Impact of COVID-19 on the gastrointestinal surgical oncology patient population

Authors

Baylee F. Bakkila, Yale School of Medicine, New Haven, CT, USA.Follow
Victoria A. Marks, Yale School of Medicine, New Haven, CT, USA.
Daniel Kerekes, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.Follow
John W. Kunstman, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow
Ronald R. Salem, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow
Kevin G. Billingsley, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow
Nita Ahuja, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow
Maxwell Laurans, Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.
Kelly Olino, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow
Sajid A. Khan, Department of Surgery, Division of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA.Follow

Document Type

Article

Publication Title

Heliyon

Abstract

BACKGROUND: The onset of the COVID-19 pandemic led to substantial alterations in healthcare delivery and access. In this study, we aimed to evaluate the impact of COVID-19 on the presentation and surgical care of patients with gastrointestinal (GI) cancers. METHODS: All patients who underwent GI cancer surgery at a large, tertiary referral center between March 15, 2019 and March 15, 2021 were included. March 15, 2020 was considered the start of the COVID-19 pandemic. Changes in patient, tumor, and treatment characteristics before the pandemic compared to during the pandemic were evaluated. RESULTS: Of 522 patients that met study criteria, 252 (48.3%) were treated before the COVID-19 pandemic. During the first COVID-19 wave, weekly volume of GI cancer cases was one-third lower than baseline (p = 0.041); during the second wave, case volume remained at baseline levels (p = 0.519). There were no demographic or tumor characteristic differences between patients receiving GI cancer surgery before versus during COVID-19 (p > 0.05 for all), and no difference in rate of emergency surgery (p > 0.9). Patients were more likely to receive preoperative chemotherapy during the first six months of the pandemic compared to the subsequent six months (35.6% vs. 15.5%, p < 0.001). Telemedicine was rapidly adopted at the start of the pandemic, rising from 0% to 47% of GI surgical oncology visits within two months. CONCLUSIONS: The COVID-19 pandemic caused an initial disruption to the surgical care of GI cancers, but did not compromise stage at presentation. Preoperative chemotherapy and telemedicine were utilized to mitigate the impact of a high COVID-19 burden on cancer care.

First Page

e18459

DOI

10.1016/j.heliyon.2023.e18459

Publication Date

8-1-2023

Recommended Citation

Bakkila, Baylee F.; Marks, Victoria A.; Kerekes, Daniel; Kunstman, John W.; Salem, Ronald R.; Billingsley, Kevin G.; Ahuja, Nita; Laurans, Maxwell; Olino, Kelly; and Khan, Sajid A., "Impact of COVID-19 on the gastrointestinal surgical oncology patient population" (2023). Surgery. 208.
https://scholar.bridgeporthospital.org/surgery/208

Identifier

37534012 (pubmed); PMC10391949 (pmc); 10.1016/j.heliyon.2023.e18459 (doi); S2405-8440(23)05667-0 (pii)