1.7-fold increase in complications of colon cancer surgery during COVID-19 Causes cancer diagnosis and treatment delay
Sep 10, 2024
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Professor Kim Jong-wan's research team at Hallym University's Dongtan Sacred Heart Hospital confirmed this in 'Impact of COVID-19 Pandemic on the Clinical and Pathological Characteristics of Colorectal Cancer: a Retrospective Multicenter Study in South Korea'. The paper was published in the recent issue of the SCIE-level international journal 'Cancer Management and Research'.
The research team analyzed the surgical results of 2,038 people who underwent colon cancer surgery at five university hospitals, including hospitals affiliated with Hallym University Medical Center. Of these, 987 underwent colon cancer surgery in 2017-2019 before the COVID-19 pandemic, and the remaining 1,051 underwent colon cancer surgery in 2020-2022, when the COVID-19 spread in earnest.
As a result, the incidence of complications in the surgical group during COVID-19 was 27%, up 1.7 times from 15.6% in the pre-COVID surgery group. In addition, the rate of complications of two or more (41.2% vs. 33.1% and 1.2 times) and the rate of severe complications of grades 3 to 5 (10.8% vs. 7.2% and 1.5 times) were also higher in the surgery group during COVID than in the previous surgery group. Complications included surgical site infection, rainy season, and bleeding.
The difference in the rate of postoperative complications was analyzed to be due to failure to diagnose cancer early or to miss the appropriate timing of surgery. During COVID-19, the surgical group had a higher proportion of emergency surgery (11.6% vs. 7.9%, 1.5 times), ostomy formation (27.4% vs. 21.4% vs. 1.3 times), and rectal cancer patients (12.5% vs. 8.9%, 1.4 times) compared to the pre-COVID surgical group.
In addition, the surgical group during COVID-19 also had higher rates of tumor periplasmic lymphatic infiltration (46.6% vs. 37.5%, 1.2 times) and T4 stage (19.4% vs. 13.9%, 1.4 times) in which the tumor was extended to all layers of the barrier with periplasmic infiltration than the pre-COVID surgical group.
Professor Kim Jong-wan explained, "The number of emergency surgeries increased during the COVID-19 period, and as a result, the intestinal cleansing to empty the inside of the large intestine before surgery was not properly performed, which increased the rate of intestinal fistula formation to prevent the risk of anastomotic leakage." He also explained, "It was analyzed that the diagnosis of colorectal cancer decreased due to the decrease in regular checkups during the COVID-19 period, but the diagnosis rate of rectal cancer accompanied by symptoms such as bloody excrement and anal pain increased relatively more."
Professor Kim said, `During COVID-19, the diagnosis of colorectal cancer was delayed as the number of COVID patients in hospitals surged during COVID-19 and people hesitated to visit hospitals due to concerns about infection,' and the study confirmed that the delay in diagnosis and treatment in colorectal cancer could lead to increased postoperative complications and a decrease in quality of life due to the formation of an ostomy.'
However, the two groups' two-year survival rate was similar at 91%, which was analyzed because the average follow-up period after colon cancer surgery was only 24 months, and the long-term follow-up results will also be analyzed in the future.
This study was conducted with the support of clinical research projects from Hallym University Medical Center. In addition, the reliability was increased by conducting research on patients from secondary and tertiary university hospitals located in Seoul, Gyeonggi-do, and Gangwon-do, where the population ratio is high.
Meanwhile, September is 'Colorectal Cancer Month' designated by the Korean Society for Colorectal Aviation to emphasize the importance of colon cancer prevention and early screening. Through the national cancer screening, people over the age of 50 can undergo a fecal occult blood test every year, and if positive, colonoscopy is recommended. In addition, if you have symptoms such as anal pain, bleeding during defecation, or diaphylaxis that you want to defecate after defecation, it is recommended to see a specialist.
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