Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
TLDR
In this paper, the authors compared the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction, and found that 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.Abstract:
Background Surgery 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. Methods This 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. Findings Of 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 Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.read more
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Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study
Christina Fotopoulou,Tabassum Khan,Juraj Bracinik,James Glasbey,Nadeem R. Abu-Rustum,Luis Chiva,Anna Fagotti,Keiichi Fujiwara,Rahel G Ghebre,Murat Gutelkin,Thomas Okpoti Konney,Joseph Ng,Rene Pareja,Rajkumar Kottayasamy Seenivasagam,Jalid Sehouli,Shylasree T Surappa,Aneel Bhangu,El Leung,Sudha Sundar +18 more
TL;DR: In this paper , the authors evaluated the changes in care and short-term outcomes of surgical patients with gynecologic cancers during the COVID-19 pandemic, and they hypothesized that the delay in surgical cancer care, especially in patients who required more extensive surgery, and such delay had an impact on cancer outcomes.
Journal ArticleDOI
European cancer mortality predictions for the year 2022 with focus on ovarian cancer.
Michela Dalmartello,Carlo La Vecchia,Paola Bertuccio,Paolo Boffetta,Fabio Levi,Eva Negri,Matteo Malvezzi +6 more
TL;DR: In this paper , the authors estimated projections and the number of avoided deaths for total cancer mortality and 10 major cancer sites, between 1989 and 2022, for the European Union (EU), the UK, France, Germany, Italy, Poland and Spain using cancer death certification and population data since 1970 from the World Health Organization and Eurostat.
Journal ArticleDOI
Projecting COVID-19 disruption to elective surgery
TL;DR: The first wave of the COVID-19 pandemic caused millions of elective surgical procedures to be cancelled worldwide during the first wave, and the National Health Service (NHS) in England has not returned to pre-pandemic elective surgery activity levels as mentioned in this paper .
Journal ArticleDOI
Involvement of the Liver in COVID-19: A Systematic Review
TL;DR: The important liver manifestations of COVID-19 are outlined, the possible underlying pathophysiological mechanisms and their diagnosis and management are discussed, and special emphasis is needed in those with nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, hepatitis B and C infections, and alcoholic liver disease and in liver transplant recipients.
Journal ArticleDOI
The impact of COVID-19 on surgical procedures in Japan: analysis of data from the National Clinical Database.
Norihiko Ikeda,Hiroyuki Yamamoto,Akinobu Taketomi,Taizo Hibi,Minoru Ono,Naoki Niikura,Iwao Sugitani,Urara Isozumi,Hiroaki Miyata,Hiroaki Nagano,Michiaki Unno,Yuko Kitagawa,Masaki Mori +12 more
TL;DR: In this paper, the authors evaluated the impact of the COVID-19 pandemic on the number of surgical procedures performed and whether the effects were more prominent during certain periods of widespread infection and in the affected regions.
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Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study.
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TL;DR: In this paper, the authors assess the burden of 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus, and evaluate cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods.
Journal ArticleDOI
A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).
Thomas Hale,Noam Angrist,Rafael Goldszmidt,Beatriz Kira,Anna Petherick,Toby Phillips,Samuel Webster,Emily Cameron-Blake,Laura Hallas,Saptarshi Majumdar,Helen Tatlow +10 more
TL;DR: The COVID-19 Government Response Tracker (OxCGRT) as mentioned in this paper is a dataset that addresses the need for continuously updated, readily usable and comparable information on policy measures.
Journal ArticleDOI
Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017
Christina Fitzmaurice,Degu Abate,Naghmeh Abbasi,Hedayat Abbastabar,Foad Abd-Allah,Omar Abdel-Rahman,Ahmed Abdelalim,Amir Abdoli,Ibrahim Abdollahpour,Abdishakur Abdulle,Nebiyu Dereje Abebe,Haftom Niguse Abraha,Laith J. 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Ellenbogen,Aisha Elsharkawy,Mohammad Hassan Emamian,Daniel Adane Endalew,Aman Yesuf Endries,Babak Eshrati,Ibtihal Fadhil,Vahid Fallah,Mahbobeh Faramarzi,Mahdieh Abbasalizad Farhangi,Andrea Farioli,Farshad Farzadfar,Netsanet Fentahun,Eduarda Fernandes,Garumma Tolu Feyissa,Irina Filip,Florian Fischer,James L. Fisher,Lisa M. Force,Masoud Foroutan,Marisa Freitas,Takeshi Fukumoto,Neal Futran,Silvano Gallus,Fortuné Gbètoho Gankpé,Reta Tsegaye Gayesa,Tsegaye Tewelde Gebrehiwot,Gebreamlak Gebremedhn Gebremeskel,Getnet Gedefaw,Belayneh K Gelaw,Birhanu Geta,Sefonias Getachew,Kebede Embaye Gezae,Mansour Ghafourifard,Alireza Ghajar,Ahmad Ghashghaee,Asadollah Gholamian,Paramjit Gill,Themba Tg Ginindza,Alem Girmay,Muluken Gizaw,Ricardo Santiago Gomez,Sameer Vali Gopalani,Giuseppe Gorini,Bárbara Niegia Garcia de Goulart,Ayman Grada,Maximiliano Ribeiro Guerra,André Luiz Sena Guimarães,Prakash C. Gupta,Rashmi Gupta,Kishor Hadkhale,Arvin Haj-Mirzaian,Arya Haj-Mirzaian,Randah R. 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Lopukhov,Raimundas Lunevicius,Mohammed Madadin,Sameh Magdeldin,Hassan Magdy Abd El Razek,Azeem Majeed,Afshin Maleki,Reza Malekzadeh,Ali Manafi,Navid Manafi,Wondimu Ayele Manamo,Morteza Mansourian,Mohammad Ali Mansournia,Lorenzo G. Mantovani,Saman Maroufizadeh,Santi Martini,Tivani P. Mashamba-Thompson,Benjamin B. Massenburg,Motswadi Titus Maswabi,Manu Raj Mathur,Colm McAlinden,Martin McKee,Hailemariam Abiy Alemu Meheretu,Ravi Mehrotra,Varshil Mehta,Toni Meier,Yohannes Adama Melaku,Gebrekiros Gebremichael Meles,Hagazi Gebre Meles,Addisu Melese,Mulugeta Melku,Peter Memiah,Walter Mendoza,Ritesh G. Menezes,Shahin Merat,Tuomo J. Meretoja,Tomislav Mestrovic,Bartosz Miazgowski,Tomasz Miazgowski,Kebadnew Mulatu Mihretie,Ted R. Miller,Edward J Mills,Seyed Mostafa Mir,Hamed Mirzaei,Hamid Reza Mirzaei,Rashmi Mishra,Babak Moazen,Dara K. 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TL;DR: The Global Burden of Disease (GBD) study as discussed by the authors has been used to describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning, including cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs).
Journal ArticleDOI
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study
TL;DR: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality, so thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older.