Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)

The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown. This multicentre ambispective observatio...

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Veröffentlicht in:European journal of cancer (1990) 2022-05, Vol.166, p.8-20
Hauptverfasser: Brugel, Mathias, Letrillart, Léa, Evrard, Camille, Thierry, Aurore, Tougeron, David, El Amrani, Mehdi, Piessen, Guillaume, Truant, Stéphanie, Turpin, Anthony, d'Engremont, Christelle, Roth, Gaël, Hautefeuille, Vincent, Regimbeau, Jean M., Williet, Nicolas, Schwarz, Lilian, Di Fiore, Frédéric, Borg, Christophe, Doussot, Alexandre, Lambert, Aurélien, Moulin, Valérie, Trelohan, Hélène, Bolliet, Marion, Topolscki, Amalia, Ayav, Ahmet, Lopez, Anthony, Botsen, Damien, Piardi, Tulio, Carlier, Claire, Bouché, Olivier
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container_title European journal of cancer (1990)
container_volume 166
creator Brugel, Mathias
Letrillart, Léa
Evrard, Camille
Thierry, Aurore
Tougeron, David
El Amrani, Mehdi
Piessen, Guillaume
Truant, Stéphanie
Turpin, Anthony
d'Engremont, Christelle
Roth, Gaël
Hautefeuille, Vincent
Regimbeau, Jean M.
Williet, Nicolas
Schwarz, Lilian
Di Fiore, Frédéric
Borg, Christophe
Doussot, Alexandre
Lambert, Aurélien
Moulin, Valérie
Trelohan, Hélène
Bolliet, Marion
Topolscki, Amalia
Ayav, Ahmet
Lopez, Anthony
Botsen, Damien
Piardi, Tulio
Carlier, Claire
Bouché, Olivier
description The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown. This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, −18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, −1.7%; p = 0.97). The number of borderline tumours increased (13.6%–21.7%), whereas the rate of metastatic diseases rate dropped (47.1%–40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%–32.6%) compared with upfront surgery (13%–7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%–69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%–9.6%) and advanced diseases increased (59.7%–69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. Clinicaltrials.gov NCT04406571. •A total of 833 patients with pancreatic adenocarcinoma were analysed.•During the lockdown, the weekly number of new cases decreased by 18.2%.•Neoadjuvant chemotherapy was favoured compared with upfront surgery (p = 0.013).•Disease stage shifted from localised to advanced disease (p = 0.046).•SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).
doi_str_mv 10.1016/j.ejca.2022.01.040
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The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown. This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, −18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, −1.7%; p = 0.97). The number of borderline tumours increased (13.6%–21.7%), whereas the rate of metastatic diseases rate dropped (47.1%–40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%–32.6%) compared with upfront surgery (13%–7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%–69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%–9.6%) and advanced diseases increased (59.7%–69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. Clinicaltrials.gov NCT04406571. •A total of 833 patients with pancreatic adenocarcinoma were analysed.•During the lockdown, the weekly number of new cases decreased by 18.2%.•Neoadjuvant chemotherapy was favoured compared with upfront surgery (p = 0.013).•Disease stage shifted from localised to advanced disease (p = 0.046).•SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2022.01.040</identifier><identifier>PMID: 35259629</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adenocarcinoma ; Adenocarcinoma - epidemiology ; Adenocarcinoma - therapy ; Cancer ; Care pathway ; Chemotherapy ; Cohort analysis ; Cohort Studies ; Communicable Disease Control ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; Diagnosis ; Diseases ; Health care ; Health services ; Human health and pathology ; Humans ; Life Sciences ; Metastases ; Observational studies ; Original Research ; Pancreas ; Pancreatic cancer ; Pancreatic Neoplasms ; Pancreatic Neoplasms - epidemiology ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - therapy ; Pandemic ; Pandemics ; Patients ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Tumors ; Viral diseases</subject><ispartof>European journal of cancer (1990), 2022-05, Vol.166, p.8-20</ispartof><rights>2022 Elsevier Ltd</rights><rights>Copyright © 2022 Elsevier Ltd. 