1
|
Hemrajani M, Mongia P, Gupta P, Joad AK. Morbidity and mortality after elective cancer surgery-How does recent Covid-19 infection impact outcome: A prospective, comparative study. J Anaesthesiol Clin Pharmacol 2024; 40:645-652. [PMID: 39759068 PMCID: PMC11694860 DOI: 10.4103/joacp.joacp_232_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/18/2023] [Accepted: 07/17/2023] [Indexed: 01/07/2025] Open
Abstract
Background and Aims Post-Covid-19 cancer patients are likely to have poor postoperative outcomes following cancer surgeries. This is mainly because of the coexisting risk factors unique to cancer patients like immunosuppression, chemotherapy, and radiotherapy-induced risk of infection and malnutrition. The purpose of this study was to compare the postoperative morbidity in cancer patients with and without a history of Covid infection. Material and Methods This was a prospective observational study. Subjects were divided into post-Covid 19 (PC) and non-Covid 19 (NC) groups based on the history of SARS CoV2. Preoperative data including details of past Covid infection, chemotherapy, radiotherapy, comorbidity index, Portsmouth-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) score, and nutritional indices were recorded for patients undergoing elective cancer surgery. Thirty-day postoperative morbidity, mortality was recorded. Results Of the total patients (n = 414), 109 had postoperative complications (26.33%), reported to be higher in the PC group (33.87%) than the NC (25%) (P value: 0.19). Pulmonary complications were commonest with higher incidence in PC (25.8%) group (P value: 0.001). It was 40% in 2-4 weeks after Covid 19 diagnosis reducing to 18% and 25% in 4-8 weeks and 8-12 weeks, respectively. The overall mortality rate was 0.72%. P-POSSUM morbidity score was similar between the two groups. (PC: 38.30 ± 19.4; Covid negative 37.8 ± 16.7 P value 0.84). Old age, hypothyroidism, and low Prognostic nutritional index were associated with a higher incidence of complications. Conclusions Cancer patients with a history of Covid infection undergoing elective surgery are at a higher risk of postoperative pulmonary complications.
Collapse
Affiliation(s)
- Manisha Hemrajani
- Department of Anaesthesiology and Palliative Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Pooja Mongia
- Department of Anaesthesiology and Palliative Medicine, Mahatama Gandhi Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Pushplata Gupta
- Department of Anaesthesiology and Palliative Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| | - Anjum K. Joad
- Department of Anaesthesiology and Palliative Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India
| |
Collapse
|
2
|
Eiberg MF, Rezahosseini O, Bukan KB, Charlotte Arp B, Le VB, Ahmad F, Howitz M, Lendorf M, Friborg J, Lindegaard B, Harboe ZB. Changes in vaccination uptake against pneumococcal disease, influenza, and coronavirus disease 2019 (COVID-19) before and after a Head and Neck cancer diagnosis. Vaccine 2024; 42:125972. [PMID: 38789370 DOI: 10.1016/j.vaccine.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/24/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Pneumonia is one of the main contributors to non-cancer mortality among patients with head and neck cancer (HNC). This study aimed to determine the vaccine uptake for pneumococcal polysaccharide and conjugate vaccines, quadrivalent influenza vaccines, and mRNA COVID-19 vaccines before and after an HNC diagnosis. Furthermore, the study investigated the timing of vaccination after a cancer diagnosis. MATERIALS & METHODS This register based multicentre study included Danish patients ≥ 18y diagnosed with HNC between 2018 and 2021. The vaccine uptake was assessed by calculating cumulative incidence (CI), while the timing of vaccination after an HNC diagnosis was explored by calculating incidence rates of vaccination the first and second half year after a cancer diagnosis. RESULTS The cumulative incidence of vaccine uptake for pneumococcal vaccines was estimated to be 8 % and 16 % one year before and after an HNC diagnosis, respectively. The CIs were 36 % and 38 % for quadrivalent influenza vaccines, respectively, whereas the CIs of vaccine uptake for mRNA COVID-19 vaccines were 60 % and 89 %. The IR of mRNA COVID-19 vaccinations the first half year after HNC diagnosis were 273 per 1000 person-months of follow-up (PMFU) and 111 per 1000 PMFU the second half year, respectively (IRR: 0.38, p < 0.001). Comparing the same periods, the IR of quadrivalent influenza vaccination was 28 per 1000 PMFU and 51 per 1000 PMFU (IRR: 1.95, 0 < 0.001). The IRs of pneumococcal vaccinations were 11 per 1000 PMFU and 14 per 1000 PMFU (IRR 1.28, p = 0.21). CONCLUSIONS Although our study shows a significant increase in pneumococcal and COVID-19 vaccine uptake after HNC diagnosis, a gap remains in vaccine uptake before diagnosis, underscoring the need for increased awareness of vaccination options and recommendations. Our findings could serve as a reference for future recommendations.
