Main Session
Sep
27
PQA 01 - Gastrointestinal Cancer and Central Nervous System
2205 - Impact of COVID-19 on Survival in Patients with Curative Stage I-III Sigmoid and Rectal Cancer: A Cohort Study of 765 Patients
Presenter(s)
Ajra Secerov Ermenc, MD, PhD - Institute of Oncology Ljubljana, Ljubljana, Slovenia
A. Secerov Ermenc1,2, J. But Hadzic1,2, T. Rutar2, S. Milicevic3, B. Peric3, Z. Moskon4, and I. Ratosa1,2; 1Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia, 2Division of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia, 3Division of Surgery, Institute of Oncology, Ljubljana, Slovenia, 4University Medical Centre Ljubljana, Ljubljana, Slovenia
Purpose/Objective(s):
The COVID-19 pandemic disrupted cancer care worldwide. We evaluated the impact of SARS-CoV-2 infection and pandemic timing on overall survival in patients with Stage I–III sigmoid and rectal cancer treated with curative intent.Materials/Methods:
From January 2018 to December 2021, we retrospectively analyzed patients with sigmoid or rectal cancer (Stage I–III) treated with surgery, radiotherapy, and/or chemotherapy at a single institution. Data included COVID-19 positivity, treatment modality, stage, sex, age, and survival. For the purpose of analysis, patients were divided into two cohorts: the pre-pandemic cohort (patients treated before March 1, 2020) and the post-pandemic cohort (patients treated after this date). Overall survival was assessed using Kaplan-Meier curves and Cox proportional hazards regression. Covariates included stage, sex, pandemic period, and COVID-19 status.Results:
A total of 765 patients with stage I–III rectal or sigmoid cancer treated with curative intent were included. Median follow-up was 56 months (range, 0–97 months). The pre- and post-COVID-19 cohorts were comparable in baseline characteristics, including cohort size (332 vs 433 patients), mean age (71 vs 68 years), sex distribution (66.5% vs 66.1% male), radiotherapy (74.3% vs 77.8% treated with radiotherapy), surgery (86.4% vs 81.6% treated with surgery), systemic treatment (42.2% vs 38.7% treated with systemic therapy), and stage III prevalence (68.5% vs 71.6%; all p > 0.05). Kaplan-Meier analysis showed no significant difference in overall survival between the pre- and post-COVID-19 cohorts. Five-year overall survival was 67.5% vs 66.7%, respectively (log-rank p = 0.898). Treatment interruptions in radiotherapy were rare, with two interruptions due to side effects and two interruptions due to COVID-19 infection. Cox proportional hazards analysis showed no significant association between COVID-19 infection (HR 1.18, 95% CI 0.85–1.66; p = 0.31), period of treatment (HR 0.93, 95% CI 0.72–1.20; p = 0.60) or stage and overall survival.Conclusion:
In this curative cohort, COVID-19 infection and the pandemic period did not significantly affect survival, suggesting that multimodal treatment outcomes remained robust during the pandemic.