Yarikkaya Enver, Cin Merve, Ecin-Demezoglu Sena, Noyan-Mod Beste, Mahsuni Sevinc Mert, Bozkaya Yakup, Dursun-Kepkep Nevra
From the Department of Pathology, University of Health Science, Istanbul Training and Research Hospital, Istanbul, Turkey.
From the Department of Pathology, University of Health Science, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Ann Saudi Med. 2025 May-Jun;45(3):169-176. doi: 10.5144/0256-4947.2025.169. Epub 2025 Jun 5.
The coronavirus disease (COVID-19) pandemic has significantly disrupted healthcare systems, delaying the diagnosis and treatment of various diseases, including colorectal cancer (CRC).
To determine differences in patient demographics, clinical and histopathological characteristics, and survival rates in patients diagnosed with CRC before and during the first year of the pandemic.
Retrospective cohort study.
Tertiary-care center.
We included 284 patients newly diagnosed with CRC, stratified into two cohorts: those diagnosed one year before and during the first year of the pandemic. Patient demographics, tumor characteristics (diameter, location, histological type, grade, multifocality, invasion depth, lymphovascular and perineural invasion, number of metastatic lymph nodes, tumor budding, and deposits), and clinical factors (operability, presence of distant metastases, and survival status) were evaluated.
Tumor stage at diagnosis, histopathological aggressiveness, and overall survival rates.
284 patients.
Patients diagnosed during the pandemic had a significantly higher incidence of distant metastasis (14.8% vs. 5.1%, =.005), a greater proportion of pT4b stage tumors (12.9% vs. 0.6%, <.001), and a higher prevalence of rectosigmoid tumors (41.4% vs. 24.4%, =.002). Additionally, tumor budding (63.6% vs. 47.3%, =.014) and perineural invasion (35.2% vs. 24.5%, =.053) were more common in the pandemic cohort. During the pandemic, significant shifts occurred in treatment modalities (=.005), with increased utilization of neoadjuvant chemotherapy (18.8% vs. 11.5%), radiotherapy (22.7% vs. 12.2%), and palliative treatments (14.9% vs. 5.1%). Survival analysis showed no differences in survival rates between groups across all time points, including at three-year follow-up (>.05).
The COVID-19 pandemic has led to increased metastasis and advanced tumor rates in CRC cases, possibly owing to diagnostic delays. Although survival outcomes were similar between the periods, delayed effects on prognosis may manifest, necessitating long-term follow-up.
Retrospective design, single-center study.
冠状病毒病（COVID-19）大流行严重扰乱了医疗系统，延误了包括结直肠癌（CRC）在内的各种疾病的诊断和治疗。
确定在大流行第一年之前和期间被诊断为CRC的患者在人口统计学、临床和组织病理学特征以及生存率方面的差异。
回顾性队列研究。
三级医疗中心。
我们纳入了284例新诊断为CRC的患者，分为两个队列：大流行前一年和大流行第一年期间诊断的患者。评估了患者的人口统计学、肿瘤特征（直径、位置、组织学类型、分级、多灶性、浸润深度、淋巴管和神经周围浸润、转移淋巴结数量、肿瘤芽生和沉积物）以及临床因素（可切除性、远处转移的存在和生存状态）。
诊断时的肿瘤分期、组织病理学侵袭性和总生存率。
284例患者。
在大流行期间诊断的患者远处转移发生率显著更高（14.8%对5.1%，P = 0.005），pT4b期肿瘤比例更大（12.9%对0.6%，P < 0.001），直肠乙状结肠肿瘤患病率更高（41.4%对24.4%，P = 0.002）。此外，肿瘤芽生（63.6%对47.3%，P = 0.014）和神经周围浸润（35.2%对24.5%，P = 0.053）在大流行队列中更常见。在大流行期间，治疗方式发生了显著变化（P = 0.005），新辅助化疗的使用率增加（18.8%对11.5%），放疗（22.7%对12.2%）和姑息治疗（14.9%对5.1%）。生存分析显示，在所有时间点，包括三年随访时，两组之间的生存率没有差异（P > 0.05）。
COVID-19大流行导致CRC病例的转移增加和肿瘤进展率升高，可能是由于诊断延迟。尽管不同时期的生存结果相似，但对预后的延迟影响可能会显现，需要进行长期随访。
回顾性设计，单中心研究。
