IMPACT OF COVID-19 ON PRESENTATION AND TREATMENT OF PANCREATIC CANCER

ABSTRACT

Purpose During the first peak of the COVID-19 pandemic in spring 2020, the American College of Surgeons released triage recommendations for cancer care to assist with resource allocation during a global healthcare crisis.1 Our study investigates the relationship between pandemic restrictions and pancreatic cancer diagnosis and care at a single institution. Methods Our paper reports a retrospective single-center analysis of newly diagnosed pancreatic cancer from 2016-2020. Patient data was collected from our institutional cancer registry. Data was stratified into pre-pandemic years (2016-2019) and the pandemic year (2020) with further separation into fiscal quarters (Q1-Q4). Comparison of case numbers, staging, type of treatment and time to treatment was performed. Time-to-treatment was defined as the time from the date of initial diagnosis to date of treatment, for both any treatment overall and for each specific treatment type. Statistical analysis was performed using Chi-square and independent t-tests Results No changes were seen in the number of patients diagnosed with pancreatic cancer from 2016-2019 (mean=117.5 cases/year) versus 2020 (104 cases, p=0.475). There was no change in clinical overall staging comparing pre-pandemic (stage 1, n=81;stage 2, n=45;stage 3, n=55, stage4, n=184) to pandemic years (stage 1, n=28;stage 2;n=10;stage 3, n=11;stage 4, n=43;p=0.145). There were 220 patients treated by surgery, 306 by chemotherapy, 67 by radiation and 3 by immunotherapy. There were 46 patients (18.78%) who received chemotherapy during Q3 in the pre-pandemic years compared to 19 patients (31.14%) in Q3 of 2020 (p<0.001, Table 1). No difference was seen between pre-pandemic and pandemic years for both neoadjuvant (p=0.347) or adjuvant chemotherapy (p=0.217). There was no difference between pre-pandemic versus pandemic years for the other treatment modalities, including neoadjuvant or adjuvant radiation. The average time-to-first-treatment in pre-pandemic years was 36.71 days compared to 41.46 days in 2020 (p=0.31). Conclusion The number of patients receiving chemotherapy treatment increased immediately after the peak pandemic months without any change in neoadjuvant or adjuvant treatment. No change was seen in case numbers, disease stage, time-to-treatment overall and all specific modalities during peak of the pandemic. This lack of change shows the diligence of both healthcare workers and the patients involved in treating pancreatic cancer. References 1. Kato H, Asano Y, Arakawa S, et al. Surgery for pancreatic tumors in the midst of COVID-19 pandemic. World J Clin Cases. 2021;9(18)4460-4466. doi10.12998/wjcc.v9.i18.4460 (Table Presented)