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Yang Y, Niu L, Zhu Y, Wu Z, Xia L, Xiao C, Shen X, Xiao X, Tian C, Lin F. Optimum timing of lung resection surgery following SARS-CoV-2 infection for non-small cell lung cancer. Cancer Med 2024; 13:e6891. [PMID: 38169158 PMCID: PMC10807575 DOI: 10.1002/cam4.6891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/29/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on postoperative recovery of non-small cell lung cancer (NSCLC) is need to be understood, thereby informing the optimal timing of surgical decision-making during the COVID-19 pandemic for NSCLC patients. This study reports the postoperative outcomes of surgical NSCLC patients with preoperative SARS-CoV-2 infection. METHOD This single-center retrospective cohort study included 241 NSCLC patients who underwent lobectomy or sub-lobectomy between December 1, 2022 and February 14, 2023. Surgical outcomes of patients with preoperative SARS-CoV-2 infection (stratified by the time from diagnosis of SARS-CoV-2 infection to surgery) were compared with those without preoperative SARS-CoV-2 infection. The primary outcomes were total postoperative complications and postoperative pulmonary complications (PPCs), the secondary outcomes included operation time, total postoperative drainage and time, length of hospital stay (LOS), 30-day and 90-day postoperative symptoms. RESULTS This study included 153 (63.5%) patients with preoperative SARS-CoV-2 infection and 88 (36.5%) patients without previous SARS-CoV-2 infection. In patients with a preoperative SARS-CoV-2 diagnosis, the incidence of total postoperative complications (OR, 3.00; 95% CI, 1.12-8.01; p = 0.028) and PPCs (OR, 4.20; 95% CI, 1.11-15.91; p = 0.035) both increased in patients infected having surgery within 2 weeks compared with non-infection before surgery. However, patients who underwent lung resection more than 2 weeks after SARS-CoV-2 diagnosis had a similar risk of postoperative complications and surgical outcomes with those non-infection before surgery. CONCLUSION This is the first study to provide evidence regarding the optimum timing of lung resection surgery and assessing early outcomes after surgery in NSCLC patients with SARS-CoV-2 infection. Our study documents that the SARS-CoV-2 infection did not complicate surgical procedures for lung cancer, and suggest that lung surgery should be postponed at least 2 weeks after SARS-CoV-2 infection for NSCLC patients.
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Affiliation(s)
- Yanbo Yang
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung CancerSichuan UniversityChengduChina
| | - Lingli Niu
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
| | - Yunke Zhu
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung CancerSichuan UniversityChengduChina
| | - Zhu Wu
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung CancerSichuan UniversityChengduChina
| | - Liang Xia
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung CancerSichuan UniversityChengduChina
| | - Congjia Xiao
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
| | - Xu Shen
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
| | - Xin Xiao
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Conglin Tian
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
| | - Feng Lin
- Department of Thoracic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of Thoracic Surgery, Shangjin Branch of Western China HospitalSichuan UniversityChengduChina
- Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung CancerSichuan UniversityChengduChina
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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] [What about the content of this article? (0)] [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.
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Arrieta O, Lara‐Mejía L, Bautista‐GonzÁlez E, Heredia D, Turcott JG, BarrÓn F, Ramos‐Ramírez M, Cabrera‐Miranda L, Salinas Padilla MÁ, Aguerrebere M, Cardona AF, Rolfo C, Arroyo‐HernÁndez M, Soto‐Pérez‐de‐Celis E, Baéz‐Saldaña R. Clinical Impact of the COVID-19 Pandemic in Mexican Patients with Thoracic Malignancies. Oncologist 2021; 26:1035-1043. [PMID: 34498780 PMCID: PMC8649017 DOI: 10.1002/onco.13962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/19/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Accumulated evidence indicates that patients with lung cancer are a vulnerable population throughout the pandemic. Limited information is available in Latin America regarding the impact of the pandemic on medical care. The goal of this study was to describe the clinical and social effect of COVID-19 on patients with thoracic cancer and to ascertain outcomes in those with a confirmed diagnosis. MATERIALS AND METHODS This cohort study included patients with thoracic neoplasms within a single institution between March 1, 2020, and February 28, 2021. All variables of interest were extracted from electronic medical records. During this period, the Depression Anxiety and Stress Scale 21 (DASS-2) was applied to evaluate and identify more common psychological disorders. RESULTS The mean age for the total cohort (n = 548) was 61.5 ± 12.9 