The Impact of COVID-19 on the presentation, stage and management of head and neck cancer patients: A real time assessment

ABSTRACT NUMBER: FEGGETTER MEDAL FOR SENIOR TRAINEES (ST3+)_3

 

AUTHOR
Lubna Sayyed Akber Uzzaman

MAIN ABSTRACT TEXT

Introduction
During the Covid-19 pandemic, it was postulated that there might be a delay in cancer patients` presentation, stage migration, changes in management leading to excess mortality in head neck cancer patients (HNC) . However, there is a paucity of real time objective data to support this, which our study has attempted to provide.

Methods
A retrospective observational study conducted by reviewing patient records. Two cohorts of diagnosed HNC patients compared – COVID 19 cohort (April-December 2020) to baseline pre-Covid-19 cohort( April–December 2019).

Results
There was 33% decrease in new confirmed HNC cases during Covid-19 (223 vs150 patients). There was significant reduction in T1 stage (25.0%vs 36.3%,p 0.003) and significant increase in T4 stage at presentation during the Covid-19 period (36.5% vs 25.0%,p 0.022), which led to reduction in overall stage I (14.0% vs 25.1%,p 0.009) and increase in overall stage IVb (13.3% vs 5.8%,p 0.012). Almost 7% increase in palliative intent between cohorts, (difference is not statistically significant). There was a significant reduction in radical surgery as the only treatment modality (20.0% vs 30.9%,p 0.023).

Conclusion
To the best of my knowledge, this is first such report confirming the relative change in T-stage and overall up-stage migration in HNC patients. Our study also showed that there was trend towards an increased use of palliative treatment and significant reduction in use of radical surgery as sole treatment modality, suggesting that the pandemic is likely to impact long-term survival of HNC patients.