SARS-COV-2疫情期间胰腺癌病例的临床表现、治疗策略和生存状况无显著变化：一项基于真实世界数据的回顾性多中心队列研究。
No changes in clinical presentation, treatment strategies and survival of pancreatic cancer cases during the SARS-COV-2 outbreak: A retrospective multicenter cohort study on real-world data.
发表日期：2023 Aug 04
作者：
Emmanuelle Kempf, Sonia Priou, Guillaume Lamé, Alexis Laurent, Etienne Guével, Stylianos Tzedakis, Romain Bey, David Fuks, Gilles Chatellier, Xavier Tannier, Gilles Galula, Rémi Flicoteaux, Christel Daniel, Christophe Tournigand,
来源：
INTERNATIONAL JOURNAL OF CANCER
摘要：
SARS-COV-2疫情对医疗系统造成了破坏。我们评估了其对巴黎地区新发胰腺癌（PCs）的病情、护理轨迹和结果的影响。我们在大巴黎大学医院（AP-HP）的数据仓库中进行了一项回顾性的多中心队列研究。我们确定了2019年1月1日到2021年6月30日期间所有新转诊的PC患者，并排除内分泌肿瘤。利用索赔数据和健康记录，我们分析了护理轨迹的时间线，初始肿瘤分期以及治疗类别：胰腺切除术、单独的全身治疗或单独的最佳支持性护理（BSC）。我们计算了患者的1年总生存率（OS），并将2019年和2020至2021年的指标进行了比较。我们纳入了2335名患者。在第一次封锁期间，转诊率下降了29%。从活检到治疗的中位时间为25天（16-50天），从第一例多学科会议（MDM）到治疗的中位时间为21天（11-40天）。在2019年至2020至2021年期间，转移性肿瘤的比例（36%对33%，P = .39）、464例实施了直接肿瘤切除的患者的pTNM分布（P = .80）以及治疗类别的比例没有变化：肿瘤切除术（32%对33%）、单独的全身治疗（49%对49%）、单独的BSC（19%对19%）。在2019年与2020至2021年的治疗类别中，1年总生存率分别为92%对89%（aHR = 1.42；95% CI，0.82-2.48）、52%对56%（aHR = 0.88；95% CI，0.73-1.08）、13%对10%（aHR = 1.00；95% CI，0.78-1.25）。尽管新PC数量最初减少，但我们没有观察到任何分期变化。总生存率没有显著变化。© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
The SARS-COV-2 pandemic disrupted healthcare systems. We assessed its impact on the presentation, care trajectories and outcomes of new pancreatic cancers (PCs) in the Paris area. We performed a retrospective multicenter cohort study on the data warehouse of Greater Paris University Hospitals (AP-HP). We identified all patients newly referred with a PC between January 1, 2019, and June 30, 2021, and excluded endocrine tumors. Using claims data and health records, we analyzed the timeline of care trajectories, the initial tumor stage, the treatment categories: pancreatectomy, exclusive systemic therapy or exclusive best supportive care (BSC). We calculated patients' 1-year overall survival (OS) and compared indicators in 2019 and 2020 to 2021. We included 2335 patients. Referral fell by 29% during the first lockdown. The median time from biopsy and from first MDM to treatment were 25 days (16-50) and 21 days (11-40), respectively. Between 2019 and 2020 to 2021, the rate of metastatic tumors (36% vs 33%, P = .39), the pTNM distribution of the 464 cases with upfront tumor resection (P = .80), and the proportion of treatment categories did not vary: tumor resection (32% vs 33%), exclusive systemic therapy (49% vs 49%), exclusive BSC (19% vs 19%). The 1-year OS rates in 2019 vs 2020 to 2021 were 92% vs 89% (aHR = 1.42; 95% CI, 0.82-2.48), 52% vs 56% (aHR = 0.88; 95% CI, 0.73-1.08), 13% vs 10% (aHR = 1.00; 95% CI, 0.78-1.25), in the treatment categories, respectively. Despite an initial decrease in the number of new PCs, we did not observe any stage shift. OS did not vary significantly.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.