years; non-small cell lung cancer was the most frequent neoplasm (86.9%), advanced stages predominated (80%), and most patients were under active therapy (82.8%). Any change in treatment was reported in 23.9% of patients, of which 78.6% were due to the COVID-19 pandemic. Treatment delays (≥7 days) were the most frequent modifications in 41.9% of cases, followed by treatment suspension at 37.4%. Patients without treatment changes had a more prolonged progression-free survival and overall survival (hazard ratio [HR] 0.21, p < .001 and HR 0.28, p < .001, respectively). The mean DASS-21 score was 10.45 in 144 evaluated patients, with women being more affected than men (11.41 vs. 9.08, p < .001). Anxiety was reported in 30.5% of cases, followed by depression and distress in equal proportions (18%). Depressed and stressed patients had higher odds of experiencing delays in treatment than patients without depression (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.53-13.23, p = .006 and OR 3.18, 95% CI 1.2-10.06, p = .006, respectively). CONCLUSION Treatment adjustments in patients with thoracic malignancies often occurred to avoid COVID-19 contagion with detrimental effects on survival. Psychological disorders could have a role in adherence to the original treatment regimen. IMPLICATIONS FOR PRACTICE The pandemic has placed an enormous strain on health care systems globally. Patients with thoracic cancers represent a vulnerable population, with increased morbidity and mortality rates. In Mexico, treatment modifications were common during the pandemic, and those who experienced delays had worse survival outcomes. Most treatment modifications were related to a patient decision rather than a lockdown of health care facilities in which mental health impairment plays an essential role. Moreover, the high case fatality rate highlights the importance of improving medical care access. Likewise, to develop strategies facing future threats that may compromise health care systems in non-developed countries.
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Affiliation(s)
- Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | - Luis Lara‐Mejía
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | | | - David Heredia
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | - Jenny G. Turcott
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | - Feliciano BarrÓn
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | | | - Luis Cabrera‐Miranda
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan)Mexico CityMexico
| | | | | | - Andrés F. Cardona
- Clinical and Translational Oncology Group, Clínica del CountryBogotaColombia
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, Mount SinaiNew YorkNew YorkUSA
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Nimgaonkar V, Aggarwal C, Berman AT, Gabriel P, Shulman LN, Kucharczuk J, Roy M, Bauml JM, Singh AP, Cohen RB, Langer CJ, Marmarelis ME. Impact of telemedicine adoption on accessibility and time to treatment in patients with thoracic malignancies during the COVID-19 pandemic. BMC Cancer 2021; 21:1094. [PMID: 34635061 PMCID: PMC8503709 DOI: 10.1186/s12885-021-08819-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility. Methods This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included. Results 240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45). Conclusions Rapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.
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Affiliation(s)
- Vivek Nimgaonkar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Charu Aggarwal
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Abigail T Berman
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter Gabriel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence N Shulman
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Kucharczuk
- Division of Thoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Megan Roy
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joshua M Bauml
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aditi P Singh
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roger B Cohen
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Corey J Langer
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Melina E Marmarelis
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Gounant V, Brosseau S, Soussi G, Pluvy J, Guezzour N, Vauchier C, Brouk Z, Namour C, Zalcman G. Patients avec cancers thoraciques et COVID-19 : au cœur de la tempête. Rev Malad Respir Actual 2021; 13:2S280-2S291. [PMID: 34659597 PMCID: PMC8504965 DOI: 10.1016/s1877-1203(21)00121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A meta-analysis of the Chinese studies in April 2020, including 3600 patients with cancer and COVID-19, first reported an increase of the COVID-19 risk and the case-fatality in these patients. Then, North-American and European series confirmed the increased COVID-19 risk for patients with cancer, as the increased risk of severe COVID-19 and death, when compared with general population, adjusting for age. Patients with lung cancer have the highest risk of severe respiratory forms, and the highest risk of SARS-CoV2-induced death (25 to 30%), after