Collapse
Affiliation(s)
- Mads Frederik Eiberg
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
| | - Omid Rezahosseini
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark
| | - Katrine Brandt Bukan
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark
| | - Bodil Charlotte Arp
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Vivian Bui Le
- Department of Acute Medicine, Copenhagen University Hospital, North Zealand, Denmark
| | - Faiza Ahmad
- Department of Ear, Nose and Throat (ENT) Diseases, Copenhagen University Hospital, North Zealand, Denmark
| | - Michael Howitz
- Department of Ear, Nose and Throat (ENT) Diseases, Copenhagen University Hospital, North Zealand, Denmark
| | - Maria Lendorf
- Department of Oncology, Copenhagen University Hospital, North Zealand, Denmark
| | - Jeppe Friborg
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Birgitte Lindegaard
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Zitta Barrella Harboe
- Department of Pulmonary Medicine and Infectious Diseases, Copenhagen University Hospital, North Zealand, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
3
|
Johns JD, Choe EJ, Chisolm PF, Pothast MJ, Randolph JR, Chou J, Maxwell JH. The impact of COVID-19 and vaccination status on outcomes in veterans with head and neck squamous cell carcinoma. Head Neck 2024; 46:1698-1705. [PMID: 38433326 DOI: 10.1002/hed.27714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/03/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The impact of both COVID-19 infection and vaccination status on patients with head and neck squamous cell carcinoma (HNSCC) remains unknown. OBJECTIVE To determine the impact of COVID-19 infection and vaccination status on 60-day mortality, cardiovascular, and respiratory complications in patients with a prior diagnosis of HNSCC. METHODS This was a retrospective cohort study through the Veterans Affairs (VA) Corporate Data Warehouse of Veterans with HNSCC who were tested for COVID-19 during any inpatient VA medical center admission. A cohort of patients was created of Veterans with a diagnosis of HNSCC of the oral cavity,oropharynx, hypopharynx, larynx, and nasopharynx based on International Classification of Disease (ICD) codes. Data collected included clinical/demographic data, vaccination status, and incidence of 60-day mortality, 60-day cardiovascular complication (including myocardial infarction, venous thromboembolism, cerebrovascular accident), and 60-day respiratory complication (including acute respiratory failure, acute respiratory distress syndrome, and pneumonia). The interactions between COVID-19 infection, vaccination status, morbidity and mortality were investigated. RESULTS Of the 14 262 patients with HNSCC who were tested for COVID-19 during inpatient admission, 4754 tested positive (33.3%), and 9508 (67.7%) tested negative. Patients who tested positive demonstrated increased 60-day mortality (4.7% vs. 2.0%, respectively; p < 0.001), acute respiratory failure (ARF; 15.4% vs. 7.1%, p < 0.001), acute respiratory distress syndrome (ARDS; 0.9% vs. 0.2%, p < 0.001), and pneumonia (PNA; 20.0% vs. 6.4%, p < 0.001) compared to those who never tested positive, respectively. Patients who received COVID-19 vaccination between 2 weeks and 6 months prior to a positive test demonstrated decreased rates of ARF (13.2% vs. 16.0%, p = 0.034) and PNA (16.7% vs. 20.9%, p = 0.003) compared to the unvaccinated group. A logistic regression of patients with COVID-19 infections who died within 60 days was performed, with no significant survival advantage among patients vaccinated between 2 weeks and 6 months prior to the positive test. CONCLUSION COVID-19 infection may significantly increase rates of 60-day mortality and respiratory complications in patients with HNSCC. COVID-19 vaccination between 2 weeks and 6 months prior to infection may decrease severity of respiratory complications but did not show significant mortality benefits in this study. These data highlight the need for surveillance of respiratory infection and vaccination in this vulnerable population.
Collapse
Affiliation(s)
- James D Johns
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Erica J Choe
- Georgetown University School of Medicine, Washington, DC, USA
| | - Paul F Chisolm
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | | | - Jackson R Randolph
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Jiling Chou
- Center for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Hyattsville, Maryland, USA
| | - Jessica H Maxwell
- Department of Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
- Department of Surgery, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
| |
Collapse
|
4
|
Khezeli M, Tavan A, Narimani S, Hoseini V, Hosseinzadeh EZ, Motamedi P. Risk perception and avoidance of preventive behavior on the COVID-19 among cancer patients. Health Sci Rep 2023; 6:e1401. [PMID: 37431485 PMCID: PMC10329738 DOI: 10.1002/hsr2.1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
Background and Aims Willingness to engage in preventive behaviors against coronavirus disease 2019 (COVID-19) depends on people's risk perception. This is especially important in cancer patients who are at risk of complications from the disease. Therefore, this study was conducted to investigate avoidance of COVID-19 preventive behavior of in cancer patients. Methods This cross-sectional analytical study was done with 200 cancer patients who were selected by convenience sampling method. The study was conducted in Imam Khomeini Hospital of Ardabil, Iran from July to August 2020. A researcher-made questionnaire was used to investigate the risk perception of cancer patients towards COVID-19 with seven subscales according to the Extended Parallel Process Model. Data were analyzed by SPSS 20 using Pearson correlation and linear regression tests. Results The mean and standard deviation of the age of 200 participants (including 109 men and 91 women) was 48 ± 17. Results showed that the response efficacy (12.6 ± 2.2) had the highest mean and defensive avoidance (8 ± 2.8) had the lowest mean score among EPPM constructs. Linear regression results showed that fear (β = 0.242, p > 0.001), and perceived severity (β = 0.191, p = 0.008) were significant predictors of defensive avoidance. Conclusion Perceived severity and fear were significant predictors of defensive avoidance, and providing accurate and reliable news and information can be effective in reducing fear and promoting preventive behaviors.
Collapse
Affiliation(s)
- Mehdi Khezeli
- Social Development and Health Promotion Research Center, Health Institute Kermanshah University of Medical Sciences Kermanshah Iran
| | - Asghar Tavan
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Sajjad Narimani
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences Iran University of Medical Sciences Tehran Iran
- Department of Nursing and Midwifery, School of Nursing, Social Determinant of Health Research Center Ardabil University of Medical Sciences Ardabil Iran
| | - Vahideh Hoseini
- Alavi Hospital Ardabil University of Medical Sciences Ardabil Iran
| | - Elham Zare Hosseinzadeh
- Department of Infectious Diseases Faculty of Alborz University of Medical of Sciences Alborz Iran
| | - Parisa Motamedi
- Department of Gynecology Ardabil University of Medical Science Ardabil Iran
| |
Collapse
|
5
|
Grigoletto I, Cavalheri V, Gobbo LA, Pozo K, Maia Filho ER, Ribeiro DG, Ielo N, De Lima FF, Ramos EMC. Effects of Semisupervised Exercise Training on Health Outcomes in People With Lung or Head and Neck Cancer: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43547. [PMID: 37223986 DOI: 10.2196/43547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative. OBJECTIVE The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer. METHODS Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival. RESULTS In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024. CONCLUSIONS This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival. TRIAL REGISTRATION Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43547.
