Yi Jae Pak, Yoon Chang Ik, Lim Su Hyun, Choi Hoon, Oh Se Jeong, Kim Hyobin, Park Dae Sun, Baek Jong Min, Kim Yong-Seok, Jeon Ye Won, Rhu Jiyoung, Kang Young-Joon
Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
Ann Surg Oncol. 2025 Mar;32(3):2029-2037. doi: 10.1245/s10434-024-16645-3. Epub 2024 Dec 4.
The coronavirus disease 2019 (COVID-19) pandemic has globally impacted healthcare systems, delaying cancer screening, diagnosis, and treatment. South Korea experienced a 3-month lockdown during the peak of the pandemic, leading to postponements in breast cancer diagnosis and treatment. Although the pandemic's severity has decreased, addressing the treatment gap remains a concern.
This retrospective cohort study included patients diagnosed with breast cancer at five academic hospitals in South Korea during the pre-COVID (May-July 2019) and COVID (May-July 2020) periods. The primary endpoint was recurrence-free survival (RFS), and secondary endpoints included overall survival (OS), stage distribution, and age subgroup analyses.
Among 716 patients (374 pre-COVID, 342 COVID), the 3-year RFS was significantly lower in the COVID group (88.3 vs. 89.7%, p = 0.030), while the 3-year OS was similar between groups (96.2 vs. 95.5%, p = 0.439). Age subgroup analysis revealed a significant RFS difference in patients under 65 years of age (p = 0.005) but not in those aged 65 years and older (p = 0.682). Stage distribution did not differ significantly between groups (p = 0.531).
The COVID-19 pandemic adversely affected 3-year RFS, especially among younger patients, despite no significant increase in advanced-stage distribution. Timely cancer screening remains crucial for young patients with fewer infectious disease complications.
2019冠状病毒病（COVID-19）大流行在全球范围内对医疗系统产生了影响，延误了癌症筛查、诊断和治疗。韩国在疫情高峰期经历了为期3个月的封锁，导致乳腺癌诊断和治疗推迟。尽管疫情的严重程度有所下降，但解决治疗差距仍是一个令人担忧的问题。
这项回顾性队列研究纳入了在韩国五家学术医院于COVID-19之前（2019年5月至7月）和COVID-19期间（2020年5月至7月）被诊断为乳腺癌的患者。主要终点是无复发生存期（RFS），次要终点包括总生存期（OS）、分期分布和年龄亚组分析。
在716例患者中（374例COVID-19之前，342例COVID-19期间），COVID-19组的3年RFS显著较低（88.3%对89.7%，p = 0.030），而两组之间的3年OS相似（96.2%对95.5%，p = 0.439）。年龄亚组分析显示，65岁以下患者的RFS存在显著差异（p = 0.005），而65岁及以上患者则无显著差异（p = 0.682）。两组之间的分期分布无显著差异（p = 0.531）。
尽管晚期分布没有显著增加，但COVID-19大流行对3年RFS产生了不利影响，尤其是在年轻患者中。对于感染性疾病并发症较少的年轻患者，及时进行癌症筛查仍然至关重要。
