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The influence of the COVID-19 pandemic on lung cancer surgery in Queensland |
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| Authors: | Frazer Kirk MBBS MSurg Kelsie Crathern MBBS Shantel Chang MD BPhty Matthew S. Yong MBBS PhD FRACS Cheng He MBBS BMedSc FRACS Ian Hughes BVSc BSVc(Vet.) PhD MBiostats Sumit Yadav MBBS MS MCh C/Th FRACS Wing Lo MBBS PhD FRACS Christopher Cole BA MBBS FRACS Morgan Windsor BMedSci MBBS Hons FRACS Rishendran Naidoo MBBCh FC Cardio SA MMED FRACS Andrie Stroebel MBBCh FC Cardio SA MMED FRACS |
| Affiliation: | 1. School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia;2. Department Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia Contribution: Investigation, Writing - review & editing;3. School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia Department Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia Contribution: Conceptualization, Methodology, Writing - review & editing;4. School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia Department Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia Contribution: Project administration, Resources, Supervision, Writing - review & editing;5. Office for Research Governance and Development, Gold Coast University Hospital, Gold Coast, Queensland, Australia Contribution: Formal analysis, Investigation, Methodology, Software, Validation;6. Department of Cardiothoracic Surgery, The Townsville University Hospital, Townsville, Queensland, Australia Contribution: Resources, Writing - review & editing;7. Department of Cardiothoracic Surgery, Princess Alexandria Hospital, Brisbane, Queensland, Australia Contribution: Resources, Writing - review & editing;8. Department of Cardiothoracic Surgery, Princess Alexandria Hospital, Brisbane, Queensland, Australia;9. The Department of Thoracic Surgery, Royal Brisbane Women's Hospital, Brisbane, Queensland, Australia Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia Contribution: Investigation, Resources, Writing - review & editing;10. Department of Cardiothoracic Surgery, The Prince Charles Hospital, Brisbane, Queensland, Australia Contribution: Investigation, Resources, Writing - review & editing;11. Department Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia Contribution: Conceptualization, Project administration, Resources, Supervision, Writing - review & editing |
| Abstract: | BackgroundThe coronavirus disease-19 (COVID-19) pandemic poses unprecedented challenges to global healthcare. The contemporary influence of COVID-19 on the delivery of lung cancer surgery has not been examined in Queensland.MethodsWe performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry (QCOR), thoracic database examining all adult lung cancer resections across Queensland from 1/1/2016 to 30/4/2022. We compared the data prior to, and after, the introduction of COVID-restrictions.ResultsThere were 1207 patients. Mean age at surgery was 66 years and 1115 (92%) lobectomies were performed. We demonstrated a significant delay from time of diagnosis to surgery from 80 to 96 days (P < 0.0005), after introducing COVID-restrictions. The number of surgeries performed per month decreased after the pandemic and has not recovered (P = 0.012). 2022 saw a sharp reduction in cases with 49 surgeries, compared to 71 in 2019 for the same period.ConclusionRestrictions were associated with a significant increase in pathological upstaging, greatest immediately after the introduction of COVID-restrictions (IRR 1.71, CI 0.93–2.94, P = 0.05). COVID-19 delayed the access to surgery, reduced surgical capacity and consequently resulted in pathological upstaging throughout Queensland. |
| Keywords: | COVID-19 lung cancer thoracic surgery |