Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer
IntroductionThe Coronavirus Disease 2019 (COVID-19) pandemic posed critical challenges in providing care to ovarian cancer (OC) patients, including delays in OC diagnosis and treatment initiation. To accommodate for delays in OC surgery, the Society of Gynecologic Oncology (SGO) recommended preferen...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1290719/full |
| _version_ | 1797242538322558976 |
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| author | Amrita Mukherjee Natalie Shammas Lanfang Xu Kimberly L. Cannavale Alec D. Gilfillan Elizabeth A. Szamreta Matthew Monberg Melissa Hodeib Chun R. Chao |
| author_facet | Amrita Mukherjee Natalie Shammas Lanfang Xu Kimberly L. Cannavale Alec D. Gilfillan Elizabeth A. Szamreta Matthew Monberg Melissa Hodeib Chun R. Chao |
| author_sort | Amrita Mukherjee |
| collection | DOAJ |
| description | IntroductionThe Coronavirus Disease 2019 (COVID-19) pandemic posed critical challenges in providing care to ovarian cancer (OC) patients, including delays in OC diagnosis and treatment initiation. To accommodate for delays in OC surgery, the Society of Gynecologic Oncology (SGO) recommended preferential use of neoadjuvant chemotherapy during the pandemic. The purpose of this study was to assess the association of the COVID-19 pandemic with neoadjuvant chemotherapy use in patients diagnosed with OC.MethodsThis retrospective cohort study included patients diagnosed with stage II-IV ovarian cancer of epithelial subtype between 01/01/2017-06/30/2021 at Kaiser Permanente Southern California (KPSC), a large integrated healthcare system in the United States. Ovarian cancer patients diagnosed between 2017-2020 were identified from KPSC’s Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry. Patients diagnosed in 2021 were identified from the electronic medical records (EMR) using ICD-10 diagnosis codes, followed by medical chart review to validate diagnosis and extract information on histology and stage at diagnosis. March 4, 2020 was used as the cut-off to define pre-pandemic and pandemic periods. Patients diagnosed with COVID-19 between OC diagnosis and treatment completion were excluded. Data on neoadjuvant chemotherapy use were extracted from the cancer registry and EMR, supplemented by chart review. Modified Poisson regression was used to evaluate the association of the pandemic with neoadjuvant chemotherapy use.ResultsOf 566 OC patients, 160 (28.3%) were diagnosed in the pandemic period. Patients diagnosed in the pandemic period were slightly younger (mean age 62.7 vs 64.9 years, p=0.07) and had a higher burden of Charlson comorbidities (p=0.05) than patients diagnosed in pre-pandemic period. No differences in time to treatment initiation were observed by pandemic periods. Neoadjuvant chemotherapy use was documented in 58.7% patients during the pandemic period compared to 47.3% in pre-pandemic period (p=0.01). After adjusting for covariates, patients diagnosed in the pandemic period were 29% more likely to receive neoadjuvant chemotherapy than patients diagnosed in pre-pandemic period [RR(95%CI): 1.29(1.12-1.49)].DiscussionsOvarian cancer patients diagnosed in the COVID-19 pandemic were more likely to receive neoadjuvant chemotherapy than patients diagnosed before the pandemic. Future research on patient outcomes and trends in the post-pandemic period are warranted. |
| first_indexed | 2024-04-24T18:40:49Z |
| format | Article |
| id | doaj.art-3b74bbedc29140c0971293c60938dafb |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-24T18:40:49Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-3b74bbedc29140c0971293c60938dafb2024-03-27T12:11:22ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-03-011410.3389/fonc.2024.12907191290719Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancerAmrita Mukherjee0Natalie Shammas1Lanfang Xu2Kimberly L. Cannavale3Alec D. Gilfillan4Elizabeth A. Szamreta5Matthew Monberg6Melissa Hodeib7Chun R. Chao8Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United StatesObstetrics and Gynecology, Adventist Health White Memorial Medical Center, Los Angeles, CA, United StatesData Reporting and Analytics, MedHealth Statistical Consulting Inc., Solon, OH, United StatesDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United StatesDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United StatesCenter for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, United StatesCenter for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ, United StatesGynecology Oncology, Kaiser Permanente Southern California, Riverside, CA, United StatesDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United StatesIntroductionThe Coronavirus Disease 2019 (COVID-19) pandemic posed critical challenges in providing care to ovarian cancer (OC) patients, including delays in OC diagnosis and treatment initiation. To accommodate for delays in OC surgery, the Society of Gynecologic Oncology (SGO) recommended preferential use of neoadjuvant chemotherapy during the pandemic. The purpose of this study was to assess the association of the COVID-19 pandemic with neoadjuvant chemotherapy use in patients diagnosed with OC.MethodsThis retrospective cohort study included patients diagnosed with stage II-IV ovarian cancer of epithelial subtype between 01/01/2017-06/30/2021 at Kaiser Permanente Southern California (KPSC), a large integrated healthcare system in the United States. Ovarian cancer patients diagnosed between 2017-2020 were identified from KPSC’s Surveillance, Epidemiology, and End Results (SEER)-affiliated cancer registry. Patients diagnosed in 2021 were identified from the electronic medical records (EMR) using ICD-10 diagnosis codes, followed by medical chart review to validate diagnosis and extract information on histology and stage at diagnosis. March 4, 2020 was used as the cut-off to define pre-pandemic and pandemic periods. Patients diagnosed with COVID-19 between OC diagnosis and treatment completion were excluded. Data on neoadjuvant chemotherapy use were extracted from the cancer registry and EMR, supplemented by chart review. Modified Poisson regression was used to evaluate the association of the pandemic with neoadjuvant chemotherapy use.ResultsOf 566 OC patients, 160 (28.3%) were diagnosed in the pandemic period. Patients diagnosed in the pandemic period were slightly younger (mean age 62.7 vs 64.9 years, p=0.07) and had a higher burden of Charlson comorbidities (p=0.05) than patients diagnosed in pre-pandemic period. No differences in time to treatment initiation were observed by pandemic periods. Neoadjuvant chemotherapy use was documented in 58.7% patients during the pandemic period compared to 47.3% in pre-pandemic period (p=0.01). After adjusting for covariates, patients diagnosed in the pandemic period were 29% more likely to receive neoadjuvant chemotherapy than patients diagnosed in pre-pandemic period [RR(95%CI): 1.29(1.12-1.49)].DiscussionsOvarian cancer patients diagnosed in the COVID-19 pandemic were more likely to receive neoadjuvant chemotherapy than patients diagnosed before the pandemic. Future research on patient outcomes and trends in the post-pandemic period are warranted.https://www.frontiersin.org/articles/10.3389/fonc.2024.1290719/fullCOVID-19 pandemicovarian cancerneoadjuvant chemotherapysurgeryrace/ethnicity |
| spellingShingle | Amrita Mukherjee Natalie Shammas Lanfang Xu Kimberly L. Cannavale Alec D. Gilfillan Elizabeth A. Szamreta Matthew Monberg Melissa Hodeib Chun R. Chao Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer Frontiers in Oncology COVID-19 pandemic ovarian cancer neoadjuvant chemotherapy surgery race/ethnicity |
| title | Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| title_full | Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| title_fullStr | Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| title_full_unstemmed | Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| title_short | Impact of the Coronavirus Disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| title_sort | impact of the coronavirus disease 2019 pandemic on neoadjuvant chemotherapy use in patients diagnosed with epithelial type ovarian cancer |
| topic | COVID-19 pandemic ovarian cancer neoadjuvant chemotherapy surgery race/ethnicity |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1290719/full |
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