Original scientific paper
https://doi.org/10.20471/LO.2021.49.01.01
COVID-19 and colorectal cancer – signs of a toxic relationship and how to break the cycle: a single institution, tertiary centre experience
Petar Matošević
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Vedrana Biošić
; Department of Surgery, County Hospital Čakovec, Čakovec, Croatia
Lucija Brkić
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Andrija Matijević
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Ozana Miličević
; School of Medicine University of Zagreb, Zagreb, Croatia
Ines Trkulja
; School of Medicine University of Zagreb, Zagreb, Croatia
Hrvoje Silovski
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Emil Kinda
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Abstract
Colorectal cancer (CRC) is one of the most prevalent oncological diseases globally, taking 3rd place in incidence in the general population. High in mortality, it is also a form of cancer whose outcome is highly dependable on its stage at diagnosis. Therefore, many countries have adopted a more or less successful screening process to ensure early diagnosis and, in turn, higher survival rates and better results overall. The COVID-19 pandemic has altered the established medical routines worldwide, with massively postponing diagnostic procedures and elective surgeries. This study aims to measure the effect the pandemic has had on colorectal cancer treatment in our Institution. Variables such as deferral time from diagnosis to commencement of treatment, lapse of time between different phases of the treatment process, time of presentation (elective versus emergent surgery), the physical status of the patient at the time of surgery (ASA classification) and metastatic index (positive lymph node ratio), were taken into account. We juxtaposed data from patients treated at the Surgical Department of Clinical Hospital Center in Zagreb in 2019 and 2020, the latter being heavily affected by the pandemic. In 2019 and 2020, 347 and 314 patients, respectively, with C18-C20 diagnoses (International Statistical Classification of Diseases and Related Health Problems ICD-10), have been treated at our Hospital. With exclusion criteria applied, the patient count falls to 173 for 2019 and 157 for 2020. These numbers include operated cases with or without an anastomosis formation and with or without neoadjuvant chemotherapy applied. From the analysis we excluded patients with recurrent colorectal tumors, synchronous and metachronous tumors, and patients treated palliatively. Furthermore, colorectal adenomas were also excluded from the study. Our data shows significant difference between observed variables in the two patient groups, attributed to the COVID-19 pandemic. Since there is still no reliable way to predict the duration of this global health crisis, it is imperative to implement strategies to lessen the damaging effect the pandemic has had on favourable oncosurgical treatment outcomes in colorectal cancer patients.
Keywords
colorectal cancer; COVID-19; screening; surgery; oncology
Hrčak ID:
257747
URI
Publication date:
25.5.2021.
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