Kirk, Frazer, Crathern, Kelsie, Chang, Shantel, Yong, Matthew S., He, Cheng, Hughes, Ian, Yadav, Sumit, Lo, Wing, Cole, Christopher, Windsor, Morgan, Naidoo, Rishendran, and Stroebel, Andrie (2023) The influence of the COVID-19 pandemic on lung cancer surgery in Queensland. ANZ Journal of Surgery, 93 (6). pp. 1536-1542.

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Abstract

Background: The coronavirus disease-19 (COVID-19) pandemic poses unprecedented challenges to global healthcare. The contemporary influence of COVID-19 on the delivery of lung cancer surgery has not been examined in Queensland.

Methods: We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry (QCOR), thoracic database examining all adult lung cancer resections across Queensland from 1/1/2016 to 30/4/2022. We compared the data prior to, and after, the introduction of COVID-restrictions.

Results: There were 1207 patients. Mean age at surgery was 66 years and 1115 (92%) lobectomies were performed. We demonstrated a significant delay from time of diagnosis to surgery from 80 to 96 days (P < 0.0005), after introducing COVID-restrictions. The number of surgeries performed per month decreased after the pandemic and has not recovered (P = 0.012). 2022 saw a sharp reduction in cases with 49 surgeries, compared to 71 in 2019 for the same period.

Conclusion: Restrictions were associated with a significant increase in pathological upstaging, greatest immediately after the introduction of COVID-restrictions (IRR 1.71, CI 0.93–2.94, P = 0.05). COVID-19 delayed the access to surgery, reduced surgical capacity and consequently resulted in pathological upstaging throughout Queensland.

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