학술논문
Impact of the COVID-19 pandemic on esophageal cancer resource allocation: a systematic review.
Document Type
Academic Journal
Author
Fialka NM; Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.; El-Andari R; Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.; Jogiat U; Division of Thoracic Surgery, Department of Surgery, Royal Alexandra Hospital, Edmonton, AB, Canada.; Bédard ELR; Division of Thoracic Surgery, Department of Surgery, Royal Alexandra Hospital, Edmonton, AB, Canada.; Laing B; Division of Thoracic Surgery, Department of Surgery, Royal Alexandra Hospital, Edmonton, AB, Canada.; Nagendran J; Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Source
Publisher: AME Publishing Company Country of Publication: China NLM ID: 101533916 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2072-1439 (Print) Linking ISSN: 20721439 NLM ISO Abbreviation: J Thorac Dis Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2072-1439
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic challenged global infrastructure. Healthcare systems were forced to reallocate resources toward the frontlines. In this systematic review, we analyze the impact of resource reallocation during the COVID-19 pandemic on the diagnosis, management, and outcomes of esophageal cancer (EC) patients.
Methods: PubMed and Embase were systematically searched for articles investigating the impact of the COVID-19 pandemic on EC patients. Of the 1,722 manuscripts initially screened, 23 met the inclusion criteria.
Results: Heterogeneity of data and outcomes reporting prohibited aggregate analysis. Reduced detection of EC and considerable variability in disease stage at presentation were noted during the COVID-19 pandemic. EC patients experienced delays in diagnostic and preoperative staging investigations but surgical resection was not associated with greater short-term morbidity or mortality. Modeling the impact of pandemic-related delays in EC care predicts significant reductions in survival with associated economic losses in the coming years.
Conclusions: Amidst resource scarcity during the COVID-19 pandemic, the multidisciplinary management of patients with EC was affected at multiple stages in the care pathway. Although the complete ramifications of reductions in EC diagnosis and delays in care remain unclear, EC surgery was able to safely continue as a result of collaboration between centers, strict adherence to COVID-19 protective measures, and reallocation of healthcare resources towards the same. Ultimately, when healthcare systems are pushed to the brink, the downstream consequences of resource reallocation require judicious analysis to optimize overall patient outcomes.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1232/coif). E.L.R.B. discloses a financial relationship with Hoffman La Roche and Astra Zeneca. The other authors have no conflicts of interest to declare.
(2024 Journal of Thoracic Disease. All rights reserved.)
Methods: PubMed and Embase were systematically searched for articles investigating the impact of the COVID-19 pandemic on EC patients. Of the 1,722 manuscripts initially screened, 23 met the inclusion criteria.
Results: Heterogeneity of data and outcomes reporting prohibited aggregate analysis. Reduced detection of EC and considerable variability in disease stage at presentation were noted during the COVID-19 pandemic. EC patients experienced delays in diagnostic and preoperative staging investigations but surgical resection was not associated with greater short-term morbidity or mortality. Modeling the impact of pandemic-related delays in EC care predicts significant reductions in survival with associated economic losses in the coming years.
Conclusions: Amidst resource scarcity during the COVID-19 pandemic, the multidisciplinary management of patients with EC was affected at multiple stages in the care pathway. Although the complete ramifications of reductions in EC diagnosis and delays in care remain unclear, EC surgery was able to safely continue as a result of collaboration between centers, strict adherence to COVID-19 protective measures, and reallocation of healthcare resources towards the same. Ultimately, when healthcare systems are pushed to the brink, the downstream consequences of resource reallocation require judicious analysis to optimize overall patient outcomes.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-1232/coif). E.L.R.B. discloses a financial relationship with Hoffman La Roche and Astra Zeneca. The other authors have no conflicts of interest to declare.
(2024 Journal of Thoracic Disease. All rights reserved.)