Should we wait or not? The preferable option for patients with stage IV oral cancer in COVID-19 pandemic

Head Neck. 2020 Jun;42(6):1173-1178. doi: 10.1002/hed.26196. Epub 2020 Apr 28.

Abstract

Background: The coronavirus infection is rapidly spreading, putting a strain on health care services across the globe. Patients with oral cancer are susceptible often immunosuppressed due to the disease and/or the treatment received.

Methods: We performed a simulation of the currently available data using a multistate and hazards model to provide an objective model for counseling and decision making for health care workers.

Results: Stage IV patients with oral cancer who did not receive treatment had progression of disease and an increased mortality rate compared to patients who receive treatment but did not contract COVID-19. The patients who received treatment and got affected with COVID-19 had a far worse impact and higher mortality rate than all other groups.

Conclusion: Isolation and deferring treatment for stage IV patients with oral cancer, so as to avoid hospital visits and contraction of COVID-19, is an advisable strategy based on this model.

Keywords: COVID-19; cancer; coronavirus; simulation.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • COVID-19
  • Cause of Death*
  • Clinical Decision-Making / methods*
  • Computer Simulation
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Disease Management
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / surgery*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Pandemics / prevention & control*
  • Patient Selection
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Proportional Hazards Models
  • Risk Assessment
  • Survival Analysis
  • United States