Safe Delivery of Surgical Care in Head and Neck Cancer Patients During COVID-19-an Audit of Pattern of Presentation and Treatment Strategies in an Oncology Centre in the Northern India.

Delay in treatment of head and neck cancer leads to stage migration and increased morbidity. Due to the COVID-19, surgical care has been severely affected. We continued our oncology services during the pandemic. We present here the pattern of presentation of head and neck cancer patients to the hospital and strategy to continue services. A retrospective audit of patients registered under Head and Neck Disease Management Group during lockdown, 23rd March to 31st May 2020, was done. Four categories were made new registrations, post-surgical patients, emergency department visits and follow-up presentation. Of the 693 patients assessed, a majority were with oral cavity cancer (80%). Seventy-eight percent of patients presented with stage IV disease. There were 382 new registrations, of which 68% were symptomatic. Of the 69 patients that underwent surgery, 17 patients were on adjuvant treatment. A total of 60 patients presented to emergency department during this period, maximum with complaints of dyspnoea (67%). One hundred eighty-nine patients were follow-up patients of which 43% were symptomatic. Among these, 12 patients were diagnosed with recurrence. Various administrative and clinical policies were formulated to continue cancer care during this time. Surgical services need not be halted during the COVID-19 pandemic. Following scientific rationale and treatment strategies, safe oncosurgical care can be delivered during pandemic.

Impact of preoperative COVID infection on the outcomes of planned curative-intent cancer surgeries in the second wave of the pandemic from a tertiary care center in India.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic was an unforeseen calamity. Sudden disruption of nonemergency services led to disruption of treatment across all specialties. Oncology revolves around the tenet of timely detection and treatment. Disruption of any sort will jeopardize cure rates. The time interval between coronavirus infection and cancer surgery is variable and needs to be tailored to avoid the progression of the disease. METHODS: We analyzed the impact of preoperative coronavirus disease 2019 (COVID-19) infection on the planned cancer surgery, delay, disease progression, and change of intent of treatment from April 1 to May 31, 2021 at a tertiary care center. All preoperative positive patients were retested after 2 weeks and were considered for surgery if the repeat test was negative and asymptomatic. FINDINGS: Our study included 432 preoperative patients of which 91 (21%) were COVID-19 positive. Amongst this cohort, 76% were operated and the morbidity and mortality were comparable to the COVID-19 negative cohort. Around 10% of the COVID-19 positive were lost to follow up and 10% had disease progression and were deemed palliative INTERPRETATION: SARS-CoV-2 infection has adversely impacted cancer care and a 2-week waiting period postinfection seems to be a safe interval in asymptomatic individuals to consider radical cancer surgery.