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新冠疫情对结直肠癌临床和病理特征的影响:韩国一项回顾性多中心研究

Impact of COVID-19 Pandemic on the Clinical and Pathologic Characteristics of Colorectal Cancer: A Retrospective Multicenter Study in South Korea.

作者信息

Kang Jae Hyun, Son Il Tae, Yoon Sang Nam, Ihm Jin Soo, Kang Byung Mo, Kim Jong Wan

机构信息

Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-Si, Gyeonggi-Do, Republic of Korea.

Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea.

出版信息

Cancer Manag Res. 2024 Sep 4;16:1131-1139. doi: 10.2147/CMAR.S478056. eCollection 2024.

Abstract

PURPOSE

The COVID-19 pandemic has influenced various aspects of colorectal cancer (CRC) patient care, including diagnosis, treatment, and outcomes. This study assesses the pandemic's impact on CRC patients.

METHODS

We performed a retrospective analysis of medical records for CRC patients who underwent surgery at five hospitals affiliated with Hallym University from January 2017 to December 2022. Patients were divided into two groups: the pre-COVID group (2017-2019) and the COVID group (2020-2022).

RESULTS

Among 2038 patients, 987 (48.4%) were in the pre-COVID group, and 1051 (51.6%) were in the COVID group. The COVID group had more patients with two or more comorbidities (P < 0.001) and a higher incidence of rectal cancer (P = 0.010). While the rates of laparoscopic surgeries were similar, the COVID group had increased emergency surgeries (P = 0.005) and diversion procedures (P = 0.002). Additionally, the COVID group faced more overall complications (P < 0.001) and severe complications (Grade III-V, P = 0.004). There was a rise in lymphovascular invasion (P < 0.001) and T4 stage tumors (P < 0.001) within the COVID group. Despite these differences, both groups had similar 2-year overall survival rates (P = 0.409).

CONCLUSION

Although patients treated during the COVID period experienced more frequent stoma formation, complications, and adverse prognostic factors, there were no differences in short-term oncologic outcomes, which was likely due to the follow-up period being insufficient to detect differences in OS.

摘要

目的

2019冠状病毒病(COVID-19)大流行影响了结直肠癌(CRC)患者护理的各个方面,包括诊断、治疗和预后。本研究评估了大流行对CRC患者的影响。

方法

我们对2017年1月至2022年12月在翰林大学附属的五家医院接受手术的CRC患者的病历进行了回顾性分析。患者分为两组:COVID前组(2017 - 2019年)和COVID组(2020 - 2022年)。

结果

在2038例患者中,987例(48.4%)在COVID前组,1051例(51.6%)在COVID组。COVID组有更多患有两种或更多合并症的患者(P < 0.001),直肠癌发病率更高(P = 0.010)。虽然腹腔镜手术的比例相似,但COVID组的急诊手术(P = 0.005)和改道手术(P = 0.002)有所增加。此外,COVID组面临更多的总体并发症(P < 0.001)和严重并发症(III - V级,P = 0.004)。COVID组内淋巴管侵犯(P < 0.001)和T4期肿瘤(P < 0.001)有所增加。尽管存在这些差异,但两组的2年总生存率相似(P = 0.409)。

结论

尽管在COVID期间接受治疗的患者造口形成、并发症和不良预后因素更为频繁,但短期肿瘤学结局并无差异,这可能是由于随访期不足以检测总生存期的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43c4/11380852/9f249cc1f7a9/CMAR-16-1131-g0001.jpg

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