Collapse
Affiliation(s)
- Isis Grigoletto
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil
- Cancer Hospital of Presidente Prudente, Presidente Prudente, São Paulo, Brazil
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Allied Health, South Metropolitan Health Service, Perth, Western Australia, Australia
| | - Luis Alberto Gobbo
- Department of Physical Education, Faculty of Science and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Karina Pozo
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil
- Cancer Hospital of Presidente Prudente, Presidente Prudente, São Paulo, Brazil
| | | | | | - Nara Ielo
- Cancer Hospital of Presidente Prudente, Presidente Prudente, São Paulo, Brazil
- São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil
| | - Fabiano Francisco De Lima
- Department of Physiotherapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ercy Mara Cipulo Ramos
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University, Presidente Prudente, São Paulo, Brazil
- Cancer Hospital of Presidente Prudente, Presidente Prudente, São Paulo, Brazil
| |
Collapse
|
6
|
Chavda VP, Patel AB, Pandya A, Vora LK, Patravale V, Tambuwala ZM, Aljabali AAA, Serrano-Aroca Á, Mishra V, Tambuwala MM. Co-infection associated with SARS-CoV-2 and their management. Future Sci OA 2022; 8:FSO819. [PMID: 36788985 PMCID: PMC9912272 DOI: 10.2144/fsoa-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/18/2022] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 was discovered in Wuhan, China and quickly spread throughout the world. This deadly virus moved from person to person, resulting in severe pneumonia, fever, chills and hypoxia. Patients are still experiencing problems after recovering from COVID-19. This review covers COVID-19 and associated issues following recovery from COVID-19, as well as multiorgan damage risk factors and treatment techniques. Several unusual illnesses, including mucormycosis, white fungus infection, happy hypoxia and other systemic abnormalities, have been reported in recovered individuals. In children, multisystem inflammatory syndrome with COVID-19 (MIS-C) is identified. The reasons for this might include uncontrollable steroid usage, reduced immunity, uncontrollable diabetes mellitus and inadequate care following COVID-19 recovery.
Collapse
Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics & Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad, Gujarat, 380009, India
| | - Aayushi B Patel
- Pharmacy Section, LM College of Pharmacy, Ahmedabad, Gujarat, 380058, India
| | - Anjali Pandya
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Lalitkumar K Vora
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, BT9 7BL, UK
| | - Vandana Patravale
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Zara M Tambuwala
- College of Science, University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
| | - Alaa AA Aljabali
- Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Faculty of Pharmacy, Irbid, 566, Jordan
| | - Ángel Serrano-Aroca
- Biomaterials & Bioengineering Lab, Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, Valencia, 46001, Spain
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, India
| | - Murtaza M Tambuwala
- Lincoln Medical School University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
| |
Collapse
|
7
|
Obermeier KT, Kraus M, Smolka W, Henkel J, Saller T, Otto S, Liokatis P. Postoperative Delirium in Patients with Oral Cancer: Is Intraoperative Fluid Administration a Neglected Risk Factor? Cancers (Basel) 2022; 14:cancers14133176. [PMID: 35804948 PMCID: PMC9265071 DOI: 10.3390/cancers14133176] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Squamous cell carcinoma is the most typical malignant tumor of the oral cavity (OSCC) and surgery, including tumor resection and neck dissection with an appropriate reconstruction, remains the first line of treatment. Postoperative complications delay the healing process, and can have negative consequences for the patient. This study aimed to evaluate the impact of intraoperative fluid administration on developing postoperative delirium, and to identify other parameters leading to an increased risk of delirium. Abstract Squamous cell carcinoma (SCC) is a malignant tumor derived from squamous cells and can be found in different localizations. In the oral cavity especially, it represents the most common type of malignant tumor. First-line therapy for oral squamous cell carcinoma (OSCC) is surgery, including tumor resection, neck dissection, and maybe reconstruction. Although perioperative mortality is low, complications such as delirium are very common, and may have long-lasting consequences on the patient’s quality of life. This study examines if excessive fluid administration, among other parameters, is an aggravating factor for the development of postoperative delirium. A total of 198 patients were divided into groups concerning the reconstruction technique used: group A for primary wound closure or reconstruction with a local flap, and group B for microsurgical reconstruction. The patients with and without delirium in both groups were compared regarding intraoperative fluid administration, fluid balance, and other parameters, such as blood loss, duration of surgery and overall ventilation, alcohol consumption, and creatinine, albumin, natrium, and hematocrit levels. The logistic regression for group A shows that fluid intake (p = 0.02, OR = 5.27, 95% CI 1.27–21.8) and albumin levels (p = 0.036, OR = 0.22, CI 0.054–0.908) are independent predictors for the development of delirium. For group B, gender (p = 0.026, OR = 0.34, CI 0.133–0.879) with a protective effect for females, fluid intake (p = 0.003, OR = 3.975, CI 1.606–9.839), and duration of ventilation (p = 0.025, OR = 1.178, CI 1.021–1.359) are also independent predictors for delirium. An intake of more than 3000 mL for group A, and 4150 mL for group B, increases the risk of delirium by approximately five and four times, respectively. Fluid management should be considered carefully in patients with OSCC, in order to reduce the occurrence of postoperative delirium. Different factors may become significant for the development of delirium regarding different surgical procedures.
Collapse
Affiliation(s)
- Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
- Correspondence:
| | - Moritz Kraus
- Musculoskeletal University Center Munich, Department of Orthopaedics and Trauma Surgery, University Hospital, LMU Munich, 80539 Munich, Germany;
| | - Wenko Smolka
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
| | - Jochen Henkel
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.H.); (T.S.)
| | - Thomas Saller
- Department of Anaesthesiology, University Hospital, LMU Munich, 81377 Munich, Germany; (J.H.); (T.S.)
