학술논문
Impact of the COVID‐19 pandemic on clinical presentation, treatments, and outcomes of new breast cancer patients: A retrospective multicenter cohort study
Document Type
article
Author
Etienne Guével; Sonia Priou; Guillaume Lamé; Johanna Wassermann; Romain Bey; Catherine Uzan; Gilles Chatellier; Yazid Belkacemi; Xavier Tannier; Sophie Guillerm; Rémi Flicoteaux; Joseph Gligorov; Ariel Cohen; Marc‐Antoine Benderra; Luis Teixeira; Christel Daniel; Barbara Hersant; Christophe Tournigand; Emmanuelle Kempf; the Assistance Publique–Hôpitaux de Paris (AP‐HP) Cancer Group, a Cancer Research Application on Big Data (CRAB) initiative
Source
Cancer Medicine, Vol 12, Iss 22, Pp 20918-20929 (2023)
Subject
Language
English
ISSN
2045-7634
Abstract
Abstract Background The SARS CoV‐2 pandemic disrupted healthcare systems. We compared the cancer stage for new breast cancers (BCs) before and during the pandemic. Methods We performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP‐HP). We identified all female patients newly referred with a BC in 2019 and 2020. We assessed the timeline of their care trajectories, initial tumor stage, and treatment received: BC resection, exclusive systemic therapy, exclusive radiation therapy, or exclusive best supportive care (BSC). We calculated patients' 1‐year overall survival (OS) and compared indicators in 2019 and 2020. Results In 2019 and 2020, 2055 and 1988, new BC patients underwent cancer treatment, and during the two lockdowns, the BC diagnoses varied by −18% and by +23% compared to 2019. De novo metastatic tumors (15% and 15%, p = 0.95), pTNM and ypTNM distributions of 1332 cases with upfront resection and of 296 cases with neoadjuvant therapy did not differ (p = 0.37, p = 0.3). The median times from first multidisciplinary meeting and from diagnosis to treatment of 19 days (interquartile 11–39 days) and 35 days (interquartile 22–65 days) did not differ. Access to plastic surgery (15% and 17%, p = 0.08) and to treatment categories did not vary: tumor resection (73% and 72%), exclusive systemic therapy (13% and 14%), exclusive radiation therapy (9% and 9%), exclusive BSC (5% and 5%) (p = 0.8). Among resected patients, the neoadjuvant therapy rate was lower in 2019 (16%) versus 2020 (20%) (p = 0.02). One‐year OS rates were 99.3% versus 98.9% (HR = 0.96; 95% CI, 0.77–1.2), 72.6% versus 76.6% (HR = 1.28; 95% CI, 0.95–1.72), 96.6% versus 97.8% (HR = 1.09; 95% CI, 0.61–1.94), and 15.5% versus 15.1% (HR = 0.99; 95% CI, 0.72–1.37), in the treatment groups. Conclusions Despite a decrease in the number of new BCs, there was no tumor stage shift, and OS did not vary.