The Impact of the COVID-19 Pandemic on the Diagnosis and Treatment Characteristics of Operated Lung Cancer Patients

J Coll Physicians Surg Pak. 2023 Nov;33(11):1271-1277. doi: 10.29271/jcpsp.2023.11.1271.

Abstract

Objective: To analyse the impact of the COVID-19 pandemic on the diagnostic method, disease stage, treatment modalities, and survival of operated non-small cell lung cancer (NSCLC) patients.

Study design: Descriptive study. Place and Duration of the Study: Department of Oncology, Gaziantep University Oncology Hospital, Sahinbey, Turkey, from March 2018 to March 2022.

Methodology: Patients who were operated for NSCLC were screened retrospectively. The diagnostic method, demographic and clinical characteristics of patients, COVID-19 infection and survival time were analysed and compared after dividing the patient into prepandemic and pandemic groups according to their chronology of enrollment.

Results: A total of 303 patients were included in the study (prepandemic=163, pandemic=140). The time from the symptom onset to the histological diagnosis was shorter in the pandemic group (p=0.005). T4 tumours were more common in the prepandemic group (p=0.01). Most patients with adenocarcinoma underwent lobectomy, and most patients with pneumonectomy had squamous cell carcinoma (SCC) histology (p=0.001). The indications for chemotherapy and radiotherapy significantly differed between the groups (p=0.005 and p=0.001, respectively). The rate of patients with incidental diagnosis was higher in the pandemic group (p=0.001), often at Stage-1; patients diagnosed with symptoms were often at Stage-3 (p=0.001). Among the incidentally diagnosed group of patients, 34 (72%) had adenocarcinoma; 127 (50%) patients in the group diagnosed with symptoms had SCC subtype (p=0.001).

Conclusion: During the pandemic, proportion of patients diagnosed incidentally increased. These patients were mostly diagnosed with adenocarcinoma subtype and diagnosed at an earlier stage.

Key words: Lung cancer, Incidentally, COVID-19 pandemic.

MeSH terms

  • Adenocarcinoma* / diagnosis
  • Adenocarcinoma* / epidemiology
  • Adenocarcinoma* / surgery
  • COVID-19 Testing
  • COVID-19* / epidemiology
  • Carcinoma, Non-Small-Cell Lung* / diagnosis
  • Carcinoma, Non-Small-Cell Lung* / epidemiology
  • Carcinoma, Non-Small-Cell Lung* / surgery
  • Carcinoma, Squamous Cell* / pathology
  • Humans
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / epidemiology
  • Lung Neoplasms* / surgery
  • Neoplasm Staging
  • Pandemics
  • Retrospective Studies