Challenges and adaptations in pancreatic cancer surgery during the COVID-19 pandemic in a high-volume center

Abstract

Background: The COVID-19 pandemic affected healthcare systems worldwide, disrupting elective surgeries including those for cancer treatment. This study examines the effects of the pandemic on outcomes of pancreatic cancer surgeries at a specialized high-volume surgery center. Materials and methods: This study compared surgical volume and outcomes of pancreas resections between the pre-pandemic (January 2019 to February 2020), early pandemic (March 2020 to January 2021), and late pandemic (February 2021 to December 2021) periods. Perioperative and postoperative data were retrospectively analyzed from a prospectively maintained database together with surgical complications, mortality rates, and hospital stays. Results: There was no significant reduction in the number of pancreas resections performed during the pandemic. The rate of primary resectable tumors was significantly lower during the late pandemic phase (66% vs. 65.9% vs. 56.5%; P = 0.024), and subsequently application of neoadjuvant therapies increased in the late pandemic phase (26% vs. 25.4% vs. 33.8%; P = 0.079). The number of chemotherapy cycles were also higher during the late pandemic phase (P = 0.009). Surgical complication rates were higher during the late pandemic phase (47.8% vs. 45.6% vs. 56%; P = 0.043), but mortality rates remained low (30-day mortality: 1.6% vs. 1% vs. 3.7%, P = 0.116; 90-day mortality: 2.5% vs. 1.6% vs. 3.7%, P = 0.296). Conclusion: Our results indicate effective management of pancreatic cancer despite the challenges presented by the pandemic. These findings suggest that centralized, specialized surgical centers can maintain high-quality care of patients with pancreatic cancer during crises like the COVID-19 pandemic. These findings underscore the importance of timely surgical interventions for cancer patients, even when the healthcare system is disrupted.