Influence of the SARS-CoV-2 outbreak on management and prognosis of new lung cancer cases, a retrospective multicentre real-life cohort study

• Published in: European journal of cancer (1990) 2022-09, Vol.173, p.33-40
• Main Authors: Priou, Sonia, Lamé, Guillaume, Zalcman, Gérard, Wislez, Marie, Bey, Romain, Chatellier, Gilles, Cadranel, Jacques, Tannier, Xavier, Zelek, Laurent, Daniel, Christel, Tournigand, Christophe, Kempf, Emmanuelle
• Format: Article
• Language: English
• Subjects: Cohort analysis; Cohort Studies; Communicable Disease Control; COVID-19; COVID-19 - epidemiology; Current; Delivery of health care; Early cancer detection; Electronic health records; Electronic medical records; Health services; Humans; Lung cancer; Lung neoplasms; Lung Neoplasms - drug therapy; Lung Neoplasms - therapy; Medical prognosis; Pandemics; Patients; Prognosis; Quality of health care; Retrospective Studies; Routinely collected health data; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Therapy; Tumors; Viral diseases
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2022.06.018

The SARS-CoV-2 pandemic has impacted the care of cancer patients. This study sought to assess the pandemic’s impact on the clinical presentations and outcomes of newly referred patients with lung cancer from the Greater Paris area. We retrospectively retrieved the electronic health records and administrative data of 11.4 million patients pertaining to Greater Paris University Hospital (AP-HP). We compared indicators for the 2018–2019 period to those of 2020 in regard to newly referred lung cancer cases. We assessed the initial tumour stage, the delay between the first multidisciplinary tumour board (MTB) and anticancer treatment initiation, and 6-month overall survival (OS) rates depending on the anticancer treatment, including surgery, palliative systemic treatment, and best supportive care (BSC). Among 6240 patients with lung cancer, 2179 (35%) underwent tumour resection, 2069 (33%) systemic anticancer therapy, 775 (12%) BSC, whereas 1217 (20%) did not receive any treatment. During the first lockdown, the rate of new diagnoses decreased by 32% compared with that recorded in 2018–2019. Initial tumour stage, repartition of patients among treatment categories, and MTB-related delays remained unchanged. The 6-month OS rates of patients diagnosed in 2018–2019 who underwent tumour resection were 98% versus 97% (HR = 1.2; 95% CI: 0.7–2.0) for those diagnosed in 2020; the respective rates for patients who underwent systemic anticancer therapy were 78% versus 79% (HR = 1.0; 95% CI: 0.8–1.2); these rates were 20% versus 13% (HR = 1.3; 95% CI: 1.1–1.6) for those who received BSC. COVID-19 was associated with poorer OS rates (HR = 2.1; 95% CI: 1.6–3.0) for patients who received systemic anticancer therapy. The SARS-CoV-2 pandemic has not exerted any deleterious impact on 6-month OS of new lung cancer patients that underwent active anticancer therapy in Greater Paris University hospitals. •During the first SARS-CoV2 lockdown, the number of new lung cancers decreased by 32%.•In 6240 cases, the initial tumour stage and treatment categories did not vary (2018–2021).•Delay between multidisciplinary boards and cancer treatments did not vary over time.•Overall survival of patients diagnosed after the outbreak did not impair.•COVID was associated with poorer OS in patients with systemic anticancer therapy.