Cancer Management and Research (Mar 2022)

Oncological Care During First Peruvian National Emergency COVID-19 Pandemic: A Multicentric Descriptive Study

  • Valdiviezo N,
  • Alcarraz C,
  • Castro D,
  • Salas R,
  • Begazo-Mollo V,
  • Galvez-Villanueva M,
  • Medina Aguirre Luz Marianela,
  • Garcia-León E,
  • Quispe-Santivañez I,
  • Cornejo-Raymundo C,
  • Paz-Cornejo E,
  • Sanchez-Vilela L,
  • Bermudez-Alfaro V,
  • Vargas-Nina JC,
  • Pérez-Ramos C,
  • Meza-Hoces A,
  • Paolo R Valdez Barreto,
  • Huaringa-Leiva R,
  • Muro-Cieza J,
  • Aguilar-Vásquez V,
  • Cuenca EY,
  • Neciosup-Delgado S,
  • Poma-Nieto N,
  • Chavez-Gavino S,
  • Fernandez-Rosas L,
  • Araujo JM,
  • Eduardo Payet,
  • Gomez HL

Journal volume & issue
Vol. Volume 14
pp. 1075 – 1085

Abstract

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Natalia Valdiviezo,1 Cindy Alcarraz,1,2 Denisse Castro,3,4 Renzo Salas,3 Victor Begazo-Mollo,5 Marco Galvez-Villanueva,6 Luz Medina Aguirre,7 Elica Garcia-León,8 Isela Quispe-Santivañez,9 Carmen Cornejo-Raymundo,10 Eduardo Paz-Cornejo,11 Luis Sanchez-Vilela,12 Vanessa Bermudez-Alfaro,13 Juan Carlos Vargas-Nina,14 Carlos Pérez-Ramos,15 Andrea Meza-Hoces,16 Paolo R Valdez Barreto,17 Ruth Huaringa-Leiva,18 Johanny Muro-Cieza,19 Valeria Aguilar-Vásquez,20 Eduardo Yache Cuenca,21 Silvia Neciosup-Delgado,1 Nathaly Poma-Nieto,22 Sheyla Chavez-Gavino,23 Lenin Fernandez-Rosas,24 Jhajaira M Araujo,2 Eduardo Payet,25 Henry L Gomez1 1Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, Peru; 2Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú; 3Departamento de Oncología Médica, Hospital Nacional Edgardo Rebagliati Martins, Lima, 15072, Peru; 4Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, 15024, Peru; 5Departamento de Medicina Oncológica, Instituto Regional de Enfermedades Neoplásicas Sur, Arequipa, Perú; 6Departamento de Medicina Oncológica, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú; 7Departamento de Medicina Oncológica, Hospital Goyeneche, Arequipa, 04600, Perú; 8Departamento de Medicina Oncológica, Hospital Regional de Lambayeque, Lambayeque, 14001, Perú; 9Departamento de Medicina Oncológica, Hospital Santa Rosa, Lima, 15084, Peru; 10Departamento de Medicina Oncológica, Hospital Nacional Dos de Mayo, Lima, Peru; 11Departamento de Medicina Oncológica, Hospital Nacional Alberto Sabogal Sologuren, Lima, Peru; 12Departamento de Medicina Oncológica, Hospital de Apoyo II Santa Rosa, Piura, Peru; 13Departamento de Medicina Oncológica, Hospital Nacional Guillermo Almenara Irigoyen, Lima, 15033, Peru; 14Departamento de Medicina Oncológica, Hospital II EsSalud de Cajamarca, Cajamarca, Peru; 15Departamento de Medicina Oncológica, Hospital María Auxiliadora, Lima, Peru; 16Departamento de Medicina Oncológica, Hospital II E de Lamas, San Martin, Peru; 17Departamento de Medicina Oncológica, Hospital de Alta complejidad Virgen de la Puerta, La Libertad, Peru; 18Departamento de Medicina Oncológica, Hospital Militar Central, Lima, Peru; 19Departamento de Medicina Oncológica, Hospital Regional Docente de Cajamarca, Cajamarca, Peru; 20Departamento de Promoción de la Salud, Prevención y Control del Cáncer, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú; 21Departamento de Epidemiología, Instituto Regional de Enfermedades Neoplásicas Norte, La Libertad, Perú; 22Departamento de Medicina Oncológica, Hospital Nacional Daniel Alcides Carrión, Lima, Perú; 23Departamento de Medicina Oncológica, Hospital Regional Eleazar Guzmán Barrón, Ancash, Perú; 24Departamento de Cirugía Oncológica, Hospital Regional Eleazar Guzmán Barrón, Ancash, Perú; 25Jefatura Institucional, Instituto Nacional de Enfermedades Neoplásicas, Lima, 15038, PeruCorrespondence: Natalia Valdiviezo, Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Av. Angamos 2520, Surquillo, Lima, 15038, Peru, Tel +51 992825055, Email [email protected]: The aim of this study is to evaluate the oncological care during the first state of national emergency due to the COVID-19 pandemic in several public cancer hospitals in Peru.Materials and Methods: A multicentric cross-sectional descriptive study was conducted by interviewing adult cancer patients diagnosed and treated between January 2019 and February 2020 from 18 hospitals. This study was carried out in September 2020, the last month of the first state of national emergency. Demographic and clinical characteristics were evaluated, including COVID-19 status and cancer treatment features.Results: A total of 1472 patients were included; the median age was 55 years (range 19– 97). Most patients (85.8%, n = 1263) had solid neoplasia, 13.5% (n = 198) hematologic neoplasia, and 0.7% (n = 11) others. SARS-CoV-2 infection was confirmed in 8.6% (n = 126), 1.2% (n = 18) were probable, 1.6% (n = 24) suspected, and 88.6% (n = 1304) negative cases. Overall, 51.6% of patients (n = 759) had cancer treatment delays, 42.5% (n = 626) changed treatment delivery (endovenous to oral systemic therapy), and 12.6% (n = 185) of cases cancer therapy was discontinued. In total, 10.3% (n = 117) of patients whose disease was controlled or in remission, experienced progression of disease during the state of emergency. A total of 6.7% (n = 98) of patients died, of whom 73.5% (n = 72) died from disease progression; 18.4% (n = 18) from SARS-CoV-2 infection and 8.1% (n = 8) from undetermined causes. Patients with hematological malignancies [hazard ratio (HR): 5.11 (95% confidence interval (CI): 1.99– 13.07)] and no response to therapy before the onset of the pandemic [5.01 (1.44– 17.42)] had an increased risk of death among COVID-19 infected individuals, whereas advanced clinical stage [5.09 (2.37– 10.95)] and discontinuation of treatment [3.66 (1.97– 6.78)] were risk factors among non-COVID-19 patients.Conclusion: Our study suggests that the COVID-19 pandemic has an adverse impact on the outcomes of Peruvian cancer patients. In our cohort, cancer mortality was higher than COVID-19 disease mortality.Keywords: COVID-19 pandemic, cancer care, Peru

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