Elective Surgical Experience During COVID Pandemic at a Tertiary Cancer Care Centre in India: A Retrospective Analysis

Roy, Sirshendu; Dhondge, Rajendra; Adhav, Aditya; Manke, Aditya; Banswal, Lalit; Upwanshi, Manish; Kulkarni, Nayana; Tandale, Ravindra; Bang, Yogesh A.; Pasumarthi, Lalitha Shankar; Subramaniam, Anuraag; Rajpari, Kamil N.; Yajurvedi, Pranay; Ansari, Shoeb; Wankhede, Bhushan; Nagarkar, Raj

doi:10.1007/s13193-021-01403-8

Cited by 7 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The timeline included two major peaks and two major nationwide lockdowns. Although some centres reported continuation of the cancer care during the Covid-19 pandemic with outcomes comparable to pre-Covid era, the results were heterogeneous and could not be generalised [ 17 – 21 ]. Gastrointestinal cancers represent 20% of all the malignancies in India, out of which nearly 20% would need early surgery [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey

Parray

Chaudhari

Bhandare

et al. 2022

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. Methods A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. Results There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. Conclusion Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s00423-022-02675-6.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey

Parray

Chaudhari

Bhandare

et al. 2022

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…The detailed characteristics of the included studies are shown in Table 1 . There were 16 case report [ 16 , 32 , 46 , 48 – 50 , 52 , 54 , 55 , 59 , 66 , 67 , 71 , 75 , 82 , 84 ], 9 case series, 41 cohort [ 8 – 17 , 23 , 25 , 26 , 29 , 31 , 34 , 43 – 45 , 51 , 53 , 56 – 58 , 60 – 65 , 68 – 70 , 73 , 74 , 77 , 79 , 80 , 83 , 85 ], 2 cross-sectional [ 72 , 76 ] and 1 case–control [ 81 ] studies. These studies were conducted in China ( n = 15), Italy ( n = 8), United States ( n = 6), United Kingdom ( n = 6), Spain ( n = 5), India ( n = 4), France ( n = 3), Turkey ( n = 2), Brazil ( n = 2), Japan ( n = 2), Colombia ( n = 1), Philippines ( n = 1), Poland ( n = 1), Iran ( n = 1), The Netherlands ( n = 1), Belgium ( n = 1), United Arab Emirates ( n = 1), Mexico ( n = 1), Sweden ( n = 1), Austria ( n = 1), Hungary ( n = 1), Australia ( n = 1), and Chile ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Few studies were made within multi-countries ( n = 3) [ 9 , 12 , 51 ]. The majority of the studies were single centre [ 11 , 16 , 23 , 25 , 27 , 28 , 30 – 35 , 44 – 50 , 52 , 54 , 55 , 58 , 59 , 61 – 63 , 65 – 69 , 71 , 72 , 74 – 76 , 78 , 80 , 82 – 84 ] and only 25 studies were multi-centre [ 8 – 10 , 12 – 17 , 26 , 29 , 36 , 43 , 51 , 53 , 56 , 57 , 60 , 64 , 70 , 73 , 77 , 79 , 81 , 85 ]. The median NOS score for these studies was 6 (range, 5–7).…”

Section: Resultsmentioning

confidence: 99%

“…In community-acquired infected SARS-CoV-2 patients, subgroup analysis showed some difference in the rates between all patients (Asia, Europe and America groups) [ 8 , 11 , 13 – 17 , 23 , 28 , 29 , 33 , 34 , 43 – 45 , 58 , 62 – 65 , 70 , 76 , 81 , 86 ]; and the Asia group [(9.1% (95% CI 6.1 to 12.2, n = 252, 10 studies, I 2 = 97%)] [ 11 , 15 – 17 , 23 , 28 , 45 , 58 , 65 , 86 ]; Europe group [(7.7% (95% CI 3.9 to 11.4, n = 801, 8 studies, I 2 = 99%)] [ 8 , 14 , 29 , 33 , 34 , 43 , 44 , 64 ]; and America group [7.0% (95% CI 3.2 to 10.7, n = 229, 6 studies, I 2 = 96%)] [ 13 , 62 , 63 , 70 , 76 , 81 ], respectively; Fig. 3 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Colorectal cancer in patients with SARS-CoV-2: a systematic review and meta-analysis

