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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.
Rottoli, Matteo; Pellino, Gianluca; Spinelli, Antonino; Flacco, Maria E; Manzoli, Lamberto; Morino, Mario; Pucciarelli, Salvatore; Jovine, Elio; Abu Hilal, Moh'd; Rosati, Riccardo; Ferrero, Alessandro; Pietrabissa, Andrea; Guaglio, Marcello; de Manzini, Nicolò; Pilati, Pierluigi; Cassinotti, Elisa; Pignata, Giusto; Goletti, Orlando; Opocher, Enrico; Danelli, Piergiorgio; Sampietro, Gianluca; Olmi, Stefano; Portolani, Nazario; Poggioli, Gilberto.
Afiliación
  • Rottoli M; Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.
  • Pellino G; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
  • Spinelli A; Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.
  • Flacco ME; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
  • Manzoli L; Colon and Rectal Surgery Division, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
  • Morino M; Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
  • Pucciarelli S; Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
  • Jovine E; General Surgery, AOU Città della Salute e della Scienza, Turin, Italy.
  • Abu Hilal M; First Surgical Clinic, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padua, Padua, Italy.
  • Rosati R; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
  • Ferrero A; Division of General and Emergency Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
  • Pietrabissa A; General Surgery, Fondazione Poliambulanza Hospital, Brescia, Italy.
  • Guaglio M; Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute and San Raffaele Vita-Salute University, Milan, Italy.
  • de Manzini N; General and Oncologic Surgery, Ospedale Mauriziano Umberto I, Turin, Italy.
  • Pilati P; Department of Surgery, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Cassinotti E; Department of Surgery, Colorectal Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
  • Pignata G; Surgical Clinic Unit, University Hospital of Trieste, Trieste, Italy.
  • Goletti O; UOC Chirurgia Oncologica Esofago e vie digestive, Istituto Oncologico Veneto (IOV-IRCCS), Padua, Italy.
  • Opocher E; General Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano - Università degli Studi di Milano, Milan, Italy.
  • Danelli P; Second General Surgery, ASST Spedali Civili di Brescia, Brescia, Italy.
  • Sampietro G; General Surgery, Humanitas Gavazzeni, Bergamo, Italy.
  • Olmi S; ASST Santi Paolo e Carlo, Dipartimento di scienze della salute - Università degli Studi di Milano, Milan, Italy.
  • Portolani N; ASST Fatebenefratelli Sacco, Milan, Italy.
  • Poggioli G; Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Milan, Italy.
BJS Open ; 6(1)2022 01 06.
Article en En | MEDLINE | ID: mdl-35143629
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: BJS Open Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: BJS Open Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido