Critical care for lung cancer patients: surgical treatment during COVID-19 pandemic

Abstract

BACKGROUND: During the COVID-19 pandemic, some factors have led to changes in the management of patients with lung cancer. In our study, we aimed to present our surgical treatment approach to patients with NSCLC during the COVID-19 pandemic. METHODS: Patients who underwent surgery for NSCLC in our thoracic surgery clinic between March 2020 and March 2021 were evaluated retrospectively. The patients operated on were retrospectively evaluated in terms of sex, age, tumor staging, lung resection type, histopathological type, COVID-19 status, length of stay, complications, and mortality. RESULTS: Thirty-fi ve patients, 27 men and 8 women, underwent surgery for lung cancer. The 2 most common types of surgery were lobectomy (in 32 patients) and pneumonectomy (in 3 patients). According to cancer staging based on 8th TNM, 14 patients were stage 2B, 12 patients were stage 2A, and 9 patients were stage 3A. The morbidity rate was 14 %. No postoperative mortality was observed. Nine patients had a history of COVID-19 before surgery. No signifi cant difference was found in terms of complications in patients with a preoperative history of COVID-19. In the postoperative period, COVID-19 was observed in no patient in our clinic. CONCLUSION: We think that surgical treatments should not be postponed for diseases such as lung cancer, where the mortality rate is high and early diagnosis and treatment are very important. There will be no delay or inadequacy in the treatment of patients if the rules determined during the COVID-19 pandemic and other types of pandemic possibly occurring in the future are followed (Tab. 1, Ref. 23).

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“…An analogous study consisting of 35 NSCLC patients undergoing surgical resection at a single centre in Turkey from 2020 to 2021 reported 0% and 14% rates of postoperative mortality and morbidity, respectively. There was no significant difference in complications in patients with a preoperative history of COVID-19 [ 41 ]. Finally, utilizing the Polish National Lung Cancer Registry, Piwkowski et al [ 25 ] reported a 20.5% overall reduction in the number of lung cancer procedures, with no difference in rates of in-hospital mortality and decreased hospital length of stay during the pandemic.…”