patients with hematological cancers. Metastatic patients, with poor PS, and those having received a cytotoxic chemotherapy within the weeks preceding SARSCoV2 infection, are those with the highest risk of death. Conversely, being treated with immune checkpoint inhibitors would not favor the cytokine storm, which makes the severity of COVID-19. SARS-CoV2 pandemic, beyond having needed the generalization of drastic social distancing measures in hospitals, also needed organizational changes, to allow healthcare continuity for cancer patients. Adaptation of therapeutic protocols was needed, with increased intervals between cycles, the choice of less toxic protocols, the systematic use of hematological growth factors, and teleconsultations follow-up. Lastly, mRNA-based SARS-CoV2 vaccines are efficient in patients with thoracic cancer, provided the interval of 21/28 days between the two injections is maintained, since protective immunization seems delayed, especially after cytotoxic chemotherapy. Only 13% of patients with very low protective antibodies titers would need a third booster injection, with a clear rise in protective antibodies titers induced by such a third injection.© 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- V. Gounant
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
| | - S. Brosseau
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
- U830 INSERM Cancer Hétérogénéité et Plasticité, Centre de Recherche, Institut Curie, 75231 Paris Cedex 05, Paris, France
| | - G. Soussi
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
| | - J. Pluvy
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
- Service de Cancérologie Multidisplinaire et innovations thérapeutiques, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - N. Guezzour
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
| | - C. Vauchier
- U830 INSERM Cancer Hétérogénéité et Plasticité, Centre de Recherche, Institut Curie, 75231 Paris Cedex 05, Paris, France
| | - Z. Brouk
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
| | - C. Namour
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
| | - G. Zalcman
- Université de Paris, Service d’Oncologie thoracique-CIC INSERM 1425, Institut Universitaire du Cancer Paris-Nord, Hôpital Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris (AP-HP) 46 rue Henri Huchard, 75018 Paris, Paris, France
- U830 INSERM Cancer Hétérogénéité et Plasticité, Centre de Recherche, Institut Curie, 75231 Paris Cedex 05, Paris, France
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Fraser S, Baranowski R, Patrini D, Nandi J, Al-Sahaf M, Smelt J, Hoffman R, Santhirakumaran G, Lee M, Wali A, Dickinson H, Jadoon M, Harrison-Phipps K, King J, Pilling J, Bille A, Okiror L, Stamenkovic S, Waller D, Wilson H, Jordan S, Begum S, Buderi S, Tan C, Hunt I, Vaughan P, Jenkins M, Hayward M, Lawrence D, Beddow E, Anikin V, Mani A, Finch J, Maheswaran H, Lim E, Routledge T, Lau K, Harling L. Maintaining safe lung cancer surgery during the COVID-19 pandemic in a global city. EClinicalMedicine 2021; 39:101085. [PMID: 34430839 PMCID: PMC8376626 DOI: 10.1016/j.eclinm.2021.101085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 has challenged health service provision worldwide. This work evaluates safe surgical pathways and standard operating procedures implemented in the high volume, global city of London during the first wave of SARS-CoV-2 infection. We also assess the safety of minimally invasive surgery(MIS) for anatomical lung resection. METHODS This multicentre cohort study was conducted across all London thoracic surgical units, covering a catchment area of approximately 14.8 Million. A Pan-London Collaborative was created for data sharing and dissemination of protocols. All patients undergoing anatomical lung resection 1st March-1st June 2020 were included. Primary outcomes were SARS-CoV-2 infection, access to minimally invasive surgery, post-operative complication, length of intensive care and hospital stay (LOS), and death during follow up. FINDINGS 352 patients underwent anatomical lung resection with a median age of 69 (IQR: 35-86) years. Self-isolation and pre-operative screening were implemented following the UK national lockdown. Pre-operative SARS-CoV-2 swabs were performed in 63.1% and CT imaging in 54.8%. 61.7% of cases were performed minimally invasively (MIS), compared to 59.9% pre pandemic. Median LOS was 6 days with a 30-day survival of 98.3% (comparable to a median LOS of 6 days and 30-day survival of 98.4% pre-pandemic). Significant complications developed in 7.3% of patients (Clavien-Dindo Grade 3-4) and 12 there were re-admissions(3.4%). Seven patients(2.0%) were diagnosed with SARS-CoV-2 infection, two of whom died (28.5%). INTERPRETATION SARS-CoV-2 infection significantly increases morbidity and mortality in patients undergoing elective anatomical pulmonary resection. However, surgery can be safely undertaken via open and MIS approaches at the peak of a viral pandemic if precautionary measures are implemented. High volume surgery should continue during further viral peaks to minimise health service burden and potential harm to cancer patients. FUNDING This work did not receive funding.
