Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)
2022; Elsevier BV; Volume: 166; Linguagem: Inglês
10.1016/j.ejca.2022.01.040
ISSN1879-0852
AutoresMathias Brügel, Léa Letrillart, Camille Evrard, A Thierry, David Tougeron, Mehdi El Amrani, Guillaume Piessen, Stéphanie Truant, Anthony Turpin, Christelle d’Engremont, Gaël S. Roth, Vincent Hautefeuille, Jean Marc Regimbeau, Nicolas Williet, Lilian Schwarz, Frédéric Di Fiore, Christophe Borg, Alexandre Doussot, Aurélien Lambert, Valérie Moulin, Hélène Trelohan, Marion Bolliet, Amalia Topolscki, Ahmet Ayav, Anthony Lopez, Damien Botsen, Tullio Piardi, Claire Carlier, Olivier Bouché,
Tópico(s)COVID-19 Clinical Research Studies
ResumoBackgroundThe COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown.MethodsThis multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown.ResultsDuring the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, −18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, −1.7%; p = 0.97). The number of borderline tumours increased (13.6%–21.7%), whereas the rate of metastatic diseases rate dropped (47.1%–40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%–32.6%) compared with upfront surgery (13%–7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%–69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%–9.6%) and advanced diseases increased (59.7%–69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).ConclusionThis cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up.Trial registrationClinicaltrials.gov NCT04406571.
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