CHANGES IN THE DEMOGRAPHIC AND CLINICAL FEATURES OF COLORECTAL CARCINOMA CASES FOLLOWING THE COVID-19 PANDEMIC

Abstract

Objective This study aimed to compare the demographic, clinical and pathological features of patients with colorectal carcinomas presenting before and after the Covid-19 pandemic. Material and Method Subjects presenting from 9 months prior to and those clinipresenting within the first 9 months of the pandemic were included in the study. The primary outcome measure of this study was the difference in the clinical and pathological features of the patients with invasive colorectal carcinomas during the two periods. Results Pre-pandemic and post-pandemic patients were similar with respect to age, gender, tumor location, tumor size, lymph node invasion, differentiation, presence of synchronous tumor, radial and distal surgical margin positivity, perineural and lymphovascular invasion, TNM stage, and liver metastasis and recurrence. Although the difference was not statistically significant when compared to the pre-pandemic period, we identified 3 patients (4.7%) with ileus and 2 patients with tumor perforation (3.2%) among post-pandemic patients. Conclusion Our findings show a slight decrease in the number of patients undergoing surgery for colorectal carcinomas in the post-pandemic period compared to the prepandemic period, probably due to the structural changes in health-care organization in hospitals and patients’ hesitation to apply for healthcare due to possible infection with SARS-CoV-2. It is evident that healthcare systems should strive to find new ways to manage serious clinical conditions such as malignancies during the Covid-19 pandemic.

Keywords

• Covid-19
• Colorectal carcinomas
• Healthcare
• Delay

COVID-19 PANDEMİSİNİ TAKİBEN KOLOREKTAL KARSİNOM VAKALARININ DEMOGRAFİK VE KLİNİK ÖZELLİKLERİNDE MEYDANA GELEN DEĞİŞİKLİKLER

Abstract

Amaç Bu çalışma, Covid-19 pandemisinden önce ve sonra başvuran kolorektal karsinomlu hastaların demografik, klinik ve patolojik özelliklerini karşılaştırmayı amaçladı. Gereç ve Yöntem Pandemiden 9 ay önce ve ilk 9 ay içinde başvuran olgular çalışmaya dahil edildi. Bu çalışmanın birincil sonuç ölçütü, iki dönem boyunca invaziv kolorektal karsinomlu hastaların klinik ve patolojik özelliklerindeki farklılıktı. Bulgular Pandemi öncesi ve pandemi sonrası hastalar yaş, cinsiyet, tümör yerleşimi, tümör boyutu, lenf nodu invazyonu, farklılaşma, senkron tümör varlığı, radyal ve distal cerrahi sınır pozitifliği, perinöral ve lenfovasküler invazyon, TNM evresi, karaciğer metastazı ve nüks bakımından benzerdi. Pandemi öncesi döneme göre fark istatistiksel olarak anlamlı olmasa da, pandemi sonrası hastalarda ileuslu 3 hasta (%4,7) ve tümör perforasyonu olan 2 hasta (%3,2) belirledik. Sonuç: Bulgularımız, pandemi sonrası dönemde kolorektal karsinom nedeniyle ameliyat olan hasta sayısında, muhtemelen hastanelerdeki sağlık organizasyonundaki yapısal değişiklikler ve hastaların SARS-CoV-2 ile olası enfeksiyon nedeniyle sağlık hizmetine başvuruda tereddüt etmesi nedeniyle pandemi öncesi döneme göre hafif bir azalma olduğunu göstermektedir. Sağlık sistemlerinin, Covid-19 salgını sırasında maligniteler gibi ciddi klinik durumları yönetmenin yeni yollarını bulmaya çalışması gerektiği açıktır.

Keywords

• Covid-19
• Kolorektal karsinomlar
• Sağlık hizmeti
• Erteleme

References

1. 1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061-9.
2. 2. Ge H, Wang X, Yuan X, Xiao G, Wang C, Deng T, et al. The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis 2020;39(6):1011-9.
3. 3. Blumenthal D, Fowler EJ, Abrams M, Collins SR. Covid-19—implications for the health care system. Mass Medical Soc; 2020. p. 1483-8.
4. 4. King JS. Covid-19 and the need for health care reform. N Engl J Med 2020;382(26):e104.
5. 5. Mafham MM, Spata E, Goldacre R, Gair D, Curnow P, Bray M, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet 2020;396(10248):381-9.
6. 6. Rodriguez-Leor O, Cid-Alvarez B, Ojeda S, Martín-Moreiras J, Rumoroso JR, López-Palop R, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC Interv Cardiol 2020;2(2):82-9.
7. 7. Yıldırım M, Geçer E, Akgül Ö. The impacts of vulnerability, perceived risk, and fear on preventive behaviours against COVID-19. Psychol Health Med 2021;26(1):35-43.
8. 8. Silistre ES, Hatipoglu HU, Yesilbas O, Gurbuz FS, Ozturk E, Yalcinkaya A. Investigating the psychological impact of COVID-19 on healthcare workers in the intensive care unit. J Surg Med 2022;6(1):29-35.

9. 9. Ewing I, Hurley JJ, Josephides E, Millar A. The molecular genetics of colorectal cancer. Frontline Gastroenterol 2014;5(1):26-30.
10. 10. Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Prz Gastroenterol 2019;14(2):89-103.
11. 11. Mohammad MA, Koul S, Olivecrona GK, Gӧtberg M, Tydén P, Rydberg E, et al. Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic. Heart 2020;106(23):1812-8.
12. 12. Fersia O, Bryant S, Nicholson R, Mcmeeken K, Brown C, Donaldson B, et al. The impact of the COVID-19 pandemic on cardiology services. Open Heart 2020;7(2):e001359.
13. 13. Ersoy A. The frontline of the COVID-19 pandemic: Healthcare workers. Turk J Inter Med 2020;2(2):31-2.
14. 14. Demirag I, Fırtın CE, Bilbil ET. Managing expectations with emotional accountability: making City Hospitals accountable during the COVID-19 pandemic in Turkey. J Public Budg Account Financial Manag 2020;32(5):889-901
15. 15. Gul M, Yucesan M. Hospital preparedness assessment against COVID-19 pandemic: A case study in Turkish tertiary healthcare services. Math Probl Eng 2021;2021:1-18.
16. 16. Wallis CJ, Novara G, Marandino L, Bex A, Kamat AM, Karnes RJ, et al. Risks from deferring treatment for genitourinary cancers: a collaborative review to aid triage and management during the COVID-19 pandemic. Eur Urol 2020;78(1):29-42.
17. 17. Ward ZJ, Walbaum M, Walbaum B, Guzman MJ, De La Jara JJ, Nervi B, et al. Estimating the impact of the COVID-19 pandemic on diagnosis and survival of five cancers in Chile from 2020 to 2030: a simulation-based analysis. Lancet Oncol 2021;22(10):1427-37.
18. 18. Park JS, Huh JW, Park YA, Cho YB, Yun SH, Kim HC, et al. Prognostic Comparison Between Mucinous and Nonmucinous Adenocarcinoma in Colorectal Cancer. Medicine 2015;94(15):e658.
19. 19. Cantay H, Anuk T, Çetin T, Özcan H, Sulu B, Binnetoğlu K, et al. Evaluation of colorectal cancers in terms of diagnosis and treatment processes. Turk J Colorectal Dis 2021;31:239-245.