The impact of the COVID-19 pandemic on the management of head and neck cancer patients at a tertiary care institution in Poland

Abstract

Aim of the study: To assess the impact of the COVID-19 pandemic on the diagnosis and treatment of patients at a tertiary hospital in Poland. Material and methods: This was a retrospective review of head and neck cancer patients who presented to the multidisciplinary tumour board (MTB) during the 12-month period from March 2020 to February 2021 and compared to patients who presented to the MTB during the prior, pre-pandemic 12-month period from February 2019 to March 2020: Patient demographic and clinical variables were compared: sex, age at diagnosis, distance from hospital, date of first visit, radiological diagnosis, pathology specimen, MTB meeting, and initiation of primary and adjuvant treatment Results: The number of patients who presented to the MTB increased by 22% (278 to 340) from the pre-pandemic to the pandemic period. The mean time from MTB presentation to treatment initiation increased significantly from 17.1 to 21.7 days. The mean time from first visit to treatment start increased from 44.7 to 54.4 days. The proportion of patients with early-stage oropharyngeal cancer who underwent primary surgery rose from 47.3% to 86.6%. The percentage of patients who received palliative radiotherapy increased from 20.5% to 32.9%. The proportion of patients who received best supportive care rose from 1.8% to 6.2%. Conclusions: One of the most notable findings of this study was the increased time from first visit to treatment initiation, which could negatively impact patient outcomes. The differences in the treatment received in these two periods should be further evaluated to determine their influence on survival.

A Single-Center Study of the Impact of the COVID-19 Pandemic on the Organization of Healthcare Service Delivery to Patients with Head and Neck Cancer

“…Moreover, cancer centres remained open throughout the pandemic, whereas other hospitals were mainly responsible for treating patients with COVID-19. This phenomenon was described in a study by Szewczyk et al [17], which included HNC patients treated at the Cancer Centre in Poznan. The authors compared the characteristics of patients diagnosed with HNC during the 12-month pre-pandemic period prior to the implementation of pandemic-related restrictions in Poland in March 2020 with those of patients diagnosed and treated during the pandemic (March 2020-February 2021).…”

“…The literature in this area provides various results. In a study by Szewczyk et al [17], the mean time from the first visit to the multidisciplinary tumour board meeting differed slightly (but not significantly) between the pre-COVID-19 pandemic period and the period of the COVID-19 pandemic. Zubair [23] confirmed that there was no delay in the initiation of first treatment after the decision to treat.…”

“…However, our follow-up period was quite short. Similarly, a study by Szewczyk et al [17] found no significant differences between the pre-pandemic period and the pandemic period in the overall percentage of locally advanced cases (stages T3-T4) and in the proportions of patients with particular tumour sites. A study by Balk et al [20] including patients with newly diagnosed or recurrent head and neck squamous cell carcinoma (HNSCC) found no significant differences with regard to the T stage, N stage and UICC stage between the pre-pandemic period and the pandemic period.…”

Healthcare Disparities and Outcomes of Cancer Patients in a Community Setting from a COVID-19 Epicenter

“…Long-term oncologic outcomes will also be important to evaluate in this population with comparison to patients from previous years. Future studies should be dedicated to evaluating both COVID-related and oncologic long-term outcomes in these vulnerable patients, especially in the context of profound changes in cancer care delivery during the pandemic [ 56 , 57 ].…”

Assessment of the impact of the COVID-19 pandemic on the level of health care services in Poland - a review

“…Odnotowano m.in. znaczny spadek średniej liczby pacjentów rozpoczynających radioterapię [40], wydłużenie czasu od pierwszej wizyty do rozpoczęcia leczenia [41] oraz mniej wstępnych rozpoznań i rozszerzonych badań diagnostycznych i konsyliów onkologicznych [42], a także znaczne zmniejszenie liczby wykonywanych zabiegów operacyjnych [43,47] u pacjentów z chorobą nowotworową, chociaż w niektórych badaniach wskazywano na dostosowanie się systemu do zaistniałej sytuacji i stosunkowo szybki powrót do realizacji świadczeń na poziomie liczebnym sprzed pandemii [44,46]. Autorzy pracy zaznaczają konieczność prowadzenia dalszych obserwacji, aby określić długoterminowy wpływ pandemii na trendy i leczenie onkologiczne, ponieważ niekorzystne skutki mogą być opóźnione [45,46].…”