Daniel M Fountain1,2, Rory J Piper3, Michael T C Poon4, Georgios Solomou5, Paul M Brennan6, Yasir A Chowdhury7, Francesca Colombo1,2, Tarek Elmoslemany8,9, Frederick G Ewbank10, Paul L Grundy10, Md T Hasan1,2, Molly Hilling11, Peter J Hutchinson12, Konstantina Karabatsou1,2, Angelos G Kolias12, Nathan J McSorley13, Christopher P Millward8, Isaac Phang14, Puneet Plaha3, Stephen J Price12, Ola Rominiyi15, William Sage16, Syed Shumon17, Ines L Silva11, Stuart J Smith16, Surash Surash17, Simon Thomson18, Jun Y Lau3, Colin Watts7,19, Michael D Jenkinson8,9. 1. Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK. 2. University of Manchester, Manchester, UK. 3. Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK. 4. Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK. 5. School of Medicine, Keele University, Staffordshire, UK. 6. Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK. 7. Department of Neurosurgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 8. Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK. 9. University of Liverpool, Liverpool, UK. 10. Department of Neurosurgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 11. Department of Neurosurgery, The Royal London Hospital, Barts Health NHS Trust, London, UK. 12. Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK. 13. Department of Neurosurgery, Ninewells Hospital, Dundee, UK. 14. Department of Neurosurgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK. 15. Department of Neurosurgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. 16. Department of Neurosurgery, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, UK. 17. Department of Neurosurgery, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK. 18. Department of Neurosurgery, Leeds General Infirmary, Leeds, UK. 19. Institute of Cancer and Genome Sciences, University of Birmingham, Birmingham, UK.
Abstract
BACKGROUND: The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumors. METHODS: We performed a multicenter prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumor between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used. RESULTS: There were 1357 referrals for newly diagnosed or recurrent intracranial tumors across 15 neuro-oncology centers. Of centers with all intracranial tumors, a change in initial management was reported in 8.6% of cases (n = 104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n = 75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n = 20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, P > .9). CONCLUSIONS: Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.
BACKGROUND: The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumors. METHODS: We performed a multicenter prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumor between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used. RESULTS: There were 1357 referrals for newly diagnosed or recurrent intracranial tumors across 15 neuro-oncology centers. Of centers with all intracranial tumors, a change in initial management was reported in 8.6% of cases (n = 104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n = 75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n = 20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, P > .9). CONCLUSIONS: Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.
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