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Affiliation(s)
- Stephanie Fraser
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Ralitsa Baranowski
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Davide Patrini
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - Jay Nandi
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | - May Al-Sahaf
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | - Jeremy Smelt
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Ross Hoffman
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | | | - Michelle Lee
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Anuj Wali
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | | | - Mehmood Jadoon
- Department of Thoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | | | - Juliet King
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - John Pilling
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Andrea Bille
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Lawrence Okiror
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Sasha Stamenkovic
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - David Waller
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Henrietta Wilson
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Simon Jordan
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Sofina Begum
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Silviu Buderi
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Carol Tan
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Ian Hunt
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Paul Vaughan
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Melanie Jenkins
- Department of Thoracic Surgery, St George's Hospital, London, United Kingdom
| | - Martin Hayward
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - David Lawrence
- Department of Thoracic Surgery, University College London Hospital, London, United Kingdom
| | - Emma Beddow
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Vladimir Anikin
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Aleksander Mani
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | - Jonathan Finch
- Department of Thoracic Surgery, Harefield Hospital, London, United Kingdom
| | | | - Eric Lim
- Department of Thoracic Surgery, Royal Brompton Hospital, London, United Kingdom
| | - Tom Routledge
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Kelvin Lau
- Department of Thoracic Surgery, St Bartholomew's Hospital, London, United Kingdom
| | - Leanne Harling
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
- Department of Surgery and Cancer, Imperial College London, United Kingdom
- Corresponding author.
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Siavashpour Z, Goharpey N, Mobasheri M. Radiotherapy based management during Covid-19 pandemic - A systematic review of presented consensus and guidelines. Crit Rev Oncol Hematol 2021; 164:103402. [PMID: 34214608 PMCID: PMC8242203 DOI: 10.1016/j.critrevonc.2021.103402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/17/2021] [Accepted: 06/18/2021] [Indexed: 01/18/2023] Open
Abstract
Treatment management of cancer patients in the radiation oncology departments during the current COVID-19 pandemic is challenging. A systematic review of published consensus/guidelines on the role of radiotherapy prioritization, suggested treatment protocols, and set up management was undertaken based on the PRISMA protocol and through PubMed/PMC, Scopus, Google Scholar, Web of Science databases until 01/20/2021. One hundred and sixty-eight publications or regional consensus were included. Summary of recommendations contained: (1) using hypo-fractionated (Hypo-F) regimens for therapeutic/palliative indications, (2) delaying radiotherapy for several weeks or until pandemic over, (3) omitting radiotherapy by replacement of alternative therapies or active surveillance, (4) applying safer patients' setup and preparation protocols, (5) developing telemedicine/telehealth service. To conclude, it is essential to carefully weigh the risk of exposure to COVID-19 infection and the benefit of treating cancer patients during the pandemic. Trying to have a global guideline facing this or any other probable crisis is crucial for health care service.
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Affiliation(s)
- Zahra Siavashpour
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Neda Goharpey
- Radiotherapy Oncology Department, Shohada-e Tajrish Educational Hospital, Tehran, Iran.
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Yang Y, Lu J, Ma Y, Xi C, Kang J, Zhang Q, Jia X, Liu K, Du S, Kocher F, Seeber A, Gridelli C, Provencio M, Seki N, Tomita Y, Zhang X. Evaluation of the reporting quality of clinical practice guidelines on lung cancer using the RIGHT checklist. Transl Lung Cancer Res 2021; 10:2588-2602. [PMID: 34295664 PMCID: PMC8264321 DOI: 10.21037/tlcr-21-405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/11/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND In recent years, the number of clinical practice guidelines (CPGs) for lung cancer has increased, but the quality of these guidelines has not been systematically assessed so far. Our aim was to assess the reporting quality of CPGs on lung cancer published since 2018 using the International Reporting Items for Practice Guidelines in Health Care (RIGHT) instrument. METHODS We systematically searched the major electronic literature databases, guideline databases and medical society websites from January 2018 to November 2020 to identify all CPGs for small cell and non-small cell lung cancer (NSCLC). The search and extraction were completed using standardized forms. The quality of included guidelines was evaluated using the RIGHT statement. We present the results descriptively, including a stratification by selected determinants. RESULTS A total of 49 CPGs were included. The mean proportion across the guidelines of the 22 items of the RIGHT checklist that were appropriately reported was 57.9%. The items most common to be poorly reported were quality assurance (item 17) and description of the role of funders (item 18b), both of which were reported in only one guideline. The proportions of items within each of the seven domains of the RIGHT checklist that were correctly reported were Basic information 75.9%; background 83.2%; evidence 44.5%; recommendations 55.4%; review and quality assurance 12.2%; funding and declaration and management of interests 42.9%; and other information 38.1%. The reporting quality of guidelines did not differ between publication years. CPGs published in journals with impact factor >30 tended to be best reported. CONCLUSIONS Our results revealed that reporting in CPGs for lung cancer is suboptimal. Particularly the declaration of funding and quality assurance are poorly reported in recent CPGs on lung cancer.
