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Impact of COVID-19 on the oncological outcomes of colorectal cancer surgery in northern Italy in 2019 and 2020: multicentre comparative cohort study

2021; Wiley; Volume: 6; Issue: 1 Linguagem: Inglês

10.1093/bjsopen/zrab139

2474-9842

Matteo Rottoli, Gianluca Pellino, Antonino Spinelli, Maria Elena Flacco, Lamberto Manzoli, Mario Morino, Salvatore Pucciarelli, Elio Jovine, Mohammad Abu Hilal, Riccardo Rosati, Alessandro Ferrero, Andrea Pietrabissa, Marcello Guagliò, Nicolò de Manzini, Pierluigi Pilati, Elisa Cassinotti, Giusto Pignata, Orlando Goletti, Enrico Opocher, Piergiorgio Danelli, Gianluca M. Sampietro, Stefano Olmi, Nazario Portolani, Gilberto Poggioli, Mario Morino, Marco E. Allaix, Gaspare Cannata, Erica Lombardi, Carlo Alberto Ammirati, Chiara Piceni, Salvatore Pucciarelli, Francesco Marchegiani, Gaya Spolverato, Giacomo Ghio, Gaia Zagolin, Andrei Dorin Dragu, Elio Jovine, Raffaele Lombardi, Chiara Cipressi, Maria Fortuna Offi, Cristina Larotonda, Matteo Rottoli, Gilberto Poggioli, Dajana Cuicchi, Paolo Bernante, Angela Romano, Marta Tanzanu, Alessandra Belvedere, D Parlanti, A P Pezzuto, Gabriele Vago, Antonio Lanci Lanci, Iris Shari Russo, Tommaso Violante, Ludovica Maurino, Gregorio Tugnoli, Eleonora Filippone, Mohammad Abu Hilal, Augusto Barbosa, Carlo Tonti, Roberta La Mendola, Riccardo Rosati, Ugo Elmore, Lorenzo Gozzini, Andrea Cossu, Mattia Molteni, Paolo Parise, Francesco Puccetti, Alessandro Ferrero, Michela Mineccia, Marco Palisi, Federica Gonella, Francesco Danese, Andrea Pietrabissa, Tommaso Dominioni, Luigi Pugliese, Andrea Peri, Marta Botti, Benedetta Sargenti, Antonino Spinelli, Michele Carvello, Caterina Foppa, Elisabetta Coppola, Matteo Sacchi, Francesco Maria Carrano, Marcello Guagliò, Maurizio Cosimelli, Luca Sorrentino, Gaia Colletti, Roberto Santalucia, Nicolò de Manzini, Paola Germani, Edoardo Osenda, Hussein Abdallah, Sara Cortinovis, Pierluigi Pilati, Boris Franzato, Ottavia De Simoni, Genny Mattara, Elisa Cassinotti, Luigi Boni, Ludovica Baldari, Cristina Bertani, Giusto Pignata, Rossella D’Alessio, Jacopo Andreuccetti, Ilaria Canfora, Elisa Arici, Michele De Capua, Orlando Goletti, Mattia Molteni, Giorgio Quartierini, Alberto Assisi, Giordano Beretta, Enrico Opocher, Andrea Pisani Ceretti, Nicolò Maria Mariani, Piergiorgio Danelli, F. Colombo, Alice Frontali, Anna Maffioli, Andrea Bondurri, Isabella Pezzoli, Alessandro Bonomi, Gianluca M. Sampietro, Carlo Corbellini, Carlo Alberto Manzo, L. Lorusso, Stefano Olmi, Matteo Uccelli, Marta Bonaldi, G Cesana, Nazario Portolani, Sarah Molfino, Federico Gheza, Marie Sophie Alfano, E Pignatelli,

Pancreatic and Hepatic Oncology Research

Abstract Background This study compared patients undergoing colorectal cancer surgery in 20 hospitals of northern Italy in 2019 versus 2020, in order to evaluate whether COVID-19-related delays of colorectal cancer screening resulted in more advanced cancers at diagnosis and worse clinical outcomes. Method This was a retrospective multicentre cohort analysis of patients undergoing colorectal cancer surgery in March to December 2019 versus March to December 2020. Independent predictors of disease stage (oncological stage, associated symptoms, clinical T4 stage, metastasis) and outcome (surgical complications, palliative surgery, 30-day death) were evaluated using logistic regression. Results The sample consisted of 1755 patients operated in 2019, and 1481 in 2020 (both mean age 69.6 years). The proportion of cancers with symptoms, clinical T4 stage, liver and lung metastases in 2019 and 2020 were respectively: 80.8 versus 84.5 per cent; 6.2 versus 8.7 per cent; 10.2 versus 10.3 per cent; and 3.0 versus 4.4 per cent. The proportions of surgical complications, palliative surgery and death in 2019 and 2020 were, respectively: 34.4 versus 31.9 per cent; 5.0 versus 7.5 per cent; and 1.7 versus 2.4 per cent. Cancers in 2020 (versus 2019) were more likely to be symptomatic (odds ratio 1.36 (95 per cent c.i. 1.09 to 1.69)), clinical T4 stage (odds ratio 1.38 (95 per cent c.i. 1.03 to 1.85)) and have multiple liver metastases (odds ratio 2.21 (95 per cent c.i. 1.24 to 3.94)), but were not more likely to be associated with surgical complications (odds ratio 0.79 (95 per cent c.i. 0.68 to 0.93)). Conclusion Colorectal cancer patients who had surgery between March and December 2020 had an increased risk of advanced disease in terms of associated symptoms, cancer location, clinical T4 stage and number of liver metastases.