Impact of COVID-19 on Head and Neck Cancer Care

Sunday, October 1, 2023

4:15 PM - 4:21 PM East Coast USA Time

Location: 201AB

Presenting Author(s)

Kelly A. Wentland, BBA

Medical Student
Loyola University Chicago Stritch School of Medicine
Chicago, Illinois, United States

Co-Author(s)

AS

Aoi Shimomura, MD

Loyola University Chicago Stritch School of Medicine, USA
KG

Kayeromi Gomez, PhD

Senior Biostatistician
Loyola University Medical Center, IL, USA
AB

Alec Block

Senior Author(s)

CB

Carol M. Bier-Laning, MD MBA FACS

Professor and Department Quality Medical Director
Dept of Otolaryngology, Loyola University Medical Center
Maywood, IL, United States

Disclosure(s):

Kelly A. Wentland, BBA: No relevant relationships to disclose.

Introduction: The outcome of patients with head and neck squamous cell carcinoma (HNSCC) has been shown to be adversely affected by increased time between diagnosis and treatment, and changes in care related to the COVID-19 pandemic had the potential to negatively impact treatment of patients with HNSCC. This project evaluated how presentation and oncologic management of patients presenting with HNSCC during the COVID-19 pandemic compared to a cohort presenting prior to COVID-19.

Methods: This study is a retrospective chart review of patients with newly diagnosed HNSCC who received treatment from March 1, 2019 to February 29, 2020 (pre-COVID) and March 1, 2020 to February 28, 2021 (COVID) at a single urban tertiary care hospital. Age, Sex, Race, Ethnicity, Marital Status, Median Income, Insurance, Cancer Site, Treatment Type, Time to Treatment, and Overall Cancer Stage variables were collected.

Results: There was a decrease in the number of patients presenting with HNSCC from pre-COVID (n=130) to COVID (n=93). There was no statistically significant difference in age, sex, marital status, insurance group, or income level between the two time periods. There was no statistically significant difference in the cancer site or overall stage between pre-COVID and COVID, although two patients presented with distant disease during COVID. There was no difference in time to treatment between pre-COVID and COVID (31 days). Radiation only as treatment increased from pre-COVID (27.69%) to COVID (40%), while surgery + radiation decreased from pre-COVID (29.23%) to COVID (16.84%) (p=0.05).

Conclusions: Our results are encouraging in that there was no statistically significant difference in patient demographics or cancer stage between pre-COVID and COVID. We did note two patients with distant metastatic disease, which we hypothesize may be related to COVID immunosuppression and/or fear of seeking care during the pandemic. Importantly, there was no difference in time to treatment between the two time periods. The treatment type did change, which may reflect limited access to surgical care and/or patient preferences during COVID.