Impact of COVID-19 on Disease Progression and Postoperative Complications in Patients with Head and Neck Cancer

Abinaya R Nadarajan; Nebu Abraham George; Shaji Thomas; Bipin T Varghese; Elizabeth Mathew Iype; Jagathnath Krishna K M

doi:10.1007/s13193-023-01779-9

Impact of COVID-19 on Disease Progression and Postoperative Complications in Patients with Head and Neck Cancer

Indian J Surg Oncol. 2023 Jun 8:1-5. doi: 10.1007/s13193-023-01779-9. Online ahead of print.

Authors

Abinaya R Nadarajan¹, Nebu Abraham George², Shaji Thomas², Bipin T Varghese², Elizabeth Mathew Iype², Jagathnath Krishna K M³

Affiliations

¹ Department of Surgical Oncology, Regional Cancer Center, Thiruvananthapuram, India.
² Department of Head & Neck Oncology, Regional Cancer Center, Thiruvananthapuram, India.
³ Cancer Epidemiology & Biostatistics, Regional Cancer Center, Thiruvananthapuram, India.

Abstract

The COVID-19 pandemic has created a remarkable challenge for the healthcare system. The delayed presentation, diagnosis, and treatment of head and neck cancer during the COVID-19 pandemic is expected to adversely affect outcomes. COVIDSurg collaborative group in 2020 concluded surgery ≥ 4 weeks after a positive COVID-19 swab result was associated with a lower risk of postoperative mortality. The aim of this study is to assess the disease progression due to COVID-19 infection in patients with head and neck cancer planned for surgery and to analyze the postoperative complications in head and neck cancer patients who underwent surgery after COVID-19 infection. This is an ambispective observational study and included patients with head and neck cancer who recovered from COVID-19 infection and underwent surgery from June 2020 to May 2022. There were a total of 1849 patients with head and neck cancer operated in the mentioned study period during COVID-19 pandemic. One hundred fifty-nine patients had documented COVID-19 infection. One hundred two patients had oral cavity carcinoma (64%), and 38 patients had thyroid carcinoma (23.8%). Early disease was noted in 49 patients (30.8%) and locally advanced disease in 108 patients (67.9%). Mean duration of delay in surgery was 4 weeks. Disease progression was noted in 27 patients (17%) out of which 15 patients were inoperable. Thirty-seven out of 159 patients (23%) had postoperative complications, and it included 2 mortality. There was increased trend noted in pulmonary complications and hemorrhage when compared to pre-COVID-19 era. Due to COVID-19 pandemic, delayed elective head and neck cancer surgery has resulted in higher rates of inoperability. COVID-19 has been associated with increased postoperative pulmonary complications and hemorrhage.

Keywords: COVID-19; Delay; Disease progression; Head and neck cancer.

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