Impact of COVID-19 Pandemic on the Clinical and Pathologic Characteristics of Colorectal Cancer: A Retrospective Multicenter Study in South Korea

Abstract

Jae Hyun Kang,1 Il Tae Son,2 Sang Nam Yoon,3 Jin Soo Ihm,4 Byung Mo Kang,5 Jong Wan Kim1 1Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-Si, Gyeonggi-Do, Republic of Korea; 2Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea; 3Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea; 4Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea; 5Department of Surgery, Chun Cheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon Si, Republic of KoreaCorrespondence: Jong Wan Kim, Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong-Si, Gyeonggi-Do, Republic of Korea, Tel [phone], Fax [phone], Email [email protected]: The COVID-19 pandemic has influenced various aspects of colorectal cancer (CRC) patient care, including diagnosis, treatment, and outcomes. This study assesses the pandemic’s impact on CRC patients.Methods: We performed a retrospective analysis of medical records for CRC patients who underwent surgery at five hospitals affiliated with Hallym University from January 2017 to December 2022. Patients were divided into two groups: the pre-COVID group (2017– 2019) and the COVID group (2020– 2022).Results: Among 2038 patients, 987 (48.4%) were in the pre-COVID group, and 1051 (51.6%) were in the COVID group. The COVID group had more patients with two or more comorbidities (P < 0.001) and a higher incidence of rectal cancer (P = 0.010). While the rates of laparoscopic surgeries were similar, the COVID group had increased emergency surgeries (P = 0.005) and diversion procedures (P = 0.002). Additionally, the COVID group faced more overall complications (P < 0.001) and severe complications (Grade III–V, P = 0.004). There was a rise in lymphovascular invasion (P < 0.001) and T4 stage tumors (P < 0.001) within the COVID group. Despite these differences, both groups had similar 2-year overall survival rates (P = 0.409).Conclusion: Although patients treated during the COVID period experienced more frequent stoma formation, complications, and adverse prognostic factors, there were no differences in short-term oncologic outcomes, which was likely due to the follow-up period being insufficient to detect differences in OS.Keywords: colorectal cancer, COVID-19 pandemic, characteristics

Keywords

• colorectal cancer
• covid-19 pandemic
• characteristics