Diagnostic and therapeutic delays in lung cancer during the COVID-19 pandemic: a single center experience at a German Cancer center.

BACKGROUND: The COVID-19 pandemic has had negative drawbacks on the healthcare system worldwide and on individuals other than those directly affected by the virus. Delays in cancer therapy and diagnosis have been reported in the literature. We hypothesized similar effects on patients with lung cancer at our center. METHODS: We retrospectively analyzed data of patients referred to our center with newly diagnosed lung cancer from 2018 to 2022. We considered distribution of UICC Stages and time from case presentation in our multidisciplinary tumor board or from therapeutic indication from treating physician to therapy initiation (surgery, systemic therapies and radiation) to define delays in diagnosis and treatment. RESULTS: 1020 patients with newly diagnosed lung cancer were referred to our center from 2018 to 2022, with a median of 206 cases yearly (range: 200-208). Cases with Stage IV in 2020-2022 were significantly higher than in 2018-2019 (57% vs. 46%, p = 0,001). 228 operative resections took place between 2018 and 2022, 100 from January 2018 to February 2020 and 128 from March 2020 to December 2022. Median time from presentation in our tumor board to resection was also significantly longer after the beginning of the pandemic than before (22 days vs. 15,5 days, p = 0,013). No significant delays were observed for administration of systemic treatment and initiation of radiation. CONCLUSIONS: During the pandemic higher disease stages were reported for patients with lung cancer, yet there were no clinically relevant delays in treatment. In the context of the post-covid era new diagnostic strategies are necessary to facilitate early diagnosis of lung cancer. Despite the pandemic, for patients with suspicious symptoms prompt access to healthcare facilities is essential for early diagnosis.

Contrast enhanced ultrasound of splenic lymphoma involvement.

OBJECTIVE: The aim of this study was to compare the value of contrast-enhanced ultrasonography (CEUS) with standard B-mode ultrasound (US) for diagnosis of splenic lymphoma involvement. METHODS: From 04/2005 to 10/2008 n=250 lymphoma patients were investigated by standard B-mode US. A homogeneous splenic echotexture was found in 199 patients (79%). To clarify the benefit of CEUS in this group a pilot series was performed with 16 of the 199 lymphoma patients. All patients with an abnormal splenic echotexture on standard B-Mode US (n=51) including focal hypoechoic splenic lesions (n=41) and an inhomogeneous splenic texture (n=10) were studied by CEUS. CEUS data were retrospectively evaluated. The diagnoses included indolent lymphoma (n=27), aggressive lymphoma (n=14), and Hodgkin's disease (n=10). Number and size of lesions were determined by B-mode US and CEUS. The visualisation of splenic lymphoma involvement by CEUS in comparison to B-mode US was classified as worse, equal, or better. RESULTS: All patients with a homogeneous spleen on B-mode US (n=16) had no visible focal lesions on CEUS. Study patients with focal lesions (n=41) had a hypoechoic (n=22) or isoechoic (n=19) enhancement during the arterial phase, and a hypoechoic enhancement during the parenchymal phase (n=41). The visualisation of focal splenic lymphoma was equal (n=32), better (n=6), or worse (n=3). In all study patients with an inhomogeneous spleen on B-mode US (n=10) no focal lesions were found by CEUS and the value of CEUS therefore was classified as worse. CONCLUSION: CEUS has no clear advantage for diagnosis of splenic lymphoma involvement.