학술논문
Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
Document Type
article
Author
Glasbey, James; Ademuyiwa, Adesoji; Adisa, Adewale; AlAmeer, Ehab; Arnaud, Alexis P; Ayasra, Faris; Azevedo, José; Minaya-Bravo, Ana; Costas-Chavarri, Ainhoa; Edwards, John; Elhadi, Muhammed; Fiore, Marco; Fotopoulou, Christina; Gallo, Gaetano; Ghosh, Dhruva; Griffiths, Ewen A; Harrison, Ewen; Hutchinson, Peter; Lawani, Ismail; Lawday, Samuel; Lederhuber, Hans; Leventoglu, Sezai; Li, Elizabeth; Gomes, Gustavo Mendonça Ataíde; Mann, Harvinder; Marson, Ella J; Martin, Janet; Mazingi, Dennis; McLean, Kenneth; Modolo, Maria; Moore, Rachel; Morton, Dion; Ntirenganya, Faustin; Pata, Francesco; Picciochi, Maria; Pockney, Peter; la Medina, Antonio Ramos-De; Roberts, Keith; Roslani, April Camilla; Seenivasagam, Rajkumar Kottayasamy; Shaw, Richard; Simões, Joana Filipa Ferreira; Smart, Neil; Stewart, Grant D; Sullivan, Richard; Sundar, Sudha; Tabiri, Stephen; Taylor, Elliott H; Vidya, Raghavan; Nepogodiev, Dmitri; Bhangu, Aneel; Glasbey, James C; Bhangu, Aneel A; Siaw-Acheampong, Kwabena; Benson, Ruth A; Bywater, Edward; Chaudhry, Daoud; Dawson, Brett E; Evans, Jonathan P; Gujjuri, Rohan R; Heritage, Emily; Jones, Conor S; Kamarajah, Sivesh K; Khatri, Chetan; Khaw, Rachel A; Keatley, James M; Knight, Andrew; Mann, Harvinder S; McLean, Kenneth A; Mckay, Siobhan C; Mills, Emily C; Pellino, Gianluca; Tiwari, Abhinav; Simoes, Joana FF; Trout, Isobel M; Venn, Mary L; Wilkin, Richard JW; Smart, Neil J; Moug, Susan; Di Saverio, Salomone; Vallance, Abigail; Vimalchandran, Dale
Source
The Lancet Oncology. 22(11)
Subject
Language
Abstract
BackgroundSurgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction.MethodsThis international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926.FindingsOf eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p