Gaurav Vidyadhar Kulkarni, Narenkumar Kumaran, Ashish Prabhakar Kelkar
Department of General and Colorectal Surgery, Kettering General Hospital, Kettering, East Midlands, United Kingdom.
Galen Med J. 2024 Feb 26;13:e3305. doi: 10.31661/gmj.v13i.3305. eCollection 2024.
We investigated the effects of COVID-19-related delay on two-year outcomes of colon cancer treatment during the first wave of the pandemic.
Ninety-two patients were referred for bowel cancer at our National Health Service (NHS) trust between March and July 2020, and 41 patients were treated for colon cancer and followed up (a two-year) through a multidisciplinary team (MDT). Treatment delays and overall survival (OS) were also assessed.
Treatment delays were observed in 48% of patients. The average delay was 31 days beyond the 62-day mark (P0.001). Logistic and binary logistic regression models showed that a comorbid diagnosis of respiratory disease had a significant effect on delays in management and two-year outcomes (P=0.04), but without the likelihood of upstaging or a poorer outcome (P=0.942). The overall survival rate was 81.5%. Eight percent of bowel cancer surgeries could have been avoided if endoscopic visualization and biopsy were available, and 8% more surgeries could have been performed laparoscopically without fear of surrounding aerosols.
The findings showed that oncologic care provided minimal disruption to trust during the COVID-19 pandemic owing to a quick association between the NHS site and a green non-NHS site, resulting in acceptable two-year outcomes for colon cancer patients.
我们调查了在疫情第一波期间,2019冠状病毒病(COVID-19)相关延误对结肠癌治疗两年期结果的影响。
2020年3月至7月期间,92例患者被转诊至我们国民健康服务体系(NHS)信托机构进行肠癌治疗,其中41例结肠癌患者接受了治疗,并通过多学科团队(MDT)进行了(为期两年的)随访。同时评估了治疗延误情况和总生存期(OS)。
48%的患者出现了治疗延误。平均延误超过62天的时间为31天(P<0.001)。逻辑回归模型和二元逻辑回归模型显示,呼吸系统疾病的合并诊断对治疗延误和两年期结果有显著影响(P=0.04),但不会导致分期升级或预后较差(P=0.942)。总生存率为81.5%。如果有内镜可视化和活检手段,8%的肠癌手术本可避免,另外8%的手术本可在不担心周围气溶胶的情况下进行腹腔镜手术。
研究结果表明,在COVID-19大流行期间,由于NHS机构与非NHS绿色机构之间的快速联合,肿瘤护理对信托机构的干扰最小,结肠癌患者的两年期结果可以接受。