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Tambuyzer T, Vanhauwaert D, Boterberg T, De Vleeschouwer S, Peacock HM, Bouchat J, Silversmit G, Verdoodt F, De Gendt C, Van Eycken L. Impact of the COVID-19 Pandemic on Incidence and Observed Survival of Malignant Brain Tumors in Belgium. Cancers (Basel) 2023; 16:63. [PMID: 38201490 PMCID: PMC10778220 DOI: 10.3390/cancers16010063] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: This study evaluates the impact of the COVID-19 pandemic on the incidence, treatment, and survival of adults diagnosed with malignant brain tumors in Belgium in 2020. (2) Methods: We examined patients aged 20 and older with malignant brain tumors (2004-2020) from the Belgian Cancer Registry database, assessing incidence, WHO performance status, vital status, and treatment data. We compared 2020 incidence rates with projected rates and age-standardized rates to 2015-2019. The Kaplan-Meier method was used to assess observed survival (OS). (3) Results: In 2020, there was an 8% drop in age-specific incidence rates, particularly for those over 50. Incidence rates plunged by 37% in April 2020 during the first COVID-19 peak but partially recovered by July. For all malignant brain tumors together, the two-year OS decreased by four percentage points (p.p.) in 2020 and three p.p. in 2019, compared to that in 2015-2018. Fewer patients (-9 p.p.) with glioblastoma underwent surgery, and the proportion of patients not receiving surgery, radiotherapy, or systemic therapy increased by six percentage points in 2020. (4) Conclusions: The COVID-19 pandemic profoundly impacted the diagnosis, treatment strategies, and survival of brain tumor patients in Belgium during 2020. These findings should guide policymakers in future outbreak responses, emphasizing the need to maintain or adapt (neuro)-oncological care pathways and promote informed decision making when care capacity is limited.
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Affiliation(s)
- Tim Tambuyzer
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | | | - Tom Boterberg
- Department of Radiation Oncology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Steven De Vleeschouwer
- Department of Neurosurgery, UZ Leuven, 3000 Leuven, Belgium;
- Laboratory of Experimental Neurosurgery and Neuroanatomy, Department Neurosciences, LEUVEN BRAIN INSTITUTE (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Hanna M. Peacock
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Joanna Bouchat
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Geert Silversmit
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Freija Verdoodt
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Cindy De Gendt
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
| | - Liesbet Van Eycken
- Belgian Cancer Registry, 1210 Brussels, Belgium; (T.T.); (J.B.); (L.V.E.)
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Mischkulnig M, Hopp B, Wadiura LI, Khalaveh F, Kiesel B, Rössler K, Widhalm G, Dorfer C. Treatment of high-grade glioma patients during the COVID-19 pandemic: Impact on overall survival, tumor size and delay of treatment. PLoS One 2023; 18:e0287993. [PMID: 37390078 PMCID: PMC10313013 DOI: 10.1371/journal.pone.0287993] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Throughout the last years, the coronavirus disease 2019 (COVID-19) pandemic posed a major challenge to the optimal and timely treatment of neurooncological patients around the world. While the importance of prompt surgical treatment in high-grade gliomas is widely accepted, there is sparse data on the impact of the pandemic on patients suffering from this malignant disease. METHODS We performed a retrospective analysis of patients undergoing surgical high-grade glioma treatment at the Medical University of Vienna between March 2020 and February 2021, as well as a control cohort of patients who received treatment between January and December 2019. Time lag between referral for surgical treatment to actual surgery, preoperative tumor volume and overall patient survival were compared between groups. RESULTS A total of 118 patients, including 62 cases treated during the first year of the COVID-19 pandemic, as well as 56 control patients, were investigated in this study. Median interval to surgery was significantly shorter in patients treated during COVID-19 compared with the control group (4.00 versus 7.00 days; p = 0.0005). In contrast, patients treated during COVID-19 exhibited marginally larger preoperative tumor volumes, while overall patient survival was comparable between groups. CONCLUSIONS The COVID-19 pandemic did not negatively affect the overall survival of patients undergoing surgical high-grade glioma treatment at our institution. The significantly shorter treatment delay in patients treated during the pandemic likely reflects increased resource allocation for this critical patient population.
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Affiliation(s)
- Mario Mischkulnig
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Benjamin Hopp
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Lisa I. Wadiura
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Farjad Khalaveh
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Karl Rössler
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Christian Dorfer
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
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Vogel MME, Wagner A, Gempt J, Krenzlin H, Zeyen T, Drexler R, Voss M, Nettekoven C, Abboud T, Mielke D, Rohde V, Timmer M, Goldbrunner R, Steinbach JP, Dührsen L, Westphal M, Herrlinger U, Ringel F, Meyer B, Combs SE. Impact of the SARS-CoV-2 pandemic on the survival of patients with high-grade glioma and best practice recommendations. Sci Rep 2023; 13:2766. [PMID: 36797335 PMCID: PMC9933015 DOI: 10.1038/s41598-023-29790-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has changed the clinical day-to-day practice. The aim of this study was to evaluate the impact of the pandemic on patients with high-grade glioma (HGG) as well as to derive best practice recommendations. We compared a multi-institutional cohort with HGG (n = 251) from 03/2020 to 05/2020 (n = 119) to a historical cohort from 03/2019 to 05/2019 (n = 132). The endpoints were outcome (progression-free survival (PFS) and overall survival (OS)) as well as patterns of care and time intervals between treatment steps. The median OS for WHO grade 4 gliomas was 12 months in 2019 (95% Confidence Interval 9.7-14.3 months), and not reached in 2020 (p = .026). There were no other significant differences in the Kaplan-Meier estimates for OS and PFS between cohorts of 2019 and 2020, neither did stratification by WHO grade reveal any significant differences for OS, PFS or for patterns of care. The time interval between cranial magnetic resonance imaging (cMRI) and biopsy was significantly longer in 2020 cohort (11 versus 21 days, p = .031). Median follow-up was 10 months (range 0-30 months). Despite necessary disease containment policies, it is crucial to ensure that patients with HGG are treated in line with the recent guidelines and standard of care (SOC) algorithms. Therefore, we strongly suggest pursuing no changes to SOC treatment, a timely diagnosis and treatment with short time intervals between first symptoms, initial diagnosis, and treatment, as well as a guideline-based cMRI follow-up.
