Impact of COVID-19 on gastric cancer treatment in Japanese high-volume centers: a JCOG stomach cancer study group survey

Tokunaga, Masanori; Yoshikawa, Takaki; Boku, Narikazu; Nishida, Yasunori; Tanahashi, Takao; Yamada, Takanobu; Haruta, Shusuke; Etoh, Tsuyoshi; Hirahara, Noriyuki; Kawachi, Yasuyuki; Tsuji, Kiichiro; Kinoshita, Takahiro; Kanazawa, Takashi; Tokumoto, Noriaki; Fujita, Junya; Terashima, Masanori

doi:10.1007/s00595-021-02329-y

Cited by 18 publications

(20 citation statements)

References 15 publications

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“…Previous studies have shown significant decreases in GC patients of older age, early CS, and curative treatment procedures. 10,[19][20][21][22][23][24] However, previous studies showed only in a small number of facilities or in foreign countries, therefore, we revealed that the trends were consistent in the tertiary medical region covering 2.9 million populations in Japan. In addition, the change rate of each diagnostic procedure has not been studied previously, for that reason, we analyzed and found that the monthly mean of GCs decreased especially in cancer screening.…”

Section: Discussionsupporting

confidence: 41%

The impact of early‐stage COVID‐19 pandemic on the diagnosis and treatment of gastric cancer: A cross‐sectional study using a large‐scale cancer registry in Hiroshima, Japan

et al. 2022

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Background After the confirmation of coronavirus infection in Japan, a behavioral change caused people and physicians to refrain from visiting hospitals or undergoing examinations. This study aimed to assess how the trend of diagnosis in gastric cancers changed, and how it affected the therapeutic strategies and the interval from diagnosis to treatment during the COVID‐19 pandemic. Methods We use 15 cancer‐designated hospitals’ registries in Hiroshima, Japan. The target period was March to December 2020, and the same period in 2019 was set as the control period. The monthly mean of diagnoses and the interval from diagnosis to treatment were compared overall and separately by age, treatment procedure, diagnostic process, and clinical stage. Result In 2020, the monthly mean (standard deviation [SD]) of patients was 192.2 (29.9), a significant 20.1% decrease from 240.7 (20.7) in 2019 due to older age and curative treatment groups. By reason for performing endoscopy, the change rate in cancer screening, endoscopic follow‐up, and symptomatic status were ‐27.0%, ‐18.0%, and ‐17.3%, respectively. Meanwhile, the interval (days) from diagnosis to treatment (SD) was 37.8 (26.5) in 2020, significantly shorter than 46 (31.5) in 2019. Conclusion From 2019 to 2020, we observed a significant decrease in the diagnosis of curable early‐stage gastric cancer and treatments, although the interval from diagnosis to treatment decreased. This study suggests that cancer screening played a significant role in the decline in cancer diagnosis that occurred during the COVID‐19 pandemic. Even under COVID‐19 pandemic conditions, there should be an awareness of cancer screening and endoscopic follow‐up.

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Section: Discussionsupporting

confidence: 41%

The impact of early‐stage COVID‐19 pandemic on the diagnosis and treatment of gastric cancer: A cross‐sectional study using a large‐scale cancer registry in Hiroshima, Japan

et al. 2022

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“…This does not necessarily indicate that each hospital was affected equally: a questionnaire survey for gastrectomy revealed that selected high‐volume centers in Japan were differently affected by COVID‐19, with the most significant effects being observed in Tokyo. 26 …”

Section: Discussionmentioning

confidence: 99%

“…Fourth, a similar trend in the number of surgical cases was observed in areas with high infection rates and in the country as a whole. This does not necessarily indicate that each hospital was affected equally: a questionnaire survey for gastrectomy revealed that selected high‐volume centers in Japan were differently affected by COVID‐19, with the most significant effects being observed in Tokyo 26 …”

Section: Discussionmentioning

confidence: 99%

Effects of the COVID‐19 pandemic on gastroenterological surgeries in 2020: A study using the National Clinical Database of Japan