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
| | - Paris Liokatis
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, 80337 Munich, Germany; (W.S.); (S.O.); (P.L.)
| |
Collapse
|
8
|
Nguyen DM, Kodia K, Szewczyk J, Alnajar A, Stephens-McDonnough JA, Villamizar NR. Effect of COVID-19 on the delivery of care for thoracic surgical patients. JTCVS OPEN 2022; 10:456-468. [PMID: 35194585 PMCID: PMC8849839 DOI: 10.1016/j.xjon.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/02/2021] [Indexed: 12/01/2022]
Abstract
Objective In this study we aimed to determine the effect of the COVID-19 pandemic on the delivery of care for thoracic surgical patients at an urban medical center. Methods A retrospective analysis of all thoracic surgical cases from May 1, 2019, to December 31, 2020, was conducted. Demographic characteristics, preoperative surgical indications, procedures, final pathologic diagnoses, and perioperative outcomes were recorded. A census of operative cases, relevant ancillary services, and outpatient thoracic clinics were obtained from our institutional database. Results Six hundred nineteen cases were included in this study (329 pre-COVID-19 and 290 COVID-19, representing an 11.8% reduction). There were no differences in type of thoracic procedures or perioperative outcomes among the 2 cohorts. Prolonged reduction of thoracic surgical cases (50% of baseline) during the first half of the COVID-19 period was followed by a resurgence of surgical volumes to 110% of baseline in the second half. A similar incidence of cases were performed for oncologic indications during the first half whereas more benign cases were performed in the second half, coinciding with the launch of our robotic foregut surgery program. After undergoing surgery during the pandemic, none of our patients reported COVID-19 symptoms within 14 days of discharge. Conclusions During the initial surge of COVID-19, while there was temporary closure of operative services, our health care system continued to provide safe care for thoracic surgery patients, particularly those with oncologic indications. Since phased reopening, we have experienced a rebound of surgical volume and case mix, ultimately mitigating the initial negative effect of the pandemic on delivery of thoracic surgical care.
Collapse
|
9
|
Le Naour J, Sztupinszki Z, Carbonnier V, Casiraghi O, Marty V, Galluzzi L, Szallasi Z, Kroemer G, Vacchelli E. A loss-of-function polymorphism in ATG16L1 compromises therapeutic outcome in head and neck carcinoma patients. Oncoimmunology 2022; 11:2059878. [PMID: 35481288 PMCID: PMC9037530 DOI: 10.1080/2162402x.2022.2059878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The anticancer immune response is shaped by immunogenic cell stress and death pathways. Thus, cancer cells can release danger-associated molecular patterns that act on pattern recognition receptors expressed by dendritic cells and their precursors to elicit an antitumor immune response. Here, we investigated the impact of single nucleotide polymorphisms (SNPs) in genes affecting this cancer-immunity dialogue in the context of head and neck squamous cell carcinoma (HNSCC). We observed that homozygosity for a loss-of-function SNP (rs2241880, leading to the substitution of a threonine residue in position 300 by an alanine) affecting autophagy related 16 like 1 (ATG16L1) is coupled to poor progression-free survival in platinum-treated HNSCC patients. This result was obtained on a cohort of patients enrolled at the Gustave Roussy Cancer Campus and was validated on an independent cohort of The Cancer Genome Atlas (TCGA). Homozygosity in rs2241880 is well known to predispose to Crohn’s disease, and epidemiological associations between Crohn’s disease and HNSCC have been reported at the levels of cancer incidence and prognosis. We speculate that rs2241880 might be partially responsible for this association.
Collapse
Affiliation(s)
- Julie Le Naour
- Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Institut Universitaire de France, Paris, France
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris Sud, Paris Saclay, Faculty of Medicine Kremlin Bicêtre, France
| | - Zsofia Sztupinszki
- Computational Health Informatics Program (CHIP), Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vincent Carbonnier
- Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Institut Universitaire de France, Paris, France
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris Sud, Paris Saclay, Faculty of Medicine Kremlin Bicêtre, France
| | - Odile Casiraghi
- Department of Head and Neck Surgical and Medical Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Virginie Marty
- Experimental and Translational Pathology Platform (PETRA), AMMICa Inserm US23/UMS CNRS3655, Gustave Roussy Cancer Campus, Villejuif, France
| | - Lorenzo Galluzzi
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
- Sandra and Edward Meyer Cancer Center, New York, NY, USA
- Caryl and Israel Englander Institute for Precision Medicine, New York, NY, USA
| | - Zoltan Szallasi
- Computational Health Informatics Program (CHIP), Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Guido Kroemer
- Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Institut Universitaire de France, Paris, France
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Institut du Cancer Paris CARPEMAP-HP, Hôpital Européen Georges Pompidou, Pôle de Biologie, Paris, France
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Erika Vacchelli
- Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Institut Universitaire de France, Paris, France
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
10
|
Vira P, Samuel SR, PV SR, Saxena PUP, Amaravadi SK, Ravishankar N, Balachandran DD. Feasibility and Efficacy of Inspiratory Muscle Training in Patients with Head and Neck Cancer receiving Concurrent Chemoradiotherapy. Asian Pac J Cancer Prev 2021; 22:3817-3822. [PMID: 34967560 PMCID: PMC9080381 DOI: 10.31557/apjcp.2021.22.12.3817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/19/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Patients with head and neck cancer (HNC) undergoing concurrent chemoradiotherapy (CCRT) often experience pulmonary symptoms. This study evaluated if a 7-week inspiratory muscle training (IMT) program during CCRT is feasible, adherent, and safe in patients with HNC. This study also evaluated the effect of IMT on diaphragm thickness, mobility, and cardiorespiratory parameters in patients with HNC receiving CCRT. METHODS Ten participants with advanced stage HNC receiving CCRT were recruited for the study. Feasibility, adherence, and safety of the intervention were the primary outcomes. Changes in diaphragm thickness and mobility, maximal inspiratory pressure, maximal expiratory pressure, forced vital capacity, forced expiratory volume in first second and functional capacity using 6-MWT were measured at baseline and post 7 weeks of CCRT. IMT was performed at one session per day for 5 days a week for 7 weeks. Eight sets of two minutes of inspiratory manoeuvres with one minute rest period between them with intensity of 40% MIP were given. RESULTS Ten participants were included in this study out of the 13 patients screened, indicating the feasibility to be 76.9%. Participants completed a total of 260 training sessions out of the 350 planned sessions denoting the adherence level as 74%. Diaphragm thickness and MEP remained significantly unchanged while significant decline was seen in diaphragm mobility, MIP,FVC, FEV1 and 6-MWD at the end of 7 weeks. No adverse events were reported following the intervention. CONCLUSION Inspiratory muscle training did not show significant effect on the diaphragm thickness, mobility, and cardiorespiratory parameters; however, it was feasible, adherent, and safe in patients with HNC receiving CCRT.
