Mukherjee Amrita, Ayoub Natalie, Xu Lanfang, Cannavale Kimberly L, Gilfillan Alec D, Szamreta Elizabeth A, Monberg Matthew J, Hodeib Melissa, Chao Chun R
Kaiser Permanente Southern California, Pasadena, CA, USA.
Adventist Health White Memorial Medical Center, Los Angeles, CA, USA.
Gynecol Oncol Rep. 2025 May 6;59:101763. doi: 10.1016/j.gore.2025.101763. eCollection 2025 Jun.
The coronavirus diseases 2019 (COVID-19) pandemic was associated with disruption of oncology care and increased utilization of telehealth. However, the impact of the pandemic on cancer outcomes is under-studied. We evaluated the impact of the COVID-19 pandemic on recurrence rates in ovarian cancer patients in a retrospective cohort study. Women (age ≥ 18 years) diagnosed with stage I-IV epithelial ovarian cancer between 01/01/2017-06/30/2021 at Kaiser Permanente Southern California who received chemotherapy and/or surgery; and achieved complete remission following first-line treatment were included. The pre-pandemic and pandemic periods were defined based on the date of implementation of stay-at-home order in California (03/04/2020). Chart reviews were conducted to determine recurrence within 12 months of remission by physician notes, imaging findings, or CA125 levels. A total of 548 patients were included; 73.4 % and 26.6 % patients were diagnosed during the pre-pandemic and pandemic periods, respectively. About a quarter of the patients had cancer recurrence within 12 months of remission; 25.6 % and 19.2 % of patients diagnosed in the pre-pandemic and pandemic periods had recurrence, respectively (p-value = 0.12). Patients diagnosed during the pandemic were 35 % less likely to have recurrence than those in the pre-pandemic period, after adjusting for age, race/ethnicity, cancer stage, and time to treatment. Additionally adjusting for poly-ADP ribose polymerase (PARP) inhibitors in patients with stage II-IV cancer led to similar findings. In conclusion, ovarian cancer patients diagnosed and treated during the COVID-19 pandemic at KPSC did not have a higher recurrence rate than patients in the pre-pandemic period, despite changes in management approach.
2019年冠状病毒病(COVID-19)大流行与肿瘤护理中断及远程医疗利用率增加有关。然而,大流行对癌症结局的影响研究不足。我们在一项回顾性队列研究中评估了COVID-19大流行对卵巢癌患者复发率的影响。纳入了2017年1月1日至2021年6月30日期间在南加州凯撒医疗机构被诊断为I-IV期上皮性卵巢癌并接受化疗和/或手术治疗,且一线治疗后达到完全缓解的18岁及以上女性。根据加利福尼亚州居家令实施日期(2020年3月4日)确定大流行前和大流行期间。通过医生记录、影像学检查结果或CA125水平进行病历审查,以确定缓解后12个月内的复发情况。共纳入548例患者;分别有73.4%和26.6%的患者在大流行前和大流行期间被诊断。约四分之一的患者在缓解后12个月内出现癌症复发;大流行前和大流行期间诊断的患者复发率分别为25.6%和19.2%(p值=0.12)。在调整年龄、种族/民族、癌症分期和治疗时间后,大流行期间诊断的患者复发可能性比大流行前的患者低35%。在II-IV期癌症患者中进一步调整聚ADP核糖聚合酶(PARP)抑制剂的使用情况,结果相似。总之,尽管管理方式有所变化,但在KPSC接受诊断和治疗的COVID-19大流行期间的卵巢癌患者复发率并不高于大流行前的患者。
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