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  • 1
    Online Resource
    Online Resource
    Impact of the Covid-19 pandemic on the treatment of resectable liver neoplasms: A cross-sectional study from Brazil.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e22524-e22524
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e22524-e22524
    Abstract: e22524 Background: By 2030, 10 million patients needing surgical oncology procedures will be from low and middle-income countries. Hepatocellular carcinoma is reported as the fifth most common cancer in men and the seventh in women worldwide. Surgical resection is the primary treatment option for patients with solitary hepatic tumors. The overload of health systems caused by the coronavirus pandemic has strongly affected Brazilian public healthcare (SUS), making the diagnosis of hepatocellular carcinoma difficult due to the lack of resources and professionals. Under these circumstances, we aimed to evaluate the impact of COVID-19 on the surgical treatment patterns for liver cancer performed by SUS during the peak of the COVID-19 pandemic. Methods: A retrospective study was conducted following the STROBE checklist. With data from DATASUS’s Hospital Information System; An agency of the Brazilian Ministry of Health; patients' identities are preserved and the conduction of any research with data from DATASUS is ethically approved. All hepatectomies from all hospitals were considered. Based on the PICO principle: People with liver cancer in Brazil from 2013 to 2021 (Population); hepatectomy (Interest); Brazilian region (Context), the study analyzes the absolute numbers of hepatectomies in oncology registered between January 2013 and December 2021 and compares it to the number of hepatic cancer diagnosis and deaths in the same period. Statistical analysis was performed on PAST, version 4.12, by applying ANOVA one way and Tukey’s test to assess the number of procedures compared over the years. Results: The total number of partial hepatectomies performed in SUS from 2013-2021 was 8,341, with an average of 695 procedures per year. In 2020, the number of hepatectomy surgeries decreased by 12.95% compared to 2019, going from 1,019 procedures in 2019 to only 887 in 2020. Decreases of 23.80%, 36.73%, 34.54%, and 23.59% in hepatectomies were reported in May, August, October, and December of 2020 compared to 2019. Despite the start of vaccinations in 2021, there was still a 6.67% decrease in hepatectomies compared to 2019. The total number of liver cancer diagnoses from 2013-2021 was 15,303, gradually increasing until 2021, when there was a 0.15% decrease in diagnoses when compared to the previous year. In 2020, the number of deaths decreased by 23.07%, from 65 in 2019 to 50 in 2020. However, in 2021, this number increased by 12%, to 56 deaths. Conclusions: The decrease in hepatectomies is apparent and may affect the prognosis of the patients who didn't have access to the health system during the Covid 19 pandemic. However, secondary delays in diagnosis could affect our observation. To deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning, and further research is needed to understand the impact of our observation on the outcome of patients.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e22524
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 2
    Online Resource
    Online Resource
    Effect of the COVID-19 pandemic on radical prostatectomy: A Brazilian retrospective study.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e17101-e17101
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e17101-e17101
    Abstract: e17101 Background: Prostate cancer is reported as the most common cancer in Brazilian men. Prostatectomy (RP) is fundamental for a better prognosis and outcome. The overload of health systems caused by the coronavirus pandemic has strongly affected surgical care in Brazilian public healthcare (SUS), making the diagnosis of prostate cancer more difficult due to the lack of resources and professionals available. Under these circumstances, we aimed to evaluate the impact of COVID-19 on the surgical treatment patterns for prostate cancer performed by SUS during the peak of the COVID-19 pandemic. Methods: A retrospective cross-sectional study was conducted using the STROBE checklist and secondary data from the Hospital Information System of DATASUS, a Ministry of Health agency. The study analyzes the absolute numbers of prostatectomies in oncology registered between January 2013 and October 2022, updated by December 15, 2022. Based on the PICo principle: People with prostate cancer in Brazil from 2013 to 2022 (Population); prostatectomy (Interest); Brazilian region (Context), the study