Maeda

Endo

Yamamoto

et al. 2022

Annals of Gastroent Surgery

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Aim This study aimed to investigate the effect of the coronavirus disease pandemic on the number of surgeries for gastroenterological cancer cases in Japan. Methods The data recorded in the National Clinical Database of Japan between 2018 and 2020 were utilized for this study. Five specific surgeries for primary cancers and surgery for acute diffuse peritonitis were considered the primary endpoints. We divided the study period into the prepandemic and postpandemic (after April 2020) periods and examined the number of surgeries in relation to clinical factors. Results Overall, 228 860 surgeries were analyzed. Among the five primary cancer surgeries, the number of distal gastrectomies for gastric cancer decreased the most (to 81.0% of the monthly number in the prepandemic period), followed by that of low anterior resections for rectal cancer (91.4%). In contrast, the number of pancreaticoduodenectomies for pancreatic cancer increased by 7.1%, while that of surgeries for peritonitis remained stable. This trend was observed nationwide. We also noted a marked reduction in the number of distal gastrectomy (to 72.5%), low anterior resection (84.0%), and esophagectomy (88.8%) procedures for T1 tumors. The noncurative resection rate and mortalities were low despite the increased proportion of T4 tumors and older patients. Conclusion A marked reduction in surgeries for gastric and rectal cancers with early T factors may reflect prioritization of surgeries and reduction in cancer screenings. Although the quality of the surgery was maintained in terms of reduced mortalities and morbidities, the long‐term effects of this pandemic should be monitored.

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“…In Japan, a significant decrease in the mean number of stage I gastric cancer cases and an increase in the number of symptomatic gastric cancer patients were observed during the COVID-19 pandemic from March to December 2020 [ 6 ]. In another Japanese study, the number of gastrectomies was < 80%, and there was a 50% decrease from May to August 2020 in Tokyo when compared to the previous year as determined using questionnaires [ 7 ]. However, there is little clarity on how the COVID-19 pandemic affected patients with gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Impact of the first era of the coronavirus disease 2019 pandemic on gastric cancer patients: a single-institutional analysis in Japan

et al. 2022

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Background Little is known about the disadvantages of the coronavirus disease 2019 (COVID-19) pandemic in patients with gastric cancer. This study aimed to examine the negative impact of the COVID-19 pandemic on patients with gastric cancer in the first era in Japan. Methods This retrospective study included 725 patients diagnosed with gastric cancer who visited our hospital between April 2019 and March 2021. The number of patients and their characteristics before and during the COVID-19 pandemic were compared. Results The number of patients diagnosed with gastric cancer during the COVID-19 pandemic decreased by 26.2% (from 417 to 308; p = 0.013) compared to that before the COVID-19 pandemic. There was a significant decrease in cStage I cancer and an increase in cStage III cancer ( p = 0.004). Patients were often symptomatic ( p = 0.029), especially those with stenosis-related symptoms ( p < 0.001) and longer symptom duration ( p < 0.001). The number of endoscopic resections was decreased by 34.8% ( p = 0.005). The number of total gastrectomy was higher than that of partial gastrectomy ( p = 0.021). The median time to treatment was significantly shorter ( p < 0.001). Conclusions In Japan, delays diagnosing patients with gastric cancer, probably due to refraining from consultation, may have resulted in an increase in the diagnosis of advanced-stage cancer. Moreover, an increasing proportion of patients required more invasive gastrectomy. Therefore, it may be necessary to educate patients not to refrain from consultation, even during the COVID-19 pandemic, as it can have a negative impact on treatment, policy decision, and prognosis of gastric cancer.

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Impact of COVID-19 on gastric cancer treatment in Japanese high-volume centers: a JCOG stomach cancer study group survey

Cited by 18 publications

References 15 publications

The impact of early‐stage COVID‐19 pandemic on the diagnosis and treatment of gastric cancer: A cross‐sectional study using a large‐scale cancer registry in Hiroshima, Japan

The impact of early‐stage COVID‐19 pandemic on the diagnosis and treatment of gastric cancer: A cross‐sectional study using a large‐scale cancer registry in Hiroshima, Japan

Effects of the COVID‐19 pandemic on gastroenterological surgeries in 2020: A study using the National Clinical Database of Japan

Impact of the first era of the coronavirus disease 2019 pandemic on gastric cancer patients: a single-institutional analysis in Japan

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