Delays in diagnosis and surgery of sarcoma patients during the COVID-19 outbreak in Spain

Jaime Carrillo-García; Serena Lacerenza; Nadia Hindi; Irene Carrasco García; Gloria Marquina; Juana María Cano Cano; Javier Martínez Trufero; Alberto Rafael Sevillano Tripero; Tania Luis García; Manuel Jorge Cuesta Rioboo; David S Moura; Marta Renshaw; Jose L Mondaza-Hernández; Davide Di Lernia; Antonio Gutierrez; Javier Martin-Broto

doi:10.1177/17588359231220611

Delays in diagnosis and surgery of sarcoma patients during the COVID-19 outbreak in Spain

Ther Adv Med Oncol. 2024 Jan 9:16:17588359231220611. doi: 10.1177/17588359231220611. eCollection 2024.

Authors

Jaime Carrillo-García^{1

2}, Serena Lacerenza³, Nadia Hindi^{1

2

4}, Irene Carrasco García⁵, Gloria Marquina⁶, Juana María Cano Cano⁷, Javier Martínez Trufero⁸, Alberto Rafael Sevillano Tripero^{2

4}, Tania Luis García⁹, Manuel Jorge Cuesta Rioboo⁹, David S Moura^{1

2}, Marta Renshaw^{1

2}, Jose L Mondaza-Hernández^{1

2}, Davide Di Lernia^{1

2}, Antonio Gutierrez¹⁰, Javier Martin-Broto^{11

2

4}

Affiliations

¹ Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, Spain.
² Medical Oncology Department, University Hospital General de Villalba, Madrid, Spain.
³ Institute of Biomedicine of Seville (IBIS), HUVR-CSIC-University of Seville, Seville, Spain.
⁴ Medical Oncology Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain.
⁵ Medical Oncology Department, University Hospital Virgen del Rocío, Seville, Spain.
⁶ Department of Medical Oncology, Hospital Clínico San Carlos, School of Medicine, Complutense University (UCM), IdISSC, Madrid, Spain.
⁷ Medical Oncology Department, University Hospital General de Ciudad Real, Ciudad Real, Spain.
⁸ Medical Oncology Department, University Hospital Miguel Servet, Zaragoza, Spain.
⁹ Department of Medical Oncology, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
¹⁰ Department of Hematology, University Hospital Son Espases, Palma, Spain.
¹¹ Health Research Institute Fundación Jiménez Díaz (IIS-FJD, UAM), Reyes Católicos 2, Madrid 28040, Spain.

Abstract

Background and objectives: Social distancing and quarantine implanted during the COVID-19 outbreak could have delayed the accession of oncologic patients to hospitals and treatments. This study analysed the management of sarcoma patients during this period in five Spanish hospitals.

Design and methods: Clinical data from adult sarcoma patients, soft tissue and bone sarcomas, managed during the COVID-19 outbreak, from 15 March to 14 September 2020 (Covid cohort), were retrospectively collected and time for diagnosis, surgery and active treatments were compared with sarcoma patients managed during the same pre-pandemic period in 2018 (Control cohort).

Results: A total of 126 and 182 new sarcoma patients were enrolled in the Covid and Control cohorts, respectively, who were mainly diagnosed as soft tissue sarcomas (81.0% and 80.8%) and at localized stage (80.2% and 79.1%). A diagnostic delay was observed in the Covid cohort with a median time for the diagnosis of 102.5 days (range 6-355) versus 83 days (range 5-328) in the Control cohort (p = 0.034). Moreover, a delay in surgery was observed in cases with localized disease from the Covid cohort with a median time of 96.0 days (range 11-265) versus 54.5 days (range 2-331) in the Control cohort (p = 0.034). However, a lower delay for neoadjuvant radiotherapy was observed in the Covid cohort with a median time from the diagnosis to the neoadjuvant radiotherapy of 47 days (range 27-105) versus 91 days (range 27-294) in the Control cohort (p = 0.039). No significant differences for adjuvant radiotherapy, neoadjuvant/adjuvant chemotherapy and neoadjuvant/adjuvant palliative chemotherapy were observed between both cohorts. Neither progression-free survival (PFS) nor overall survival (OS) was significantly different.

Conclusion: Delays in diagnosis and surgery were retrospectively observed in sarcoma patients during the COVID-19 outbreak in Spain, while the time for neoadjuvant radiotherapy was reduced. However, no impact on the PFS and OS was observed.

Keywords: COVID-19 outbreak; bone sarcoma; delay in surgery; diagnostic delay; soft tissue sarcoma.