者诊断和治疗潜在限制的影响尚未得到充分研究。关于这一主题的数据相互矛盾。到目前为止,德国尚无来自更大患者群体的数据。
本调查的目的是在一个大型队列中明确COVID-19大流行是否对头颈肿瘤患者的诊断和治疗有影响。
对勃兰登堡和柏林临床与流行病学癌症登记处(Klinisch-epidemiologischen Krebsregisters Brandenburg-Berlin,KKRBB)2018年至2020年4831例头颈肿瘤报告数据进行回顾性数据分析。将2020年4月1日前的时期评估为大流行前队列,并与2020年4月1日至2020年12月31日大流行队列的病例在患者相关基线数据、肿瘤位置、肿瘤分期、肿瘤多学科讨论组及所给予的治疗方面进行比较。
在患者相关基线数据、肿瘤定位和肿瘤分期方面,大流行前队列与大流行队列之间未观察到差异。同样,在大流行期间,诊断、肿瘤多学科讨论组及治疗也没有明显的时间延迟。相反,在大流行阶段,诊断与治疗开始之间的时间间隔平均缩短了2.7天。与之前时期相比,大流行期间T4期肿瘤接受手术治疗的频率更高(20.8%对29.6%),而大流行期间原发性放(化)疗减少(53.3%对40.4%)。对于所有其他肿瘤分期和类型,治疗方面没有差异。
与最初的推测相反,即COVID-19大流行可能导致肿瘤病例减少、初诊时肿瘤分期增加以及诊断和治疗延迟,针对勃兰登堡和柏林的研究队列显示,肿瘤治疗既没有延迟,初诊时肿瘤大小和分期也没有增加。然而,所进行的治疗倾向于手术,这种趋势是否会长期持续还有待观察。