Cazacu Sergiu Marian, Rogoveanu Ion, Turcu-Stiolica Adina, Vieru Alexandru Marian, Gabroveanu Anca, Popa Petrică, Pirscoveanu Mircea, Cartu Dan, Streba Liliana
Gastroenterology Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Romania.
Biostatistics Department, University of Medicine and Pharmacy Craiova, Petru Rares Street No 2-4, 200349 Craiova, Romania.
Healthcare (Basel). 2025 Apr 3;13(7):805. doi: 10.3390/healthcare13070805.
: Gastrointestinal tract cancers may have been severely affected by the COVID-19 pandemic. The limitations of digestive endoscopy, the fear effect, and restrictions on hospital admissions during the pandemic may have delayed the presentation of patients to hospitals and surgical procedures and may have impacted overall survival. : We conducted an observational, cross-sectional study of esophageal, gastric, small bowel, and colorectal cancer patients admitted to our hospital between 1 January 2018 and 31 December 2021. We analyzed the hospitalization rates, pathological type, the onset by complications, staging, and surgery during the pandemic compared to a pre-pandemic period (January 2018-December 2019). : During 2018-2021, 1613 patients with malignant gut tumors were admitted to our hospital (112 esophageal and eso-cardial tumors, 419 gastric tumors, 34 small bowel tumors, and 1058 colorectal tumors). Admission was reduced by 30.3% for esophageal and eso-cardial malignant tumors, 27.6% for gastric tumors, and 17.3% for malignant colorectal tumors. For esophageal and eso-cardial tumors, a higher frequency of stenosing tumors and palliative gastrostomies was noted. More stage III gastric cancers and a lower rate of vascular invasion were recorded during the pandemic. No differences regarding small bowel tumors were noted. In colorectal tumors, slightly more stage II cancers and more stenosing tumors were recorded, but occlusive, bleeding, and perforated tumors were similar; also, surgical rates were similar, with a two-fold higher perioperative mortality. The overall survival of gastric and colorectal carcinoma was higher during the pandemic (but with no statistical significance), although a clear explanation has not emerged. : The impact of the COVID-19 pandemic on gut cancer included a significantly lower rate of newly diagnosed admissions, more stage II colorectal and stage III gastric carcinomas, a two-fold higher perioperative mortality for colorectal carcinoma, and a trend for a surprisingly higher overall survival for gastric and colorectal tumors (but without statistical significance). Future research is necessary for assessing long-term impact.
胃肠道癌症可能受到了新冠疫情的严重影响。消化内镜检查的局限性、恐惧效应以及疫情期间对住院的限制，可能导致患者延迟就医和接受手术治疗，进而可能影响总体生存率。
我们对2018年1月1日至2021年12月31日期间入住我院的食管癌、胃癌、小肠癌和结直肠癌患者进行了一项观察性横断面研究。我们分析了疫情期间与疫情前时期（2018年1月至2019年12月）相比的住院率、病理类型、并发症发病情况、分期以及手术情况。
2018年至2021年期间，我院收治了1613例肠道恶性肿瘤患者（112例食管和食管贲门肿瘤、419例胃癌、34例小肠肿瘤和1058例结直肠癌）。食管和食管贲门恶性肿瘤的入院人数减少了30.3%，胃癌减少了27.6%，结直肠癌恶性肿瘤减少了17.3%。对于食管和食管贲门肿瘤，狭窄性肿瘤和姑息性胃造口术的发生率较高。疫情期间记录到更多的III期胃癌和较低的血管侵犯率。小肠肿瘤方面未发现差异。在结直肠癌中，记录到的II期癌症略多，狭窄性肿瘤也更多，但闭塞性、出血性和穿孔性肿瘤相似；此外，手术率相似，围手术期死亡率高出两倍。疫情期间胃癌和结直肠癌的总体生存率较高（但无统计学意义），尽管尚未找到明确的解释。
新冠疫情对肠道癌症的影响包括新诊断入院率显著降低、II期结直肠癌和III期胃癌增多、结直肠癌围手术期死亡率高出两倍，以及胃癌和结直肠癌总体生存率出人意料地呈上升趋势（但无统计学意义）。有必要开展进一步研究以评估长期影响。