Collapse
Affiliation(s)
- Prina Vira
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Stephen R Samuel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Santosh Rai PV
- Department of Radiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - PU Prakash Saxena
- Department of Radiation Oncology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Sampath Kumar Amaravadi
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
- Department of Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates.
| | - Nagaraja Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi - 110007, India.
| | - Diwakar D Balachandran
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| |
Collapse
|
11
|
Reduction of Elective Radiotherapy Treatment Volume in Definitive Treatment of Locally Advanced Head and Neck Cancer-Comparison of a Prospective Trial with a Revised Simulated Contouring Approach. J Clin Med 2021; 10:jcm10204653. [PMID: 34682782 PMCID: PMC8537676 DOI: 10.3390/jcm10204653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Definitive radiochemotherapy of locally advanced head and neck squamous cell cancer (HNSCC) achieves high locoregional tumor control rates; but is frequently associated with long-term toxicity. A future direction could be a de-escalation strategy focusing on treated volume rather than radiotherapy dose. This analysis evaluates radiotherapy dose and volume parameters of patients treated with a standard contouring approach in a clinical trial context compared with a revised volume-reduced contouring approach. In this case, 30 consecutive patients from the CheckRad-CD8 trial treated at a single study center were included in this analysis. Treatment toxicity and quality of life were assessed at the end of radiotherapy. Standard treatment plans (ST) following state of the art contouring guidelines that were used for patient treatment and volume reduced treatment plans (VRT) according to a revised simulated approach were calculated for each patient. Planning target volumes (PTV) and mean doses to 38 organs-at-risk structures were compared. At the end of radiotherapy patients reported high rates of mucositis; dysphagia and xerostomia. In addition; patient reported quality of life as assessed by the EORTC QLQ-HN35 questionnaire deteriorated. Comparing the two contouring approaches; the elective PTV_56 Gy and the high risk PTV_63 Gy (shrinking field) were significantly smaller in the VRT group. Significant reduction of mean dose to structures of the oral cavity; the larynx as well as part of the swallowing muscles and the submandibular glands was achieved in the simulated VRT-plan. Treatment de-intensification by reduction of the irradiated volume could potentially reduce treatment volume and mean doses to organs at risk. The proposed contouring approach should be studied further in the context of a clinical trial.
Collapse
|
12
|
Cavalieri S, Colombo E, Bottiglieri A, Massa G, Platini F, Ottini A, Filippini DM, Zattarin E, Bergamini C, Resteghini C, Alfieri S, Di Martino V, Tiraferri V, Locati LD, Licitra L. Monitoring patients with head and neck cancer for flu-like symptoms during the COVID-19 pandemic. TUMORI JOURNAL 2021; 108:240-249. [PMID: 33849307 DOI: 10.1177/03008916211007940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To capture and monitor flu-like symptoms in relation to the clinical characteristics and the oncologic treatment of a large head and neck cancer (HNC) patient cohort during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS Patients were monitored through by 2 rounds of interviews. Clinical characteristics of patients with no symptoms (group 0) and of those reporting ⩾1 (group A), ⩾3 (group B), or ⩾5 symptoms (group C) were analyzed. Patients with ⩾1 symptom at both interviews were defined as group A2. RESULTS Five hundred patients with HNC were analyzed. A higher frequency of patients with the following characteristics was observed in group A vs group 0: active treatment (40% vs 24%, p = 0.0002), gastrostomy (6% vs 2%, p = 0.027), recent active treatment (48% vs 29%, p < 0.0001), and higher number of concomitant medications (p = 0.01). A lower median age was observed in group B vs group no-B (patients with fewer than three symptoms) (59 vs 63.55 years, p = 0.016) and in group A2 vs group no-A2 (patients without at least one symptom at both interviews) (56 vs 63 years, p = 0.021); patients in group B received more recent active treatment than those in group no-B and in group A2 vs those in group no-A2 (p = 0.024 and 0.043, respectively); patients in group B had a lower body mass index than those in group no-B (22.4 vs 23.93 kg/m2, p = 0.0066). CONCLUSIONS This work is based on patient-reported symptoms and signs independently of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. In the future, these results might serve as a a benchmark for clinicians triaging and managing patients with HNC during infectious outbreaks involving flu-like symptoms.
