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385 COVID-19 associated delay in endometrial cancer staging procedure is associated with higher rate of sentinel lymph node positivity.
  1. Atefeh Rezaei1,
  2. Hadi Erfani2 and
  3. Karina Nieto1
  1. 1Seidman Cancer Institute, Cleveland, United States
  2. 2Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, United States


Introduction/Background The COVID-19 pandemic has resulted in major disruptions of cancer care. Our objective was to assess the impact of the pandemic on the time from endometrial cancer diagnosis to the time of hysterectomy.

Methodology Women with endometrial carcinoma who underwent surgical staging from 2019–2020 were included; all grades and histologies were included. Prepandemic and pandemic patients were compared. The primary outcome was time from endometrial cancer diagnosis to time of hysterectomy bilateral salpingo-oophorectomy and staging (THBSO). Prepandemic patients were defined as those diagnosed in 2019; pandemic patients as those diagnosed in 2020. Primary outcome was time from diagnosis to hysterectomy. Secondary outcomes were time to radiation therapy, time to chemotherapy. Continuous and categorical variables were reported as median [interquartile range] and number [rate].

Results 93,337 women who underwent THBSO were included in this study. 49,779 (53.3%) diagnosed in 2019, and 43,558 (46.7%) in 2020. Age, race, education, insurance status, and histology were not different between the groups. Grade was not different between groups; Grade I: 51.9% in 2019, 52.1% in 2020; Grade II: 27.0% in 2019, 27.2% in 2020; Grade III 21.1% in 2019, 20.8% in 2020.

Median time from the cancer diagnosis to THBSO was 21 [9, 39] days versus 43 [23, 68] days in pre pandemic versus pandemic era, respectively (p=0.01).

488 (1.0 %) and 601 (1.5%), p<0.001 of women who THBSO had positive sentinel lymph nodes either unilaterally or bilaterally in 2019 and 2020, respectively (OR: 1.4, 95% confidence interval: 1.2–1.6).

Amongst women treated with radiation therapy, or chemotherapy, there was no significant difference in time from diagnosis to time of treatment.

Conclusion COVID positive status was associated with a 105% increase in the number of days between diagnosis and treatment with THBSO and higher rate of lymph node positivity in patients with endometrial cancer.

Disclosures Authors have nothing to disclose.

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