Introduction/Background*COVID-19 outbreak has correlated with the disruption of screening activities and diagnostic assessments. The risk of delayed diagnosis has consequently increased during the pandemic. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.
Methodology This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: 03/01/2019 – 02/29/2020) and during (period 2: 01/04/2020 – 3/31/2021) the COVID-19 outbreak.
Result(s)*Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). The adoption of minimally invasive surgery was consistent in the two study periods (p=0.976). Before COVID-19 pandemic, 1,848 (72.8%), 666 (26.3%), and 25 (0.9%) patients had minimally invasive, open and vaginal surgery, respectively. During the COVID-19 pandemic, 1,663 (72.8%), 582 (25.5%), and 41 (1.7%) patients had minimally invasive, open, and vaginal surgery, respectively. Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2;p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had not adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy (in particular chemotherapy) use has increased during COVID-19 pandemic (p<0.001).
Conclusion*Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.
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