Collapse
Affiliation(s)
- Stefano Cavalieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Elena Colombo
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Achille Bottiglieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giacomo Massa
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Francesca Platini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Arianna Ottini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Daria Maria Filippini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Emma Zattarin
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Cristiana Bergamini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Carlo Resteghini
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Salvatore Alfieri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Vito Di Martino
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Valentina Tiraferri
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Lisa Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| |
Collapse
|
13
|
Sevinç C, Tertemiz KC, Atik M, Güler N, Ulusoy M, Coşkun F, Uyar N, Ellidokuz H, İtil O, Cimrin AH, Uçan ES. How were Non-COVID pulmonary patients and diseases affected from COVID-19 pandemic period? Turk Thorac J 2021; 22:149-153. [PMID: 33871339 DOI: 10.5152/turkthoracj.2021.20249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/01/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study aimed to focus on non-COVID-19 patients during the process when all physicians focused on COVID-19 patients. Patients with pulmonary diseases in the COVID-19 pandemic period were analyzed. MATERIAL AND METHODS Non-COVID-19 cases who were hospitalized in the pulmonology clinic, outpatients, and patients who applied to the non-COVID-19 emergency service and requested a pulmonology consultation in the period from March 16, 2020 to May 15, 2020 and in the same period of the previous year (i.e., from March 16, 2019 to May 15, 2019) were included in this study. RESULTS In the pandemic period, it was found that there was an 84% decrease in outpatient admissions, a 43% decrease in inpatients, and a 75% decrease in emergency services. During the pandemic period, in outpatient setting, male and younger case admissions increased, admissions with chronic obstructive pulmonary disease (COPD), and interstitial lung diseases decreased, whereas the frequency of admission to asthma, pneumonia, and pulmonary thromboembolism increased. In the period of the pandemic, patients with asthma, COPD, and lung cancer were less hospitalized, whereas patients with pulmonary thromboembolism, pneumonia, and pleural effusion were hospitalized more. In non-COVID-19 patient treatments during the pandemic period, usage of a metered dose inhaler increased. CONCLUSION During the COVID-19 pandemic, non-COVID pulmonary pathologies decreased significantly, and there was a change in the profile of the patients. From now on, to be prepared for pandemic and similar extraordinary situations, to organize hospitals for the epidemic, to determine health institutions to which nonepidemic patients can apply, to make necessary plans in order not to neglect the nonepidemic patients, and to develop digital health service methods, especially telemedicine, would be appropriate.
Collapse
Affiliation(s)
- Can Sevinç
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Kemal Can Tertemiz
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Merve Atik
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Nurcan Güler
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Mustafa Ulusoy
- Department of Emergency Medicine, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Figen Coşkun
- Department of Emergency Medicine, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Nezihe Uyar
- Department of Clinic of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Hülya Ellidokuz
- Department of Biostatistics and Medical Informatics, Dokuz Eylül University Medical Faculty, İnciralti, İzmir, Turkey
| | - Oya İtil
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Arif Hikmet Cimrin
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| | - Eyup Sabri Uçan
- Department of Pulmonology, Dokuz Eylül University Hospital, İnciralti, İzmir, Turkey
| |
Collapse
|
14
|
Longo F, Trecca EMC, D'Ecclesia A, Copelli C, Tewfik K, Manfuso A, Pederneschi N, Mastromatteo A, Russo MA, Pansini A, Lacerenza LM, Marano PG, Cassano L. Managing head and neck cancer patients during the COVID-19 pandemic: the experience of a tertiary referral center in southern Italy. Infect Agent Cancer 2021; 16:9. [PMID: 33546738 PMCID: PMC7862967 DOI: 10.1186/s13027-021-00352-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/28/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The medical community has been deeply involved in fighting the Coronavirus disease 2019 (COVID-19) pandemic and, as a consequence, the care of non-COVID-19 patients has been impacted. However, the treatment of head and neck cancer patients is not deferrable, and an integrated strategy is required. The aim of the current article is to present the experience in the management of head and neck patients during the COVID-19 pandemic at the research hospital "Casa Sollievo della Sofferenza". This review contains replicable and widely usable instructions on how to avoid delays in the diagnosis and treatment of head and neck tumors and to ensure a gradual return to elective procedures. MAIN TEXT The Head and Neck Department of the research hospital "Casa Sollievo della Sofferenza" includes an Otolaryngology and a Maxillofacial Surgery Unit, both of which deal with the diagnosis and treatment of benign and malignant pathologies of the head and neck, as well as urgent/emergent consultations and surgical procedures that necessitate time sensitive operative management, such as cochlear implantation (CI). Given these premises and the complexity of the Department, the "COVID-19 organizing protocol" of the research hospital "Casa Sollievo della Sofferenza" was divided into two phases in accordance with the different stages of the pandemic and the priority of treatment. Special attention was given to the medical surveillance of health care workers and hospitalized patients, to the organization of the outpatient clinic and the operating setting as well as to the implementation of telehealth systems. CONCLUSIONS The COVID-19 pandemic is going to be a long-term situation with lasting effects on the public health and the entire society. Therefore, an efficient health care system has to adopt a double strategy: always being ready for a "new wave" of the pandemic and not forgetting non-COVID-19 patients, among whom head and neck cancer patients represent a priority. More than 1 year since the first outbreak in Wuhan, this review offers a unique and helpful perspective that incorporates awareness of the disease.
Collapse
Affiliation(s)
- Francesco Longo
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Eleonora M C Trecca
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy.
- Department of Otolaryngology- Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy.
| | - Aurelio D'Ecclesia
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Chiara Copelli
- Department of Surgical Sciences; Unit of Maxillofacial Surgery, University Hospital of Turin- Città della salute e delle scienze, Turin, Italy
| | - Karim Tewfik
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Alfonso Manfuso
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Nicola Pederneschi
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Annalisa Mastromatteo
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Matteo Aldo Russo
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Antonio Pansini
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit Naples, University of Naples Federico II, Naples, Italy
| | - Luca M Lacerenza
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| | - Pier Gerardo Marano
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
- Department of Otolaryngology- Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy
| | - Lazzaro Cassano
- Department of Maxillofacial Surgery and Otolaryngology, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 1, 71013, San Giovanni Rotondo (Foggia), Italy
| |
Collapse
|
15
|
New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era. J Clin Med 2021; 10:jcm10040587. [PMID: 33557273 PMCID: PMC7915471 DOI: 10.3390/jcm10040587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/20/2022] Open
Abstract
Locally advanced head and neck cancer is a unique challenge for cancer management in the Covid-19 situation. The negative consequences of delaying radio-chemotherapy treatment make it necessary to prioritize these patients, the continuation of radiotherapy being indicated even if SARS-CoV-2 infection is confirmed in the case of patients with moderate and mild symptoms. For an early scenario, the standard chemo-radiotherapy using simultaneous integrated boost (SIB) technique is the preferred option, because it reduces the overall treatment time. For a late scenario with limited resources, hypo-fractionated treatment, with possible omission of chemotherapy for elderly patients and for those who have comorbidities, is recommended. Concurrent chemotherapy is controversial for dose values >2.4 Gy per fraction. The implementation of hypo-fractionated regimens should be based on a careful assessment of dose-volume constraints for organs at risks (OARs), using recommendations from clinical trials or dose conversion based on the linear-quadratic (LQ) model. Induction chemotherapy is not considered the optimal solution in this situation because of the risk of immunosuppression even though in selected groups of patients TPF regimen may bring benefits. Although the MACH-NC meta-analysis of chemotherapy in head and neck cancers did not demonstrate the superiority of induction chemotherapy over concurrent chemoradiotherapy, an induction regimen could be considered for cases with an increased risk of metastasis even in the case of a possible Covid-19 pandemic scenario.
