COVID-19对子宫内膜癌分期及治疗的影响：来自意大利一家综合癌症中心的癌症登记分析
Impact of COVID-19 on the Stage and Treatment of Endometrial Cancer: A Cancer Registry Analysis from an Italian Comprehensive Cancer Center.
作者信息
Roncaglia Francesca, Mangone Lucia, Marinelli Francesco, Bisceglia Isabella, Braghiroli Maria Barbara, Mastrofilippo Valentina, Morabito Fortunato, Magnani Antonia, Neri Antonino, Aguzzoli Lorenzo, Mandato Vincenzo Dario
机构信息
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
Obstetrics and Gynecological Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy.
出版信息
Cancers (Basel). 2025 Aug 18;17(16):2686. doi: 10.3390/cancers17162686.
: The COVID-19 pandemic has impacted cancer diagnosis and treatment. This study assessed the effects of the pandemic on the stage and delays between diagnosis and treatment in endometrial cancer. : The study included 543 cases diagnosed between 2017 and 2023 in a population-based cancer registry. Data on stage, diagnostic procedures, treatments, and time to surgery (TTS) were compared across the pre-COVID (2017-2019), COVID (2020-2022), and post-COVID (2023) periods. Multiple regression analysis was used to identify factors influencing TTS. : During the three periods, stages I and II showed no variation, whereas a significant increase was recorded in stage III (7.5%, 9.5%, and 17.8%, respectively; < 0.05), as well as a slight increase in grade 3 (15.4%, 13.6%, and 19.2%, respectively). A significant decrease in laparotomies (30.3%, 11.6%, and 11.0%, respectively; < 0.01) and an increase in laparoscopies (60.1%, 78.1%, and 80.8%, respectively; < 0.05) were observed. TTS decreased for interventions performed within 30 days (10.1%, 3.7%, and 1.4%, respectively; < 0.01) and within 60 days (38.6%, 19.4%, and 6.9%, respectively; < 0.01), while a significant increase was observed for >60 days (22.8%, 29.8%, and 37.0%, respectively; < 0.05) and >90 days (7.5%, 23.1%, and 20.5%, respectively; < 0.01). Multivariable analysis confirmed a reduction in TTS in the pre-COVID period (β -19.63; CI 95% -31.31; -7.95) and an increase in the post-COVID period (β 31.60; CI 95% 13.68; 49.53); while an increase was confirmed only for stage IV (β 48.80; CI 95% 23.15; 74.45). : The COVID-19 pandemic has led to an increase in more advanced cancers and delays in surgery.
新冠疫情对癌症的诊断和治疗产生了影响。本研究评估了疫情对子宫内膜癌分期以及诊断与治疗之间延迟情况的影响。
该研究纳入了2017年至2023年期间在一个基于人群的癌症登记处确诊的543例病例。对新冠疫情前（2017 - 2019年）、新冠疫情期间（2020 - 2022年）和新冠疫情后（2023年）三个时间段的分期、诊断程序、治疗方法以及手术时间（TTS）数据进行了比较。采用多元回归分析来确定影响手术时间的因素。
在这三个时间段内，I期和II期没有变化，而III期有显著增加（分别为7.5%、9.5%和17.8%；<0.05），3级也略有增加（分别为15.4%、13.6%和19.2%）。开腹手术显著减少（分别为30.3%、11.6%和11.0%；<0.01），腹腔镜手术增加（分别为60.1%、78.1%和80.8%；<0.05）。30天内进行的干预手术时间缩短（分别为10.1%、3.7%和1.4%；<0.01），60天内进行的干预手术时间也缩短（分别为38.6%、19.4%和6.9%；<0.01），而>60天（分别为22.8%、29.8%和37.0%；<0.05）和>90天（分别为7.5%、23.1%和20.5%；<0.01）的手术时间则显著增加。多变量分析证实，新冠疫情前手术时间缩短（β -19.63；95%置信区间 -31.31；-7.95），新冠疫情后手术时间增加（β 31.60；95%置信区间 13.68；49.53）；而仅IV期手术时间增加得到证实（β 48.80；95%置信区间 23.15；74.45）。
新冠疫情导致了更晚期癌症的增加以及手术延迟。
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