A multi-institutional study of the impact of the COVID-19 pandemic on pancreatic cancer diagnosis and management.

Authors

null

Claudia Rosso

University of California, Irvine, School of Medicine, Irvine, CA

Claudia Rosso , Jennifer B. Valerin , Parisa Oviedo , Niloofar Radgoudarzi , Wen-Pin Chen , Christine E. McLaren , Rebekah Ruth White , Jason Zell

Organizations

University of California, Irvine, School of Medicine, Irvine, CA, UC Irvine, Orange, CA, UCSD Department of Surgery, La Jolla, CA, UCSD School of Medicine, La Jolla, CA, University of California, Irvine, Chao Family Comprehensive Cancer Center, Irvine, CA, UC Irvine, Irvine, CA, Moores Cancer Center, San Diego, CA, UCI Health, Orange, CA

Research Funding

Other

Background: The impact of COVID-19 on cancer patients may be attributed not only to its direct effects on the immune system but also to delays in diagnosis and treatment. Data on the effects of COVID-19 on pancreatic ductal adenocarcinoma (PDAC) patients are scarce. Therefore, we set out to determine the impact of the pandemic on diagnosis and treatment initiation. We hypothesized that time from diagnosis to treatment would be increased in the COVID era compared to the pre-COVID era. Methods: We conducted an IRB-approved retrospective chart review of 488 patients diagnosed with PDAC from March 2019 to September 2020 at two academic medical centers. Patients were divided into two groups, based on the date of initial pathologic diagnosis. We defined the pre-COVID era as March 2019 to March 2020, the 12-month time period before California’s statewide lockdown. The COVID era was defined as the 6 months following the lockdown, March 2020 to September 2020. Demographics, clinical stage, and treatment type were recorded. In addition, initial clinical encounter date, pathologic diagnosis date, and initial treatment date were also collected. All data were gathered at two large-scale academic institutions. Descriptive statistics were used in the analysis. Results: There were 333 patients diagnosed during the pre-COVID era and 155 patients during the COVID era. While race/ethnicity and age at diagnosis were statistically similar for both groups, females made up a significantly larger proportion of COVID era patients than pre-COVID era patients (p= 0.02). There was no significant difference in clinical stage at diagnosis between the two groups (p= 0.84). In the pre-COVID era, 19.5% of cases were resectable, 11.1% borderline resectable, 20.1% locally advanced, and 31.8% metastatic. In the COVID era, 17.4% of patients were resectable, 11% borderline resectable, 23.9% locally advanced, and 32.9% metastatic. Median time from pathologic diagnosis to initiation of treatment was 32 days for the pre-COVID era patients and 28 days for the COVID era patients (p= 0.38). Initial treatment type was also similar between the two groups (p= 0.29). Conclusions: Fortunately, our data indicate that the COVID-19 pandemic has not significantly prevented PDAC patients from seeking care. Additionally, it does not appear that COVID-19 has delayed treatment initiation or changed initial treatment type. We believe that the successful adoption of telemedicine and other safety protocols have allowed patients with PDAC to continue receiving appropriate care during the pandemic.

Impact of California COVID-19 lockdown on diagnosis and median time to treatment (days).


Pre-COVID Era (Days, 95% CI)
COVID Era (Days, 95% CI)
p-value
Time from symptom onset to clinical encounter
21 (14-31)
21 (15-31)
0.65
Time from clinical encounter to diagnosis
11 (9-13)
13 (10-17)
0.15
Time from diagnosis to treatment
32 (26-36)
28 (25-32)
0.38

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Abstract Details

Meeting

2022 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Impact of COVID-19

DOI

10.1200/JCO.2022.40.4_suppl.526

Abstract #

526

Poster Bd #

E8

Abstract Disclosures

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