Collapse
|
16
|
SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021; 9:e14. [PMID: 33681819 PMCID: PMC7927752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
| |
Collapse
|
17
|
SeyedAlinaghi S, Afsahi AM, MohsseniPour M, Behnezhad F, Salehi MA, Barzegary A, Mirzapour P, Mehraeen E, Dadras O. Late Complications of COVID-19; a Systematic Review of Current Evidence. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021. [PMID: 33681819 PMCID: PMC7927752 DOI: 10.22037/aaem.v9i1.1058] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Salehi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan
| |
Collapse
|
18
|
Covid-19 pandemic: A new contributing factor to diagnostic and treatment delay in oral cancer patients. Oral Oncol 2021; 116:105176. [PMID: 33485790 PMCID: PMC7832748 DOI: 10.1016/j.oraloncology.2020.105176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022]
|
19
|
Hoffmann TK, Greve J, Laban S, Schuler PJ. [Treatment of patients with head and neck cancer during the COVID-19 pandemic]. HNO 2020; 69:14-16. [PMID: 33170312 PMCID: PMC7653450 DOI: 10.1007/s00106-020-00967-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 12/19/2022]
Affiliation(s)
- T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89081, Ulm, Deutschland.
| | - J Greve
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89081, Ulm, Deutschland
| | - S Laban
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89081, Ulm, Deutschland
| | - P J Schuler
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89081, Ulm, Deutschland
| |
Collapse
|
20
|
Wai KC, Xu MJ, Lee RH, El-Sayed IH, George JR, Heaton CM, Knott PD, Park AM, Ryan WR, Seth R, Ha PK. Head and neck surgery during the coronavirus-19 pandemic: The University of California San Francisco experience. Head Neck 2020; 43:622-629. [PMID: 33098178 DOI: 10.1002/hed.26514] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/02/2020] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Guidelines regarding head and neck surgical care have evolved during the coronavirus-19 (COVID-19) pandemic. Data on operative management have been limited. METHODS We compared two cohorts of patients undergoing head and neck or reconstructive surgery between March 16, 2019 and April 16, 2019 (pre-COVID-19) and March 16, 2020 and April 16, 2020 (COVID-19) at an academic center. Perioperative, intraoperative, and postoperative outcomes were recorded. RESULTS There were 63 operations during COVID-19 and 84 operations during pre-COVID-19. During COVID-19, a smaller proportion of patients had benign pathology (12% vs 20%, respectively) and underwent thyroid procedures (2% vs 23%) while a greater proportion of patients underwent microvascular reconstruction±ablation (24% vs 12%,). Operative times increased, especially among patients undergoing microvascular reconstruction±ablation (687 ± 112 vs 596 ± 91 minutes, P = .04). Complication rates and length of stay were similar. CONCLUSIONS During COVID-19, perioperative outcomes were similar, operative time increased, and there were no recorded transmissions to staff or patients. Continued surgical management of head and neck cancer patients can be provided safely.
Collapse
Affiliation(s)
- Katherine C Wai
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Mary Jue Xu
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Rex H Lee
- School of Medicine, University of California, San Francisco, California, USA
| | - Ivan H El-Sayed
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Jonathan R George
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Chase M Heaton
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - P Daniel Knott
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Andrea M Park
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - William R Ryan
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Rahul Seth
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Patrick K Ha
- Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco, California, USA
| |
Collapse
|
21
|
Baird BJ, Sung CK. Coronavirus Disease-19: Challenges Associated with the Treatment of Head and Neck Oncology and Laryngology Patients in the Coronavirus Disease-19 Era. Otolaryngol Clin North Am 2020; 53:1159-1170. [PMID: 33039099 PMCID: PMC7442893 DOI: 10.1016/j.otc.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This review explores the changes to practice associated with COVID-19 for providers treating patients with head and neck cancer and laryngeal pathology. The aim of the review is to highlight some of the challenges and considerations associated with treating this patient population during the pandemic. Additionally, it seeks to discuss some of the areas of concern related to ramping up clinical volume.
Collapse
Affiliation(s)
- Brandon J Baird
- Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, 5841 South Maryland Avenue, MC 1035, Chicago, IL 60637, USA.
| | - C Kwang Sung
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94304, USA
| |
Collapse
|
22
|
Zaga CJ, Pandian V, Brodsky MB, Wallace S, Cameron TS, Chao C, Orloff LA, Atkins NE, McGrath BA, Lazarus CL, Vogel AP, Brenner MJ. Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1320-1334. [PMID: 32525695 DOI: 10.1044/2020_ajslp-20-00089] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose As the COVID-19 pandemic has unfolded, there has been growing recognition of risks to frontline health care workers. When caring for patients with tracheostomy, speech-language pathologists have significant exposure to mucosal surfaces, secretions, and aerosols that may harbor the SARS-CoV-2 virus. This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection. Method Data were collated through review of literature, guidelines, and consensus statements relating to COVID-19 and similar high-consequent infections, with a focus on mitigating risk of transmission to health care workers. Particular emphasis was placed on speech-language pathologists, nurses, and other allied health professionals. A multinational interdisciplinary team then analyzed findings, arriving at recommendations through consensus via electronic communications and video conference. Results Reports of transmission of infection to health care workers in the current COVID-19 pandemic and previous outbreaks substantiate the need for safe practices. Many procedures routinely performed by speech-language pathologists have a significant risk of infection due to aerosol generation. COVID-19 testing can inform level of protective equipment, and meticulous hygiene can stem spread of nosocomial infection. Modifications to standard clinical practice in tracheostomy are often required. Personal protective equipment, including either powered air-purifying respirator or N95 mask, gloves, goggles, and gown, are needed when performing aerosol-generating procedures in patients with known or suspected COVID-19 infection. Conclusions Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission.