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Affiliation(s)
- Yongjie Yang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Jingli Lu
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Yanfang Ma
- School of Chinese Medicine of Hong Kong Baptist University, Hong Kong, China
| | - Chen Xi
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Jian Kang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Qiwen Zhang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Xuedong Jia
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Kefeng Liu
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Shuzhang Du
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
| | - Florian Kocher
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University Innsbruck, Innsbruck, Austria
| | - Cesare Gridelli
- A.O.R.N. San Giuseppe Moscati, Contrada Amoretta, Avellino, AV, Italy
| | - Mariano Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Nobuhiko Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yusuke Tomita
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Xiaojian Zhang
- Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou University, Zhengzhou, China
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9
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Zhang Z, Yang S, Ma Y, Zhou H, Wu X, Han J, Hou J, Hao L, Spicer JD, Koh YW, Provencio M, Reguart N, Mitsudomi T, Wang Q. Consistency of recommendations for the diagnosis and treatment of non-small cell lung cancer: a systematic review. Transl Lung Cancer Res 2021; 10:2715-2732. [PMID: 34295672 PMCID: PMC8264323 DOI: 10.21037/tlcr-21-423] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/04/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND To systematically assess the consistency of recommendations regarding diagnosis and treatment of non-small cell lung cancer (NSCLC) in clinical practice guidelines (CPGs). METHODS We systematically searched relevant literature databases and websites to identify CPGs related to NSCLC. We extracted the general characteristics of the included guidelines and their recommendations and descriptively compared and analyzed the consistency of recommendations across the guidelines. RESULTS A total of 28 NSCLC guidelines were retrieved. The recommendations covered mainly diagnosis and treatment. The recommendations in the guidelines differed substantially in various topics, such as the application of positron emission tomography (PET) and the classification of stage III. Fourteen guidelines divided stage III into two types: operable and inoperable; and the remaining 14 guidelines into three sub-stages IIIA, IIIB and IIIC. Recommendations regarding the treatment in stage III were relatively inconsistent. In driver gene (EGFR, ALK, ROS1) positive patients, targeted therapy was the most common recommendation for first-line treatment, but recommendations regarding second-line treatment varied according to the site of the mutation. In driver gene negative patients, immunotherapy was the most frequently recommended option as both first- and second-line treatment, followed by chemotherapy. DISCUSSION A number of countries are devoting themselves to develop NSCLC guidelines and the process of updating guidelines is accelerating, yet recommendations between guidelines are not consistent. We adopted a systematic review method to systematically search and analyze the NSCLC guidelines worldwide. We objectively reviewed the differences in recommendations for NSCLC diagnosis and treatment between the guidelines. Inconsistency of recommendations across guidelines can result from multiple potential reasons. Such as, the guidelines developed time, different countries and regions and many more. Poor consistency across CPGs can confuse the guideline users, and we therefore advocate paying more attention to examining the controversies and updating guidelines timely to improve the consistency among CPGs. Our study had also several limitations, we limited the search to CPGs published in Chinese or English, the interpretation of recommendations is inherently subjective, we did not evaluate the details of the clinical content of the CPG recommendations. Our research presents the current status of NSCLC guidelines worldwide and give the opportunity to pay more attention to the existing gaps. Further investigations should determine the reasons for inconsistency, the implications for recommendation development, and the role of synthesis across recommendations for optimal guidance of clinical care treatment. With the continuous revision and update of the guidelines, we are confident that future guidelines will be formulated with higher quality to form clear, definite and consistent recommendations for NSCLC diagnosis and treatment.
