Abstract 1354P
Background
COVID19 pandemic has represented an important clinical challenge for patients (pts) with lung cancer since higher mortality rates have been observed in these pts when affected by COVID19. In the last years, however, we have also observed several indirect consequences in pts with thoracic malignancies: several experiences have highlighted its possible negative role on the clinical history of these pts.
Methods
We evaluated all pts with thoracic malignancies affering to our Centre from March 2019 to February 2020 (pre-COVID group) and compared them to all pts affering from March 2020 to February 2021 (post-COVID group). In these two groups, we evaluated several parameters: the total number of accesses, the mean time from symptom and first imaging, the mean time from symptoms or imaging (whichever came first) and the achievement of a histological diagnosis, the stage at diagnosis, and the pts’ overall survival (OS, calculated from the time of diagnosis to death).
Results
We observed a reduction of 26.9% in the total number of accesses at our centre (208 pts in the pre-COVID group, 152 in the post-COVID group). The mean time from symptom to first imaging was slightly longer: 48.42 ± 52.73 days in the post-COVID group versus 36.18 ± 48.38 days in the pre-COVID group, but this was not statistically significant (p = 0.07). However, we observed a statistically significant longer mean time from first symptoms or imaging (whichever came first) and the histological diagnosis in the post-COVID group (99.52 ± 72.58 vs 83.38 ± 65.35 days, p = 0.04). In the post-COVID group we observed more stage-IV cancer (74.8% vs 63%, p = 0.03) and fewer stage I-II cancer (7.1% vs 15%, p = 0.03). The median OS has not been reached yet (only 27 events have been censored), but the estimated mean OS was 38.73 months (95CI% 35.85-41.63) in the pre-COVID group versus 17.55 months (95%CI 15.97-19.12) in the post-COVID group (log-rank p = 0.029).
Conclusions
COVID19 pandemic led to a reduction of pts accessing to our Oncology Centre. The time for histological diagnosis was longer. A relevant increase in the percentage of patients presenting with advanced disease at diagnosis was observed. Pts experienced a worse mean OS in the post-COVID era.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Sbrana: Financial Interests, Personal, Writing Engagements: Novartis; Financial Interests, Personal, Other, Travel fee: Pfizer. All other authors have declared no conflicts of interest.