Collapse
Affiliation(s)
- Charissa J Zaga
- Department of Speech Pathology, Austin Health, Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Vinciya Pandian
- Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
| | - Martin B Brodsky
- Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD
- Department of Physical Medicine & Rehabilitation, Johns Hopkins University, Baltimore, MD
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Sarah Wallace
- Department of Speech Voice and Swallowing, Manchester University NHS Foundation Trust, United Kingdom
| | - Tanis S Cameron
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
| | - Caroline Chao
- Tracheostomy Review and Management Service, Austin Health, Melbourne, Victoria, Australia
- Department of Physiotherapy, Austin Health, Melbourne, Victoria, Australia
| | - Lisa Ann Orloff
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, CA
| | - Naomi E Atkins
- Department of Respiratory Medicine, Austin Health, Melbourne, Victoria, Australia
| | - Brendan A McGrath
- Anaesthetics & Intensive Care Medicine, Manchester University NHS Foundation Trust, United Kingdom
| | - Cathy L Lazarus
- Department of Otolaryngology-Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adam P Vogel
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Redenlab, Melbourne, Victoria, Australia
| | - Michael J Brenner
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical School, Ann Arbor
| |
Collapse
|
23
|
Kulcsar MA, Montenegro FL, Santos AB, Tavares MR, Arap SS, Kowalski LP. Recommendations for head and neck surgical procedures during the COVID-19 pandemic. Clinics (Sao Paulo) 2020; 75:e2084. [PMID: 32638909 PMCID: PMC7333519 DOI: 10.6061/clinics/2020/e2084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits and non-essential elective procedures is also recommended. However, surgery should not be postponed in the case of the most essential elective indications (mostly associated with head and neck cancers). As malignant tumors of the head and neck are clinically time sensitive, neither consultations for these tumors nor their treatment should be postponed. Postponing surgical treatment can result in a change in the disease stage and alter an individual's chance of survival. In this situation, planning of all treatments must begin with the request for, in addition to routine examinations, a nasal swab polymerase chain reaction for SARS-CoV-2 and chest computed tomography. Only if the results of these tests are positive or if fever or other symptoms suggestive of COVID-19 are present should the surgical procedure be postponed until the patient completely recovers. This is mandatory not only because of the risk of contamination of the surgical team but also because of the increased risk of postoperative complications and high risk of death. During this pandemic, the most effective safety measures are social distancing for the general public and the adequate availability and use of PPE in the healthcare field. The treatment of other chronic diseases, such as cancer, should be continued, as the damming of cases of these diseases will have a deleterious effect on the public healthcare system.
Collapse
Affiliation(s)
- Marco A.V. Kulcsar
- Servico de Cirurgia de Cabeca e Pescoco, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Servico de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Fabio L.M. Montenegro
- Servico de Cirurgia de Cabeca e Pescoco, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - André B.O. Santos
- Servico de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcos R. Tavares
- Servico de Cirurgia de Cabeca e Pescoco, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Sergio S. Arap
- Servico de Cirurgia de Cabeca e Pescoco, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Luiz P. Kowalski
- Servico de Cirurgia de Cabeca e Pescoco, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Servico de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| |
Collapse
|
24
|
Silverman DA, Lin C, Tamaki A, Puram SV, Carrau RL, Seim NB, Eskander A, Rocco JW, Old MO, Kang SY. Respiratory and pulmonary complications in head and neck cancer patients: Evidence-based review for the COVID-19 era. Head Neck 2020; 42:1218-1226. [PMID: 32343013 PMCID: PMC7267530 DOI: 10.1002/hed.26217] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pulmonary complications and infections frequently affect patients with head and neck squamous cell carcinoma (HNSCC). Common characteristics can predispose these patients to the development of severe respiratory illness, which may be particularly relevant during the 2019 coronavirus disease (COVID-19) pandemic. METHODS A scoping review was performed to assess the impact of pulmonary comorbidities and adverse respiratory outcomes in HNSCC patients. RESULTS Advanced age, history of tobacco and alcohol abuse, and cardiopulmonary comorbidities are significant risk factors for the development of adverse respiratory outcomes. Treatment toxicities from radiation or chemoradiation therapy significantly increase these risks. CONCLUSION Respiratory complications are a frequent cause of morbidity and mortality among HNSCC patients, and the COVID-19 pandemic may disproportionately affect this population. Interventions designed to decrease smoking and alcohol use, improve oral hygiene, and aggressively manage medical comorbidities are important to the long-term management and health of these patients.
Collapse
Affiliation(s)
- Dustin A Silverman
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Chen Lin
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Akina Tamaki
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Sidharth V Puram
- Department of Otolaryngology-Head and Neck Surgery and Department of Genetics, Washington University School of Medicine, Ear, Nose & Throat Center, St. Louis, Missouri, USA
| | - Ricardo L Carrau
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Nolan B Seim
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, USA
| | - James W Rocco
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Matthew O Old
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| | - Stephen Y Kang
- Division of Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, James Cancer Center and Solove Research Institute, Columbus, Ohio, USA
| |
Collapse
|