Population-based impact of COVID-19 on incidence, treatment, and survival of patients with pancreatic cancer

Merlijn U J E Graus; Ignace H J T de Hingh; Marc G Besselink; Marco J Bruno; Johanna W Wilmink; Vincent E de Meijer; Marie-Louise F van Velthuysen; Liselot B J Valkenburg-van Iersel; Lydia G M van der Geest; Judith de Vos-Geelen; Dutch Pancreatic Cancer Group (DPCG) and the COVID & Cancer-NL consortium; Dutch Nationwide Pathology Databank (Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief, PALGA); SONCOS (Dutch Multidisciplinary Oncology Foundation)

doi:10.1016/j.hpb.2023.04.017

Population-based impact of COVID-19 on incidence, treatment, and survival of patients with pancreatic cancer

HPB (Oxford). 2023 Oct;25(10):1195-1202. doi: 10.1016/j.hpb.2023.04.017. Epub 2023 May 6.

Authors

Collaborators

S Siesling¹⁰, J C van Hoeve¹⁰, M A W Merkx¹¹, N J de Wit¹², C W Helsper¹², I Dingemans¹³, I D Nagtegaal¹⁴, M van der Schaaf¹⁵, C H van Gils¹⁶, H C P M van Weert¹⁷, M Verheij¹⁸

Affiliations

¹ Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
² GROW, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands; Catharina Ziekenhuis Eindhoven, Department of Surgery, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
³ Amsterdam UMC, Location University of Amsterdam, Department of Surgery, de Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands; Cancer Center Amsterdam, de Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands.
⁴ Erasmus University Medical Center, Department of Gastroenterology and Hepatology, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
⁵ Cancer Center Amsterdam, de Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands; Amsterdam UMC, Location University of Amsterdam, Department of Medical Oncology, de Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands.
⁶ University Medical Center Groningen, Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
⁷ Erasmus Medical Center, Department of Pathology, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
⁸ Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands.
⁹ Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands; GROW, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands. Electronic address: Judith.de.vos@mumc.nl.
¹⁰ Dept of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht, the Netherlands.
¹¹ Dept of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht, the Netherlands; Dept of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
¹² Dept of General Practice, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht (UMCU), Utrecht University, Utrecht, the Netherlands.
¹³ Dutch Federation of Cancer Patient Organisations (NFK), Utrecht, the Netherlands.
¹⁴ Dept of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
¹⁵ Department of Insight and Innovation, Dutch Hospital Data (DHD), Utrecht, the Netherlands.
¹⁶ Dept of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands.
¹⁷ Dept of General Practice, Amsterdam Public Health, Amsterdam UMC Location AMC, Amsterdam, the Netherlands.
¹⁸ Dept of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.

Abstract

Background: The COVID-19 pandemic has put substantial strain on the healthcare system of which the effects are only partly elucidated. This study aimed to investigate the impact on pancreatic cancer care.

Methods: All patients diagnosed with pancreatic cancer between 2017 and 2020 were selected from the Netherlands Cancer Registry. Patients diagnosed and/or treated in 2020 were compared to 2017-2019. Monthly incidence was calculated. Patient, tumor and treatment characteristics were analyzed and compared using Chi-squared tests. Survival data was analyzed using Kaplan-Meier and Log-rank tests.

Results: In total, 11019 patients were assessed. The incidence in quarter (Q)2 of 2020 was comparable with that in Q2 of 2017-2019 (p = 0.804). However, the incidence increased in Q4 of 2020 (p = 0.031), mainly due to a higher incidence of metastatic disease (p = 0.010). Baseline characteristics, surgical resection (15% vs 16%; p = 0.466) and palliative systemic therapy rates (23% vs 24%; p = 0.183) were comparable. In 2020, more surgically treated patients received (neo)adjuvant treatment compared to 2017-2019 (73% vs 67%; p = 0.041). Median overall survival was comparable (3.8 vs 3.8 months; p = 0.065).

Conclusion: This nationwide study found a minor impact of the COVID-19 pandemic on pancreatic cancer care and outcome. The Dutch health care system was apparently able to maintain essential care for patients with pancreatic cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
COVID-19* / therapy
Humans
Incidence
Pancreatic Neoplasms* / epidemiology
Pancreatic Neoplasms* / pathology
Pancreatic Neoplasms* / therapy
Pandemics
Survival Rate