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Affiliation(s)
- Zhe Zhang
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Sen Yang
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yanfang Ma
- School of Chinese Medicine of Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Hanqiong Zhou
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xuan Wu
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Jing Han
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Jiabao Hou
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Lidan Hao
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Jonathan D. Spicer
- Division of Thoracic and Upper Gastrointestinal Surgery, Department of Surgery, McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Young Wha Koh
- Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Mariano Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain
| | - Noemi Reguart
- Thoracic Oncology Unit, Department of Medical Oncology, IDIPAPS, Hospital Clinic Barcelona, Villarroel, Spain
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Qiming Wang
- Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
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Provencio M, Mazarico Gallego JM, Calles A, Antoñanzas M, Pangua C, Mielgo Rubio X, Nadal E, Castro RL, López-Martín A, Del Barco E, Dómine M, Franco F, Diz P, Sandoval C, Girona ES, Sullivan I, Sala MÁ, Ledo GG, Cucurull M, Mosquera J, Martínez M, Chara LE, Arriola E, Herrera BE, Jarabo JR, Álvarez RÁ, Baena J, Cao MG. Lung cancer patients with COVID-19 in Spain: GRAVID study. Lung Cancer 2021; 157:109-115. [PMID: 34016490 PMCID: PMC8118702 DOI: 10.1016/j.lungcan.2021.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Patients with cancer may be at increased risk of more severe COVID-19 disease; however, prognostic factors are not yet clearly identified. The GRAVID study aimed to describe clinical characteristics, outcomes, and predictors of poor outcome in patients with lung cancer and COVID-19. METHODS Prospective observational study that included medical records of patients with lung cancer and PCR-confirmed COVID-19 diagnosis across 65 Spanish hospitals. The primary endpoint was all-cause mortality; secondary endpoints were hospitalization and admission to intensive care units (ICU). RESULTS A total of 447 patients with a mean age of 67.1 ± 9.8 years were analysed. The majority were men (74.3 %) and current/former smokers (85.7 %). NSCLC was the most frequent type of cancer (84.5 %), mainly as adenocarcinoma (51.0 %), and stage III metastatic or unresectable disease (79.2 %). Nearly 60 % of patients were receiving anticancer treatment, mostly first-line chemotherapy. Overall, 350 (78.3 %) patients were hospitalized for a mean of 13.4 ± 11.4 days, 9 (2.0 %) were admitted to ICU and 146 (32.7 %) died. Advanced disease and the use of corticosteroids to treat COVID-19 during hospitalization were predictors of mortality. Hospitalized, non-end-of-life stage patients with lymphocytopenia and high LDH had an increased risk of death. Severity of COVID-19 correlated to higher mortality, ICU admission, and mechanical ventilation rates. CONCLUSIONS Mortality rate was higher among patients treated with corticosteroids during hospitalization, while anticancer therapy was not associated with an increased risk of hospitalization or death. Tailored approaches are warranted to ensure effective cancer management while minimizing the risk of exposure to SARS-CoV-2.
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Affiliation(s)
| | | | - Antonio Calles
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Ernest Nadal
- Institut Catala d'Oncologia (ICO), L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - Manuel Dómine
- Hospital Universitario Fundación Jiménez Diaz, IIS-FJD, Madrid, Spain
| | - Fernando Franco
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Pilar Diz
- Complejo Asistencial Universitario de León, León, Spain
| | | | | | | | | | | | - Marc Cucurull
- Institut Catala d'Oncologia (ICO), Hospital Universitari Germans Trias i Pujol, B-ARGO, IGTP, Badalona, Barcelona, Spain
| | | | | | | | | | | | | | | | - Javier Baena
- Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - María González Cao
- Instituto Oncológico Dr Rosell, Hospital Universitario Dexeus, Barcelona, Spain
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11
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Arrieta O, Varela-Santoyo E, Cardona AF, Sánchez-Reyes R, Lara-Mejía L, Bassarmal SS, Valle-Bautista D, Corrales-Rodríguez L, Motola-Kuba D, Cabrera-Miranda L, Martín C. Association of Carcinoembryonic Antigen Reduction With Progression-free and Overall Survival Improvement in Advanced Non-small-cell Lung Cancer. Clin Lung Cancer 2021; 22:510-522. [PMID: 33947631 DOI: 10.1016/j.cllc.2021.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Non-small cell lung cancer elevates serum carcinoembryonic antigen (CEA). CEA determinations are not recommended currently. This study aims to identify the correlation between reducing serum CEA levels with progression-free survival (PFS) and overall survival. METHODS This study assessed at baseline and in every scheduled visit serum CEA levels throughout first-line therapy. A sensitivity and specificity analysis identified the best cut-off point and correlated it with progression-free survival and overall survival. Multivariate Cox proportional hazard models were conducted. RESULTS We assessed 748 patients with elevated serum CEA levels at diagnosis. A ≥20% decrease from baseline was associated with a 2-fold median survival compared with patients with lower decreases (20.5 months vs 9.1 months; hazard ratio, 0.53; 95% confidence interval, 0.44 to -0.64; P < .001). CEA sensitivity and specificity to predict survival was 79.8% and 59.8%, respectively. A ≥10% decrease in CEA concentrations was associated with longer progression-free survival (7.7 months vs 5.9 months; hazard ratio, 0.71; 95% confidence interval, 0.57 to -0.88; P = .001) in those treated with chemotherapy, and in patients under tyrosine kinase inhibitors (11.9 months vs 7.3 months; hazard ratio, 0.63; 95% confidence interval, 0.47 to -0.83; P = .0001) and a ≥20% decrease. CONCLUSION In patients with metastatic non-small cell lung cancer with an elevated baseline CEA level, the percentage decrease of CEA concentrations above the threshold during the first-line therapy was associated with more prolonged survival and progression-free intervals. Serum CEA determinations are a feasible, noninvasive option for monitoring and prognosis.
