Journal Article

The impact of the COVID-19 pandemic upon pancreatic cancer treatment (CONTACT Study): a UK national observational cohort study

Lloyd-Jones, Karen, Scutt, Bethany, Heenan, Kerri-Marie, McCain, Stephen, Aroori, Somaiah, Zafar, Muneeb, Bandlamudi, Nanda, Menzies, Donald, Rowley, Megan, Kumar, Yogesh, O’Kane, Rebecca, Canelo, Ruben, Gall, Tamara, Almonib, Ahmed, Hebbar, Madhu, Lykoudis, Pavlos, Moulding, Samuel, Jones, Vicky, Mclellan, Morag, Suresh, Nikhil, Havard, Tim, Johnson, Sarah, Warner, Ben, Pike, Tom, Magill, Laura, Smith, Conor, Meilak, Joseph, Thorne, Thomas, Hayton, Philip, Mohamed, Badreldin, Khokar, Usman, Osunlusi, Oluwafemi, Slater, Sarah, Whitelaw, Douglas, Kocher, Hemant, Shaukat, Syed, Ramachandran, Veena, Brown, Christopher, Howard, Richard, Bailey, Robert, Jones, Claire, Olabintan, Olaolu, Tanno, Lulu, Hughes, Charlotte, Mahalingam, Aarini, Joshi, Neerav, Finch, Guy, Powell-Brett, Sarah, Sharer, Nicholas, Hanna, Michael, Corrie, Pippa, Kausar, Ambareen, Smith, Andrew, Wilson, Phoebe, Chung, Yooyun, Sen, Gourab, Clyde, Danielle, Abbadi, Reyad, Currow, Chelise, Varley, Rebecca, West, Alexander, Beluso, Ann, Khan, Areeb, Laverick, Sophie, Tsironis, Dimitrios, Waite, Daniel, Laverty, Lauren, Laxaman, Hemant, Alkari, Bassam, Propper,

2023

Overview

IntroductionCONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC).MethodsThe treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up.ResultsAmong 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8–4.1) vs. 4.4 (IQR 3.6–5.2) months, p = 0.093).ConclusionPathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.

• Publisher: Nature Publishing Group
• Subject: Adenocarcinoma / Cancer therapies / Chemotherapy / Cohort analysis / COVID-19 / Observational studies / Pancreatic cancer / Pandemics / Patients / Survival