Time to Treatment Initiation for Breast Cancer During the 2020 COVID-19 Pandemic.
Time to Treatment Initiation for Breast Cancer During the 2020 COVID-19 Pandemic.
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DOI：
10.1200/op.20.00807
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发表时间：
2021-09
影响因子：
4
通讯作者：
Laughlin AI
中科院分区：
文献类型：
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作者：
Hawrot K;Shulman LN;Bleiweiss IJ;Wilkie EJ;Frosch ZAK;Jankowitz RC;Laughlin AI
COVID-19大流行对医疗保健系统构成重大压力，令人担忧相关护理延误将导致过多癌症相关死亡。由于迫切需要有关对乳腺癌患者影响的数据，我们的目的是为在大型学术中心接受治疗的新诊断乳腺癌患者提供COVID-19对治疗开始时间（TTI）影响的初步估计。我们对2020年1月1日至2020年5月15日期间新诊断的早期乳腺癌患者进行了回顾性研究，在此期间护理受到COVID-19的影响，以及2018年1月1日至2018年5月15日期间诊断的未受影响的队列。结果包括患者数量、TTI和初始治疗方式。采用多变量线性回归对调整后的TTI进行比较。共纳入366例患者。与2018年（n = 202）相比，2020年（n = 164）的患者数量减少了18.8%。诊断时间（COVID-19前或COVID-19期间）与调整后的TTI之间没有关联（P = 0.926）。2020年队列中原位诊断较少（P = .040）。与2018年（总体16.4%，化疗12.4%，激素治疗4.0%）相比，2020年（总体43.9%，化疗20.7%，激素治疗23.2%）术前全身治疗的使用增加（P < .001）。在COVID-19大流行期间，在一个大型学术中心诊断和治疗乳腺癌的患者中维持TTI。患者数量减少，特别是原位疾病患者，并且初始治疗转向使用术前激素治疗。
The COVID-19 pandemic has posed significant pressures on healthcare systems, raising concern that related care delays will result in excess cancer-related deaths. Because data regarding the impact on patients with breast cancer are urgently needed, we aimed to provide a preliminary estimate of the impact of COVID-19 on time to treatment initiation (TTI) for patients newly diagnosed with breast cancer cared for at a large academic center. We conducted a retrospective study of patients with newly diagnosed early-stage breast cancer between January 1, 2020, and May 15, 2020, a time period during which care was affected by COVID-19, and an unaffected cohort diagnosed between January 1, 2018 and May 15, 2018. Outcomes included patient volume, TTI, and initial treatment modality. Adjusted TTI was compared using multivariable linear regression. Three hundred sixty-six patients were included. There was an 18.8% decrease in patient volume in 2020 (n = 164) versus 2018 (n = 202). There was no association between time of diagnosis (pre-COVID-19 or during COVID-19) and adjusted TTI (P = .926). There were fewer in situ diagnoses in the 2020 cohort (P = .040). There was increased use of preoperative systemic therapy in 2020 (43.9% overall, 20.7% chemotherapy, and 23.2% hormonal therapy) versus 2018 (16.4% overall, 12.4% chemotherapy, and 4.0% hormonal therapy) (P < .001). TTI was maintained among patients diagnosed and treated for breast cancer during the COVID-19 pandemic at a single large academic center. There was a decrease in patient volume, specifically in patients with in situ disease and a shift in initial therapy toward the use of preoperative hormonal therapy.