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Affiliation(s)
- Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México.
| | - Edgar Varela-Santoyo
- Oncologic Center "Diana Laura Riojas de Colosio" Clinical Foundation Médica Sur, México City, México
| | - Andrés F Cardona
- Clinical and Translational Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Roberto Sánchez-Reyes
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Luis Lara-Mejía
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | | | - Dafne Valle-Bautista
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | | | - Daniel Motola-Kuba
- Oncologic Center "Diana Laura Riojas de Colosio" Clinical Foundation Médica Sur, México City, México
| | - Luis Cabrera-Miranda
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), México City, México
| | - Claudio Martín
- Thoracic Oncology Unit, Alexander Fleming Institute, Buenos Aires, Argentina
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12
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Krawczyk P, Kowalski DM, Wojas-Krawczyk K, Dziadziuszko R. Predictive factors testing proposal for NSCLC patients during the COVID-19 pandemic. Expert Rev Anticancer Ther 2021; 21:569-572. [PMID: 33724132 DOI: 10.1080/14737140.2021.1901585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Paweł Krawczyk
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - Dariusz M Kowalski
- Department of Lung Cancer and Chest Tumors, The Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warsaw, Poland
| | - Kamila Wojas-Krawczyk
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - Rafał Dziadziuszko
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
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13
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Fernandes GA, Feriani D, França E Silva ILA, Mendonça E Silva DR, Arantes PE, Canteras JDS, da Silva RR, Curado MP. Differences in mortality of cancer patients with COVID-19 in a Brazilian cancer center. Semin Oncol 2021; 48:171-180. [PMID: 33573780 PMCID: PMC7849494 DOI: 10.1053/j.seminoncol.2021.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil. METHODS Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable. RESULTS Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33-12.34) and hematological (OR 2.17, 95% CI 0.96-4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25-6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19. CONCLUSIONS Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.
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Affiliation(s)
| | - Diego Feriani
- Department of Infection Prevention and Control, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Paola Engelmann Arantes
- Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Maria Paula Curado
- Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil.
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Montenegro P, Pinillos L, Young F, Aguilar A, Tirado-Hurtado I, Pinto JA, Vallejos C. Telemedicine and the current opportunities for the management of oncological patients in Peru in the context of COVID-19 pandemic. Crit Rev Oncol Hematol 2021; 157:103129. [PMID: 33227573 PMCID: PMC7581359 DOI: 10.1016/j.critrevonc.2020.103129] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/29/2022] Open
Abstract
COVID-19 pandemic is the more challenging public health emergency of the century, producing the collapse of health systems and unprecedented levels of morbidity and mortality around the world, especially in low resource settings. Patients with chronic diseases are the most affected, not only due to the high susceptibility to SARS-CoV-2 infection but also due to the decrease in opportunities for timely care. In this dark landscape, telemedicine, before limited to very specific scenarios, has become one of our main tools to manage cancer patients, particularly in Latin America where COVID-19 has had a strong impact on the public health. Telemedicine can provide rapid access to specialized cancer care in a scenario complicated, reducing the exposure of patients and healthcare personnel to the SARS-CoV-2. In this review, we would like to share our experience and our workflow using telemedicine at Oncosalud-AUNA, a private clinic in Peru.
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Affiliation(s)
| | | | | | | | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, AUNA, Lima41, Peru
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