The impact of the COVID-19 pandemic on oncological disease extent at FDG PET/CT staging: the ONCOVIPET study

Abstract

Purpose To investigate whether the COVID-19 pandemic and national lockdown had an impact on the extent of cancer disease at FDG PET/CT staging as surrogate marker. Methods Retrospective observational study including cancer patients submitted to FDG PET/CT staging from June 1 to October 31, 2020, and June 1 to October 31, 2019, respectively. Data regarding primary tumour, nodal (N) status and number of involved nodal stations, and presence and number of distant metastases (M) were collected. Each scan was classified in limited vs advanced status. Data were aggregated across the study population and tumour type. Bi-weekly frequencies of the observed events were analysed. Results Six hundred eleven patients were included (240 in 2019 vs 371 in 2020, respectively). A significant increase of advanced disease patients (rate 1.56, P < 0.001), N + or M + patients (rate 1.84 and 2.09, respectively, P < 0.001), and patients with a greater number of involved N stations or M (rate 2.01 and 2.06, respectively, P < 0.001) were found in 2020 compared with data of 2019. Analysis by tumour type showed a significant increase of advanced disease in lymphoma and lung cancer in 2020 compared with 2019 ( P < 0.001). In addition, a significant increase of nodal involvement was found in lung, gastro-intestinal, and breast cancers, as well as in lymphoma patients ( P < 0.02). A significant increase of distant metastases was found in lung cancers ( P = 0.002). Conclusion Cancer patients with advanced disease at FDG PET/CT staging increased in 2020 compared with 2019, following the national lockdown due to the COVID-19 pandemic, 1.5-fold with a significant increase of patients with N or M involvement. Targeted health interventions are needed to mitigate the effects of the pandemic on patient outcome. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05629-0.

Diagnosis and Management of Classical Hodgkin Lymphoma During the COVID-19 Pandemic

“…Caldarella et al [22] compared the FDG-PET/CT staging of cancer patients with different tumor types in a 5-month period of the pandemic and in the same months 1 year before the pandemic. The study included 611 patients, 39.3% and 60.7% of the patients were diagnosed prior to and during the pandemic, respectively.…”

The impact of the COVID‐19 pandemic on nasopharyngeal carcinoma extent at FDG PET/MR staging: The NPCOVIPET study

“…The 2013 updated consensus guidelines of the neck node levels for head and neck tumors were adopted for evaluating the status of regional lymph nodes metastases 14 . For the number of distant metastases, a 4‐point scale was adopted (0, no distant metastases; 1, 1–3 lesions; 2, 4–7 lesions; 3, >7 lesions) 15 . Two dually board‐certified nuclear medicine and radiology physicians with more than 10 years of experience in head and neck cancers independently evaluated all scans, and any disagreements were resolved by consensus.…”

Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data

“…Compared with cancer patients in 2019, those in 2020 had significantly greater nodal involvement (rate, 2.01) and metastasis (rate, 2.06). There was a significant increase in advanced disease in ML and lung cancer in 2020 compared to 2019, with significantly higher rates of LN involvement in lung cancer, gastrointestinal cancer, breast cancer, and ML; and significantly higher rates of metastasis in lung cancer ( 174 ).…”