The impact of the COVID-19 pandemic on head and neck cancer diagnosis: a single-center study
, , y | 25 ago 2023
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Article Category: Original Study
Publicado en línea: 25 ago 2023
Páginas: 65 - 71
Recibido: 02 feb 2023
Aceptado: 12 jun 2023
DOI: https://doi.org/10.2478/ahem-2023-0013
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© 2023 Marcin Turski et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.
Patient history and treatment
| Variable | Total N = 172 | Pre-COVID group N = 86 | COVID group N = 86 | P-value |
|---|---|---|---|---|
| Duration of symptoms: | 0.603 | |||
| No symptoms | 16 (9.3) | 8 (9.3) | 8 (9.3) | |
| Up to one month | 11 (6.4) | 4 (4.7) | 7 (8.1) | |
| 1 to 3 months | 29 (16.9) | 16 (18.6) | 13 (15.1) | |
| 3 to 6 months | 49 (28.5) | 24 (27.9) | 25 (29.1) | |
| 6 to 12 months | 13 (7.6) | 4 (4.7) | 9 (10.5) | |
| 12 and more months | 7 (4.1) | 5 (5.8) | 2 (2.3) | |
| No data | 47 (27.3) | 25 (29.1) | 22 (25.6) | |
| Smoking: | 0.264 | |||
| Yes | 93 (54.1) | 50 (58.1) | 43 (50.0) | |
| No | 60 (34.9) | 25 (29.1) | 35 (40.7) | |
| No data | 19 (11.0) | 11 (12.8) | 8 (9.3) | |
| Type of treatment: | 0.768 | |||
| Radical | 118 (68.6) | 62 (72.1) | 56 (65.1) | |
| Palliative | 15 (8.7) | 6 (7.0) | 9 (10.5) | |
| Induct | 15 (8.7) | 7 (8.1) | 8 (9.3) | |
| Other | 24 (14.0) | 11 (12.8) | 13 (15.1) | |
| Treatment method: | 0.657 | |||
| Surgery | 38 (22.1) | 20 (23.3) | 18 (20.9) | |
| RTh | 32 (18.6) | 14 (16.3) | 18 (20.9) | |
| Surgery + RTh/RCTh | 33 (19.2) | 17 (19.8) | 16 (18.6) | |
| RCTh | 19 (11.0) | 12 (14.0) | 7 (8.1) | |
| CTh + surgery | 1 (0.6) | 1 (1.2) | 0 (0.0) | |
| CTh | 21 (12.2) | 8 (9.3) | 13 (15.1) | |
| Other | 28 (16.3) | 14 (16.3) | 14 (16.3) |
Clinical characteristics of patients
| Variable | Total N = 172 | pre-COVID group N = 86 | COVID group N = 86 | P-value |
|---|---|---|---|---|
| Tumor: | 0.249 | |||
| T0, n (%) | 12 (7.0) | 9 (10.5) | 3 (3.5) | |
| T1, n (%) | 41 (23.8) | 23 (26.7) | 18 (20.9) | |
| T2, n (%) | 28 (16.3) | 13 (15.1) | 15 (17.4) | |
| T3, n (%) | 29 (16.9) | 10 (11.6) | 19 (22.1) | |
| T4a, n (%) | 47 (27.3) | 24 (27.9) | 23 (26.7) | |
| T4b, n (%) | 15 (8.7) | 7 (8.1) | 8 (9.3) | |
| Lymph nodes: | 0.693 | |||
| N0, n (%) | 77 (44.8) | 40 (46.5) | 37 (43.0) | |
| N1, n (%) | 15 (8.7) | 8 (9.3) | 7 (8.2) | |
| N2, n (%) | 51 (29.6) | 22 (25.6) | 29 (33.7) | |
| N3, n (%) | 29 (16.9) | 16 (18.6) | 13 (15.1) | |
| Metastasis: | 0.329 | |||
| M0, n (%) | 162 (94.2) | 83 (96.5) | 79 (91.9) | |
| M1, n (%) | 10 (5.8) | 3 (3.5) | 7 (8.1) | |
| Grading: | 0.429 | |||
| G1, n (%) | 22 (12.8) | 13 (15.1) | 9 (10.5) | |
| G2, n (%) | 98 (57.0) | 50 (58.1) | 48 (55.8) | |
| G3, n (%) | 27 (15.7) | 14 (16.3) | 13 (15.1) | |
| No data, n (%) | 25 (14.5) | 9 (10.5) | 16 (18.6) | |
| Stage: | 0.758 | |||
| I, n (%) | 35 (20.3) | 18 (20.9) | 17 (19.8) | |
| II, n (%) | 17 (9.9) | 10 (11.6) | 7 (8.1) | |
| III, n (%) | 23 (13.4) | 12 (14.0) | 11 (12.8) | |
| IVA, n (%) | 51 (29.7) | 25 (29.1) | 26 (30.2) | |
| IVB, n (%) | 38 (22.1) | 19 (22.1) | 19 (22.1) | |
