To depict how the COVID-19 pandemic impacted the management of non-functioning pancreatic neuroendocrine tumors (NF-PNETs) in a high-volume surgical center, focusing on surgical outcomes and patient management changes.
Key Findings:
Increased median time from diagnosis to surgery from 182 days to 382 days during the COVID-19 period (p < 0.001), indicating significant delays in treatment.
Higher frequency of preoperative oncological treatments during the pandemic (p < 0.001), suggesting a shift in management strategies.
Increased prevalence of suspected vascular infiltration (15% vs. 6%, p = 0.005) and metastatic lymphadenopathies (24% vs. 15%, p = 0.024) at diagnosis during COVID-19, highlighting changes in tumor characteristics.
Major postoperative complications were less frequent during COVID-19 (24% vs. 13%, p = 0.007), which may reflect changes in patient selection or management.
Interpretation:
The COVID-19 pandemic significantly delayed surgical interventions for NF-PNETs, leading to increased waiting times and altered patient management, while also resulting in a shift in the characteristics of tumors diagnosed during this period. This underscores the need for adaptive strategies in oncological care.
Limitations:
Retrospective design may introduce selection bias.
Data limited to a single high-volume center, which may not be generalizable.
Conclusion:
The pandemic necessitated a reallocation of healthcare resources, impacting the management of NF-PNETs and highlighting the need for adaptive strategies in oncological care during crises, such as prioritizing timely interventions and resource allocation.
by Salvatore Paiella, Luca Landoni, Matteo De Pastena, Giovanni Elio, Fabio Casciani, Sara Cingarlini, Mirko D’Onofrio, Giulia Maistri, Ivan Ciatti, Massimiliano Tuveri, Maria Vittoria Davì, Claudio Luchini, Katia Donadello, Gessica Manzini, Giuseppe Malleo, Roberto Salvia
