COVID-19 时代的根治性子宫切除术病例量和宫颈癌治疗：对国家癌症研究所指定的综合癌症中心的多站点分析。
Radical hysterectomy case volume and cervical cancer treatment in the era of COVID-19: A multi-site analysis of National Cancer Institute-designated Comprehensive Cancer Centers.
发表日期：2023 Nov 07
作者：
Natalie E Wickenheisser, Mairead Dillon, Gloria Broadwater, Kathleen Zacherl, Kristin Bixel, Monica Levine, Meredith Newton, Hannah Thel, Katherine Tucker, Paola Gehrig, Varun U Khetan, Laurie L Brunette-Masi, Koji Matsuo, Olivia R Khouri, Ashley Duhon, Divya Gowthaman, Matthew Cowan, Rachel Mojdehbakhsh, Stephen Rose, Alexander Olawaiye, Brittany A Davidson, Haley A Moss, Laura J Havrilesky
来源：
GYNECOLOGIC ONCOLOGY
摘要：
旨在比较在 COVID-19 大流行之前和之后诊断的浸润性宫颈癌的根治性子宫切除术病例量、癌症分期以及活检到治疗的时间。在 6 个大型、不同地域的国家癌症中心进行的一项多机构回顾性队列研究中在研究所指定的癌症中心，根据首次妇科肿瘤就诊日期，将新诊断浸润性宫颈癌接受治疗的患者分为 2 个时间组： (1) 大流行前：2018 年 3 月 1 日至 2020 年 2 月 28 日； (2) 疫情
To compare radical hysterectomy case volume, cancer stage, and biopsy-to-treatment time of invasive cervical cancer diagnosed before and after onset of the COVID-19 pandemic.In a multi-institution retrospective cohort study conducted at 6 large, geographically diverse National Cancer Institute-designated cancer centers, patients treated for newly diagnosed invasive cervical cancer were classified into 2 temporal cohorts based on date of first gynecologic oncology encounter: (1) Pre-Pandemic: 3/1/2018-2/28/2020; (2) Pandemic & Recovery: 4/1/2020-12/31/2021. The primary outcome was total monthly radical hysterectomy case volume. Secondary outcomes were stage at diagnosis and diagnosis-to-treatment time. Statistical analyses used chi-squared and two sample t-tests.Between 3/1/2018-12/31/2021, 561 patients were diagnosed with cervical cancer. The Pre-Pandemic and Pandemic & Recovery cohorts had similar age, race, ethnicity, smoking status, and Body Mass Index (BMI). During Pandemic & Recovery, the mean monthly radical hysterectomy case volume decreased from 7[SD 2.8] to 5[SD 2.0] (p = 0.001), the proportion of patients diagnosed with Stage I disease dropped from 278/561 (49.5%) to 155/381 (40.7%), and diagnosis of stage II-IV disease increased from 281/561 (50.1%) to 224/381 (58.8%). Primary surgical management was less frequent (38.3% Pandemic & Recovery versus 46.7% Pre-Pandemic, p = 0.013) and fewer surgically-treated patients received surgery within 6 weeks of diagnosis (27.4% versus 38.9%; p = 0.025).Lower radical hysterectomy case volume, a shift to higher cervical cancer stage, and delay in surgical therapy were observed across the United States following the COVID-19 outbreak. Decreased surgical volume may result from lower detection of early-stage disease or other factors.Copyright © 2023. Published by Elsevier Inc.