Abstract
Introduction CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC).
Methods The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up.
Results Among 984 patients (pre-COVID: n=483, COVID: n=501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5 vs 37.2%, p=0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5 vs 76.6%, p=0.001) and increase in the proportion recommended upfront chemotherapy (45.5 vs 23.4%, p=0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4 vs 57.3%, p=0.004) or received palliative anti-cancer therapy (20.5 vs 26.5%, p=0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4 vs 9.3%, p=0.036), whilst more patients received no anti-cancer treatment (69.3 vs 59.2% p=0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8-4.1) vs 4.4 (IQR 3.6-5.2) months, p=0.093).
Conclusion Pathways for patients with PDAC were significantly disrupted during the first-wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.
Methods The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up.
Results Among 984 patients (pre-COVID: n=483, COVID: n=501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5 vs 37.2%, p=0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5 vs 76.6%, p=0.001) and increase in the proportion recommended upfront chemotherapy (45.5 vs 23.4%, p=0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4 vs 57.3%, p=0.004) or received palliative anti-cancer therapy (20.5 vs 26.5%, p=0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4 vs 9.3%, p=0.036), whilst more patients received no anti-cancer treatment (69.3 vs 59.2% p=0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8-4.1) vs 4.4 (IQR 3.6-5.2) months, p=0.093).
Conclusion Pathways for patients with PDAC were significantly disrupted during the first-wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.
| Original language | English |
|---|---|
| Journal | British Journal of Cancer |
| Publication status | Accepted/In press - 2 Feb 2023 |
Research Beacons, Institutes and Platforms
- Manchester Cancer Research Centre