| IVC, n (%) | 8 (4.7) | 2 (2.3) | 6 (7.0) | |
| Histopathological diagnosis: | 0.541 | |||
| Squamous cell carcinoma | 143 (83.1) | 73 (84.9) | 70 (81.4) | |
| Others | 29 (16.9) | 13 (15.1) | 16 (18.6) | |
| Location: | 0.360 | |||
| Lip and Oral Cavity | 7 (4.1) | 5 (5,8) | 2 (2,3) | |
| Nasopharynx | 4 (2.3) | 2 (2,3) | 2 (2,3) | |
| Hypopharynx | 31 (18.0) | 12 (14,0) | 19 (22,1) | |
| Oropharynx | 16 (9.3) | 6 (7,0) | 10 (11,6) | |
| Larynx | 80 (46.5) | 41 (47,7) | 39 (45,3) | |
| Nasal Cavity and Paranasal Sinuses | 8 (4.7) | 5 (5,8) | 3 (3,5) | |
| Unknown Primary | 12 (7.0) | 9 (10,5) | 3 (3,5) | |
| Major Salivary Glands | 14 (8.1) | 6 (7,0) | 8 (9,3) |
Number (percentage) of patients in the subgroups, differing in the timing of treatment and dyspnea, emergency tracheotomy and PEG, the result of the independence test and the value of the odds ratio and its 95% confidence interval
| Dyspnoea | P-value | OR (95% CI) | ||
|---|---|---|---|---|
| Yes (N = 18) | No (N = 154) | |||
| During a pandemic | 11 (61.1) | 75 (48.7) | 0.455 | 1.66 (0.61; 4.49) |
| Before the pandemic | 7 (38.9) | 79 (51.3) | 1.00 (ref.) | |
| Emergency tracheotomy | ||||
| Yes (N = 16) | No (N = 156) | |||
| During a pandemic | 10 (62.5) | 76 (48.7) | 0.294 | 1.75 (0.61; 5.06) |
| Before the pandemic | 6 (37.5) | 80 (51.3) | 1.00 (ref.) | |
| PEG | ||||
| Yes (N = 19) | No (N = 153) | |||
| During a pandemic | 14 (73.7) | 72 (47.1) | 0.049 | 3.15 (1.08; 9.18) |
| Before the pandemic | 5 (26.3) | 81 (52.9) | 1.00 (ref.) | |
General characteristics of patients
| Variable | Total N = 172 | pre-COVID group N = 86 | COVID group N = 86 | P-value |
|---|---|---|---|---|
| Gender: | 0.141 | |||
| Female, n (%) | 38 (22.1) | 15 (17.4) | 23 (26.7) | |
| Male, n (%) | 134 (77.9) | 71 (82.6) | 63 (73.3) | |
| Age (years): | 0.703 | |||
| M ± SD | 63.8 ± 10.6 | 63.5 ± 10.9 | 64.1 ± 10.3 | |
| Me [Q1; Q3] | 63 [59; 71] | 63 [58; 71] | 64 [60; 70] | |
| Min - Max | 30 – 86 | 30 – 86 | 34 – 85 | |
| BMI (kg/m2): | 0.235 | |||
| M ± SD | 25.4 ± 5.1 | 25.9 ± 5.4 | 24.8 ± 4.9 | |
| Me [Q1; Q3] | 25 [22; 28] | 26 [22; 30] | 25 [22; 27] | |
| Min - Max | 16 – 47 | 16 – 39 | 16 – 47 | |
| BMI: | 0.168 | |||
| Thinness (Less than 17), n (%) | 4 (2.3) | 2 (2.3) | 2 (2.3) | |
| Underweight (17.0 – 18.4), n (%) | 3 (1.7) | 1 (1.2) | 2 (2.3) | |
| Normal weight (18.5 – 24.9), n (%) | 48 (27.9) | 24 (27.9) | 24 (27.9) | |
| Overweight (25.0 – 29.9), n (%) | 37 (21.5) | 16 (18.6) | 21 (24.4) | |
| Obesity (30 and more), n (%) | 19 (11.0) | 15 (17.4) | 4 (4.7) | |
| No data, n (%) | 61 (35.5) | 28 (32.6) | 33 (38.4) | |
| Distance (km): | 0.203 | |||
| M ± SD | 25.4 ± 5.1 | 25.9 ± 5.4 | 24.8 ± 4.9 | |
| Me [Q1; Q3] | 25 [22; 28] | 26 [22; 30] | 25 [22; 27] | |
| Min - Max | 16 – 47 | 16 – 39 | 16 – 47 | |
| Distance: | 0.321 | |||
| a) 0 – 9 km | 38 (22.1) | 22 (25.6) | 16 (18.6) | |
| b) 10 – 24 km | 18 (10.5) | 8 (9.3) | 10 (11.6) | |
| c) 25 – 49 km | 24 (14.0) | 13 (15.1) | 11 (12.8) | |
| d) 50 – 74 km | 41 (23.8) | 24 (27.9) | 17 (19.8) | |
| e) 75 – 99 km | 32 (18.6) | 12 (14.0) | 20 (23.3) | |
| f) 100 – 252 km | 19 (11.0) | 7 (8.1) | 12 (14.0) |