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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)

Mathias Brugel 1, 2 Léa Letrillart 1, 2 Camille Evrard 3 Aurore Thierry 1 David Tougeron 3 Mehdi El Amrani 4, 5 Guillaume Piessen 4, 5 Stéphanie Truant 4, 5 Anthony Turpin 4, 5 Christelle d'Engremont 6, 7 Gaël Roth 6, 7 Vincent Hautefeuille 8 Jean-Marc Regimbeau 9, 10 Nicolas Williet 11 Lilian Schwarz 12, 13 Frédéric Di Fiore 12, 13 Christophe Borg 14, 15, 16 Alexandre Doussot 14 Aurélien Lambert 17 Valérie Moulin 18 Hélène Trelohan 18 Marion Bolliet 19 Amalia Topolscki 19 Ahmet Ayav 20, 21 Anthony Lopez 20, 22 Damien Botsen 2, 1, 23 Tulio Piardi 1, 24 Claire Carlier 2, 1, 23 Olivier Bouché 2, 1 
Abstract : Background: 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. Methods: 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. Results: 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%). Conclusion: 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. Trial registration: Clinicaltrials.gov NCT04406571.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03638373
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Soumis le : mardi 12 avril 2022 - 11:02:36
Dernière modification le : vendredi 5 août 2022 - 11:26:02

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Mathias Brugel, Léa Letrillart, Camille Evrard, Aurore Thierry, David Tougeron, et al.. 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). European Journal of Cancer, Elsevier, 2022, 166, pp.8-20. ⟨10.1016/j.ejca.2022.01.040⟩. ⟨hal-03638373⟩

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