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Affiliation(s)
- Marco M. E. Vogel
- grid.6936.a0000000123222966Department of Radiation Oncology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany ,grid.4567.00000 0004 0483 2525Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany
| | - Arthur Wagner
- grid.6936.a0000000123222966Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany
| | - Jens Gempt
- grid.6936.a0000000123222966Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany
| | - Harald Krenzlin
- grid.410607.4Department of Neurosurgery, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Thomas Zeyen
- grid.10388.320000 0001 2240 3300Division of Clinical Neurooncology, Department of Neurology and Center of Integrated Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-University of Bonn, Venusberg-Campus 1, 53105 Bonn, Germany
| | - Richard Drexler
- grid.13648.380000 0001 2180 3484Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Universität Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
| | - Martin Voss
- grid.411088.40000 0004 0578 8220Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Schleusenweg 2-16, 60528 Frankfurt/Main, Germany
| | - Charlotte Nettekoven
- grid.411097.a0000 0000 8852 305XCenter for Neurosurgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Tammam Abboud
- grid.411984.10000 0001 0482 5331Department of Neurosurgery, University Medical Center Göttingen, University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - Dorothee Mielke
- grid.411984.10000 0001 0482 5331Department of Neurosurgery, University Medical Center Göttingen, University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - Veit Rohde
- grid.411984.10000 0001 0482 5331Department of Neurosurgery, University Medical Center Göttingen, University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
| | - Marco Timmer
- grid.411097.a0000 0000 8852 305XCenter for Neurosurgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Roland Goldbrunner
- grid.411097.a0000 0000 8852 305XCenter for Neurosurgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Joachim P. Steinbach
- grid.411088.40000 0004 0578 8220Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Schleusenweg 2-16, 60528 Frankfurt/Main, Germany
| | - Lasse Dührsen
- grid.13648.380000 0001 2180 3484Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Universität Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
| | - Manfred Westphal
- grid.13648.380000 0001 2180 3484Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Universität Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
| | - Ulrich Herrlinger
- grid.10388.320000 0001 2240 3300Division of Clinical Neurooncology, Department of Neurology and Center of Integrated Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-University of Bonn, Venusberg-Campus 1, 53105 Bonn, Germany
| | - Florian Ringel
- grid.410607.4Department of Neurosurgery, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany
| | - Bernhard Meyer
- grid.6936.a0000000123222966Department of Neurosurgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany
| | - Stephanie E. Combs
- grid.6936.a0000000123222966Department of Radiation Oncology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), Ismaninger Strasse 22, 81675 Munich, Germany ,grid.4567.00000 0004 0483 2525Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany ,grid.7497.d0000 0004 0492 0584Deutsches Konsortium Für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany
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Azab MA, Azzam AY, Eraky AM, Sabra M, Hassanein SF. Analyzing outcomes of neurosurgical operations performed before and during the COVID-19 pandemic in Egypt. A matched single-center cohort study. Interdiscip Neurosurg 2021; 26:101369. [PMID: 34485093 PMCID: PMC8409057 DOI: 10.1016/j.inat.2021.101369] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/16/2021] [Accepted: 08/29/2021] [Indexed: 11/28/2022]
Abstract
Background Since the emergence of the first COVID-19 case in Wuhan, the virus affected several health care systems. Globally, the COVID-19 has a transforming effect on health care provision. Substantial evidence was clear that the global surgical services were impacted. The field of neurosurgery was primarily affected, and most elective surgeries were suspended. There are no current reports from Egypt that describe the mortality outcome of neurosurgical procedures in the context of the pandemic. Methods We performed that study at a large tertiary center in Egypt (Cairo University Hospital). It is a single-center matched cohort study. Results Our results examined about 346 patients earlier during the COVID-19 pandemic. About 46 (13.29%) were unmatched, so we excluded them from the final analysis of the data. About 300 patients' were matched to 304 patients' before the pandemic in 2019. The mortality outcome of neurosurgical interventions was higher during the pandemic. Conclusions Amid the COVID-19 pandemic, the mortality outcome of neurosurgical procedures was higher than on regular days at our center. The anesthesia time was prolonged while the operation time was shortened. We strongly suggest further multicenter studies to assess the effect of COVID-19 on neurosurgical mortality and functional outcome.
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Affiliation(s)
- Mohammed A Azab
- Department of Neurosurgery, Cairo University Faculty of Medicine, Cairo, Egypt.,Department of Biomedical Sciences, Boise State University, Idaho, USA
| | - Ahmed Y Azzam
- October 6 University Faculty of Medicine, Giza, Egypt
| | - Akram M Eraky
- Department of Neurosurgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Mohamed Sabra
- Cardiovascular Research Center, Rhode Island Hospital, Providence, RI 02903, USA
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