Abstract 1516P
Background
COVID-19 pandemic led to reduced access to clinics, interruption of screenings and delay in cancer diagnoses and treatments. Although long-term negative effects emerged in several studies in oncology, fewer data are available in sarcomas. We analysed the impact of COVID-19 pandemic on diagnostic delay in a sarcoma referral centre in Italy.
Methods
We performed a retrospective study including patients (pts) with histological diagnosis of soft tissue sarcoma (STS), bone sarcoma (BS), and aggressive benign connective diseases (ABCD) followed at Regina Elena National Cancer Institute in Rome during the first year of pandemic and the year before. Pts were classified in Control Group (CG) and COVID Group (COVG) according to the date of diagnosis, respectively before or after the start of lockdown in Italy (March 9th 2020).
Results
We enrolled 185 pts affected by STS (129), BS (41), and ABCD (15), male/female 113/72. The median age at diagnosis was 53.9 (range 17-101). 92 pts were classified in the CG and 93 in COVG. We observed a diagnostic delay in the COVG with a median time from the first symptom to the diagnosis of 103 days (d) (95% Confidence Interval (CI) 92,8 - 113,2) vs 90 d (95% CI 69,5 - 110,5) in the CG (p 0.024), but not a delay in starting treatment (time from first symptoms to treatment 151 d (95% CI 132,9 - 169,1) vs 144 d (95% CI 120,3 - 167,7) in the COVG and CG respectively, p 0.208). Although the diagnostic delay was evident in all the trimesters, this was significant in the trimester Sep-Nov (99 (95% CI 88.4 - 109.5) vs 70 (95% CI 59.5 - 80.5) d respectively, p 0.035). We noticed a reduction in the number of diagnoses in the first trimester of the pandemic (14 vs 33), with a subsequent recovery with 33 vs 22, 32 vs 20, and 14 vs 17 new diagnosis in the Jun-Aug, Sep-Nov, Dec-Feb trimesters respectively (p 0.005). No differences in stage at diagnosis was observed (12% vs 16.5% in the COVG and CG respectively, p 0.380). Progression free (p 0.897) and overall survival (p 0.725) were comparable in the subgroup of STS pts.
Conclusions
A significant delay in sarcoma diagnosis but not in starting treatment has been highlighted, with greatest impact in the trimester Sep-Nov 2020. No difference in stage at diagnosis, nor in terms of survival have been observed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Local Ethics Committee.
Funding
Fund from Istituto Soka Gakkai for COMETA Project.
Disclosure
All authors have declared no conflicts of interest.