compared the number of cancer diagnoses in the same period. Statistical analysis was performed by applying ANOVA one way to assess the number of procedures compared over the years. Results: In Brazil, on SUS, between January 2013 and October 2022, there were 31,716 RPs, with an annual average of 2,883 procedures. The total number of prostate cancer surgeries decreased by 27.20% in 2020, going from 3,499 procedures in 2019 to 2547 in the following year. There was a 43.02%, 38.87%, 35.77%, and 35.03% decrease in July, October, May, and August, respectively, compared to 2019. Despite vaccination in 2021, prostatectomies decreased by 22.32% compared to 2019. From 2013 to 2022, there were 293,308 prostate cancer diagnoses, with a 71% increase from 2017 to 2019, a 25% decrease from 2019 to 2020, and a 5% increase in 2021. The results show that the total of deaths in prostatectomies is 142. In 2019, 10 deaths were reported on SUS, and that number increased to 13 in 2020, 16 in 2021, and 18 in 2022, showing a progressive increase after the pandemic. Conclusions: The decrease in the number of RP is apparent and may impact the prognosis of the patients who were unable to access the health system during the COVID-19 pandemic. It is fundamental to know the amount of damming from those surgeries to propose measures to prevent adverse outcomes. For all to receive safe, cost-effective, and timely cancer surgery, it is crucial that surgical procedures are a central component of both global and national cancer control plans.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e17101
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Robotic and laparoscopic surgery versus open surgery for perihilar cholangiocarcinoma: A meta-analysis.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 4127-4127
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 4127-4127
    Abstract: 4127 Background: Robotic and laparoscopic surgeries provide a new approach for patients with perihilar cholangiocarcinoma (pCCA). However, whether it can achieve similar outcomes to traditional open surgery (OS) remains controversial. Therefore, to compare the outcomes of laparoscopic/robotic surgery with open surgery and investigate the efficiency for Klatskin tumors further, we systematically summarized the currently available data and performed a meta-analysis. Methods: A systematic review and meta-analysis were conducted to examine the most recent studies on the topic. The search was updated to January 15, 2023, and was performed on PubMed, LILACS, and Embase. The inclusion criteria were case cohort comparing two arms: robotic or laparoscopic and open surgery for pCCA, based in PICOS principle, while the exclusion criteria were review, letter, and articles with incomplete data. All the included literature was evaluated for quality and risk of bias using the Joanna Briggs Institute's critical appraisal tool and the data were extracted and entered into an Excel spreadsheet by two authors. The data was then analyzed using Review Manager 5.4 applying Odds Ratio and Mean Difference. The study protocol was registered in PROSPERO (CRD42023388478) and was conducted following the PRISMA 2020 checklist. Results: A total of 1133 patients were included in the study (411 laparoscopic/robotic, 722 open surgeries), 15 retrospective cohort were used in the meta-analysis. The meta-analysis revealed that laparoscopic surgery resulted in less blood loss (Mean difference -77.87; 95% CI = -89.97, -67.78; p 〈 0,00001, I²= 84%), shorter hospital stay (Mean difference -3.25; 95% CI = -4.83, -1.67; p 〈 0,0001, I²= 79%) but longer operation time (Mean difference 53.95; 95% CI = 48.09, 59.81; p 〈 0,00001, I²= 86%). The mortality rate was not significantly different between the two groups (odds ratio = 0.82; 95% CI = 0.47 a 1.42; p = 0.48; I²= 0%). Both surgeries showed similar results for age (Mean difference 1.71; 95% CI = -0.62, 4.03; p =0.15, I²= 53%), bilirubin (Mean difference -43.45; 95% CI = -77.11, -9.79; p 〈 0.01, I²= 0%), BMI (Mean difference 0.25; 95% CI = -0.24, 0.74; p= 0.31, I²= 0%), and tumor diameter (mean difference -0.06; 95% CI = -0.52, 0.40; p =0.80, I²= 0%). Conclusions: The limitations of the study evidence are due to the small number of patients included in each article. Concerning blood loss and hospital stay, minimally invasive surgery offers better results. However, open surgery still has a shorter operating time. Both surgeries had similar results in mortality. Minimally invasive surgery is as safe as open surgery for pCCA resection.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.4127
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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