Alhumaid

Mutair

Busubaih

et al. 2022

Infect Agents Cancer

View full text Add to dashboard Cite

Background Patients with colorectal cancer (CRC) are more likely to develop severe course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and experience increased risk of mortality compared to SARS-CoV-2 patients without CRC. Objectives To estimate the prevalence of SARS-CoV-2 infection in CRC patients and analyse the demographic parameters, clinical characteristics and treatment outcomes in CRC patients with COVID-19 illness. Methods For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature for studies on the incidence of SARS-CoV-2 infection in CRC patients, published from December 1, 2019 to December 31, 2021, with English language restriction. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). Sub-group analyses were performed to minimize heterogeneity. Binary logistic regression model was used to explore the effect of various demographic and clinical characteristics on patient’s final treatment outcome (survival or death). Results Of the 472 papers that were identified, 69 articles were included in the systematic review and meta-analysis (41 cohort, 16 case-report, 9 case-series, 2 cross-sectional, and 1 case-control studies). Studies involving 3362 CRC patients with confirmed SARS-CoV-2 (all patients were adults) were analyzed. The overall pooled proportions of CRC patients who had laboratory-confirmed community-acquired and hospital-acquired SARS-CoV-2 infections were 8.1% (95% CI 6.1 to 10.1, n = 1308, 24 studies, I2 98%, p = 0.66), and 1.5% (95% CI 1.1 to 1.9, n = 472, 27 studies, I2 94%, p < 0.01). The median patient age ranged from 51.6 years to 80 years across studies. The majority of the patients were male (n = 2243, 66.7%) and belonged to White (Caucasian) (n = 262, 7.8%), Hispanic (n = 156, 4.6%) and Asian (n = 153, 4.4%) ethnicity. The main source of SARS-CoV-2 infection in CRC patients was community-acquired (n = 2882, 85.7%; p = 0.014). Most of those SARS-CoV-2 patients had stage III CRC (n = 725, 21.6%; p = 0.036) and were treated mainly with surgical resections (n = 304, 9%) and chemotherapies (n = 187, 5.6%), p = 0.008. The odd ratios of death were significantly high in patients with old age (≥ 60 years) (OR 1.96, 95% CI 0.94–0.96; p < 0.001), male gender (OR 1.44, 95% CI 0.41–0.47; p < 0.001) CRC stage III (OR 1.54, 95% CI 0.02–1.05; p = 0.041), CRC stage IV (OR 1.69, 95% CI 0.17–1.2; p = 0.009), recent active treatment with chemotherapies (OR 1.35, 95% CI 0.5–0.66; p = 0.023) or surgical resections (OR 1.4, 95% CI 0.8–0.73; p = 0.016) and admission to ICU (OR 1.88, 95% CI 0.85–1.12; p < 0.001) compared to those who survived. Conclusion SARS-CoV-2 infection in CRC patient is not uncommon and results in a mortality rate of 26.2%. Key determinants that lead to increased mortality in CRC patients infected with COVID-19 include older age (≥ 60 years old); male gender; Asian and Hispanic ethnicity; if SARS-CoV-2 was acquired from hospital source; advanced CRC (stage III and IV); if patient received chemotherapies or surgical treatment; and if patient was admitted to ICU, ventilated or experienced ARDS.

show abstract

“…Although some centres reported continuation of the cancer care during the Covid-19 pandemic with outcomes comparable to pre-Covid era, the results were heterogeneous and could not be generalised. [17][18][19][20][21] Gastrointestinal cancers represent 20% of all the malignancies in India, out of which nearly 20% would need early surgery. [22] Moreover, there was about 80% decrease in endoscopic procedures worldwide in the early part of Covid-19 pandemic that seriously impacted the number of newly diagnosed gastrointestinal cases.…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on Gastrointestinal Cancer Surgery: A National Survey

Parray,

Chaudhari,

Bhandare

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers.Methods: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era.Results: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by esophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3(18%) centres reported higher morbidity, while rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however 6 (37%) centres reported slightly higher mortality in the active Covid phase.Conclusion: Covid -19 pandemic resulted in significant reduction is new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid -19 exposure.

show abstract

Elective Surgical Experience During COVID Pandemic at a Tertiary Cancer Care Centre in India: A Retrospective Analysis

Cited by 7 publications

References 22 publications

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey

Colorectal cancer in patients with SARS-CoV-2: a systematic review and meta-analysis

Impact of Covid-19 on Gastrointestinal Cancer Surgery: A National Survey

Contact Info

Product

Resources

About