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The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown. This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, −18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, −1.7%; p = 0.97). The number of borderline tumours increased (13.6%–21.7%), whereas the rate of metastatic diseases rate dropped (47.1%–40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%–32.6%) compared with upfront surgery (13%–7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%–69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%–9.6%) and advanced diseases increased (59.7%–69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. Clinicaltrials.gov NCT04406571. •A total of 833 patients with pancreatic adenocarcinoma were analysed.•During the lockdown, the weekly number of new cases decreased by 18.2%.•Neoadjuvant chemotherapy was favoured compared with upfront surgery (p = 0.013).•Disease stage shifted from localised to advanced disease (p = 0.046).•SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - therapy</subject><subject>Cancer</subject><subject>Care pathway</subject><subject>Chemotherapy</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Communicable Disease Control</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Diagnosis</subject><subject>Diseases</subject><subject>Health care</subject><subject>Health services</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Metastases</subject><subject>Observational studies</subject><subject>Original Research</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms</subject><subject>Pancreatic Neoplasms - epidemiology</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - therapy</subject><subject>Pandemic</subject><subject>Pandemics</subject><subject>Patients</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Tumors</subject><subject>Viral diseases</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1DAUhSMEokPhBVggS2zaRQY7zo-NEFI0UDrSiLIAtpZj3zQeJXGwnUF9Pl4Mp1Mq6IKVLd_vHF9fnyR5SfCaYFK-2a9hr-Q6w1m2xmSNc_woWRFW8RSzInucrDAveMpwzk-SZ97vMcYVy_HT5IQWWcHLjK-SX9thkiog26LQAdpcfd9-SAlHkxw1DEYhOyJtPEgPyAd5DSgWUHAgwwBjQK11kQ0m7j36aUK3KNVSjlqpYbRKOmVGO8i3qEYXDkbVIWWHyUEHozcHQMPcRzo6uOg-NMZPoMJSsI0Hd4hWdpR9FHXWhdjFrG_Q2ab-Un--bff8efKklb2HF3frafLt4uPXzWW6u_q03dS7VBWkCqmWuZaNok3BicpxoaBqAFpW0qLFGcgKU97SgjPCKWW4kbTRVQkEc655nBw9Td4ffae5GUDfdix7MTkzSHcjrDTi38poOnFtD4KxjOUZiQbnR4Pugeyy3onlDNOSMlrRw8Ke3V3m7I8ZfBCD8Qr6Xo5gZy-yklYFwzQvI_r6Abq3s4sjW6gyZoCXrIhUdqSUs947aO87IFgseRJ7seRJLHkSmIiYpyh69feT7yV_AhSBd0cA4uAPBpzwKoZBgTYu_qLQ1vzP_zdki966</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Brugel, Mathias</creator><creator>Letrillart, Léa</creator><creator>Evrard, Camille</creator><creator>Thierry, Aurore</creator><creator>Tougeron, David</creator><creator>El Amrani, Mehdi</creator><creator>Piessen, Guillaume</creator><creator>Truant, Stéphanie</creator><creator>Turpin, Anthony</creator><creator>d'Engremont, Christelle</creator><creator>Roth, Gaël</creator><creator>Hautefeuille, Vincent</creator><creator>Regimbeau, Jean M.</creator><creator>Williet, Nicolas</creator><creator>Schwarz, Lilian</creator><creator>Di Fiore, Frédéric</creator><creator>Borg, Christophe</creator><creator>Doussot, Alexandre</creator><creator>Lambert, Aurélien</creator><creator>Moulin, Valérie</creator><creator>Trelohan, Hélène</creator><creator>Bolliet, Marion</creator><creator>Topolscki, Amalia</creator><creator>Ayav, Ahmet</creator><creator>Lopez, Anthony</creator><creator>Botsen, Damien</creator><creator>Piardi, Tulio</creator><creator>Carlier, Claire</creator><creator>Bouché, Olivier</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2282-0101</orcidid><orcidid>https://orcid.org/0000-0001-6704-3206</orcidid><orcidid>https://orcid.org/0000-0003-0543-1793</orcidid><orcidid>https://orcid.org/0000-0003-3147-1350</orcidid><orcidid>https://orcid.org/0000-0001-7574-9364</orcidid><orcidid>https://orcid.org/0000-0002-8065-9635</orcidid><orcidid>https://orcid.org/0000-0001-9990-1201</orcidid><orcidid>https://orcid.org/0000-0003-2735-6448</orcidid><orcidid>https://orcid.org/0000-0001-7631-9112</orcidid><orcidid>https://orcid.org/0000-0002-7296-5464</orcidid><orcidid>https://orcid.org/0000-0001-5822-4320</orcidid><orcidid>https://orcid.org/0000-0002-2117-4750</orcidid><orcidid>https://orcid.org/0000-0001-9908-8265</orcidid><orcidid>https://orcid.org/0000-0001-9744-7826</orcidid></search><sort><creationdate>20220501</creationdate><title>Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)</title><author>Brugel, Mathias ; Letrillart, Léa ; Evrard, Camille ; Thierry, Aurore ; Tougeron, David ; El Amrani, Mehdi ; Piessen, Guillaume ; Truant, Stéphanie ; Turpin, Anthony ; d'Engremont, Christelle ; Roth, Gaël ; Hautefeuille, Vincent ; Regimbeau, Jean M. ; Williet, Nicolas ; Schwarz, Lilian ; Di Fiore, Frédéric ; Borg, Christophe ; Doussot, Alexandre ; Lambert, Aurélien ; Moulin, Valérie ; Trelohan, Hélène ; Bolliet, Marion ; Topolscki, Amalia ; Ayav, Ahmet ; Lopez, Anthony ; Botsen, Damien ; Piardi, Tulio ; Carlier, Claire ; Bouché, Olivier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c517t-da4dabc3b591c405ce7beef8635f02ea7039f3598193380ba3bd76e1099d90783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - 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Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brugel, Mathias</au><au>Letrillart, Léa</au><au>Evrard, Camille</au><au>Thierry, Aurore</au><au>Tougeron, David</au><au>El Amrani, Mehdi</au><au>Piessen, Guillaume</au><au>Truant, Stéphanie</au><au>Turpin, Anthony</au><au>d'Engremont, Christelle</au><au>Roth, Gaël</au><au>Hautefeuille, Vincent</au><au>Regimbeau, Jean M.</au><au>Williet, Nicolas</au><au>Schwarz, Lilian</au><au>Di Fiore, Frédéric</au><au>Borg, Christophe</au><au>Doussot, Alexandre</au><au>Lambert, Aurélien</au><au>Moulin, Valérie</au><au>Trelohan, Hélène</au><au>Bolliet, Marion</au><au>Topolscki, Amalia</au><au>Ayav, Ahmet</au><au>Lopez, Anthony</au><au>Botsen, Damien</au><au>Piardi, Tulio</au><au>Carlier, Claire</au><au>Bouché, Olivier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>166</volume><spage>8</spage><epage>20</epage><pages>8-20</pages><issn>0959-8049</issn><eissn>1879-0852</eissn><abstract>The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) – from diagnosis to treatment – of the reorganisation of the health care system during the first lockdown. This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown. During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, −18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, −1.7%; p = 0.97). The number of borderline tumours increased (13.6%–21.7%), whereas the rate of metastatic diseases rate dropped (47.1%–40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%–32.6%) compared with upfront surgery (13%–7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%–69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%–9.6%) and advanced diseases increased (59.7%–69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%). This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up. Clinicaltrials.gov NCT04406571. •A total of 833 patients with pancreatic adenocarcinoma were analysed.•During the lockdown, the weekly number of new cases decreased by 18.2%.•Neoadjuvant chemotherapy was favoured compared with upfront surgery (p = 0.013).•Disease stage shifted from localised to advanced disease (p = 0.046).•SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>35259629</pmid><doi>10.1016/j.ejca.2022.01.040</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-2282-0101</orcidid><orcidid>https://orcid.org/0000-0001-6704-3206</orcidid><orcidid>https://orcid.org/0000-0003-0543-1793</orcidid><orcidid>https://orcid.org/0000-0003-3147-1350</orcidid><orcidid>https://orcid.org/0000-0001-7574-9364</orcidid><orcidid>https://orcid.org/0000-0002-8065-9635</orcidid><orcidid>https://orcid.org/0000-0001-9990-1201</orcidid><orcidid>https://orcid.org/0000-0003-2735-6448</orcidid><orcidid>https://orcid.org/0000-0001-7631-9112</orcidid><orcidid>https://orcid.org/0000-0002-7296-5464</orcidid><orcidid>https://orcid.org/0000-0001-5822-4320</orcidid><orcidid>https://orcid.org/0000-0002-2117-4750</orcidid><orcidid>https://orcid.org/0000-0001-9908-8265</orcidid><orcidid>https://orcid.org/0000-0001-9744-7826</orcidid><oa>free_for_read</oa></addata></record>
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issn 0959-8049
1879-0852
language eng
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source MEDLINE; Elsevier ScienceDirect Journals
subjects Adenocarcinoma
Adenocarcinoma - epidemiology
Adenocarcinoma - therapy
Cancer
Care pathway
Chemotherapy
Cohort analysis
Cohort Studies
Communicable Disease Control
Coronaviruses
COVID-19
COVID-19 - epidemiology
Diagnosis
Diseases
Health care
Health services
Human health and pathology
Humans
Life Sciences
Metastases
Observational studies
Original Research
Pancreas
Pancreatic cancer
Pancreatic Neoplasms
Pancreatic Neoplasms - epidemiology
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - therapy
Pandemic
Pandemics
Patients
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Tumors
Viral diseases
title Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)
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