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The impact of the COVID-19 pandemic upon pancreatic cancer treatment (CONTACT Study): a UK national observational cohort study

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INTRODUCTION: CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic ('COVID' cohort, 16/03/2020-10/05/2020), with 12-month follow-up. RESULTS: Among 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8-4.1) vs. 4.4 (IQR 3.6-5.2) months, p = 0.093). CONCLUSION: Pathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.

Institutions

Birmingham Dental HospitalUniversity of BirminghamQueen Elizabeth Hospital BirminghamSouthend University Hospital NHS Foundation TrustCancer Research UK Clinical Trials UnitThe Christie NHS Foundation TrustCambridge University Hospitals NHS Foundation TrustUniversity College BirminghamSt George's HospitalForth Valley Royal HospitalLuton and Dunstable HospitalQueen Alexandra HospitalUniversity Hospitals of Leicester NHS TrustFreeman HospitalUniversity Hospital of WalesQueen's HospitalWhittington HospitalUniversity College LondonBristol Royal InfirmaryWalsall Manor HospitalEastbourne District General HospitalDarent Valley HospitalRoyal Lancaster InfirmaryUniversity of HullHull and East Yorkshire Hospitals NHS TrustFrimley Health NHS Foundation TrustFurness General HospitalNHS GrampianColchester HospitalMorriston HospitalAiredale General HospitalIpswich HospitalInverclyde Royal HospitalThe Royal Wolverhampton NHS TrustDerriford HospitalUniversity Hospitals Plymouth NHS TrustSouthampton General HospitalRoyal London HospitalEast Kent Hospitals University NHS Foundation TrustUniversity Hospitals of North Midlands NHS TrustHinchingbrooke HospitalNorthampton General HospitalRoyal Derby HospitalNorth Tees and Hartlepool NHS Foundation TrustWest Suffolk HospitalBedford Hospital NHS TrustRoyal Gwent HospitalUniversity of UlsterAltnagelvin Area HospitalBasingstoke and North Hampshire HospitalCumberland InfirmaryChurchill HospitalWest Middlesex University HospitalMiddlesex HospitalBroomfield HospitalHomerton University HospitalJames Paget University HospitalRoyal Bournemouth HospitalManchester Royal InfirmaryAntrim Area HospitalGloucestershire Royal HospitalConquest HospitalDumfries and Galloway Royal InfirmaryRoyal Sussex County HospitalUniversity Hospitals Sussex NHS Foundation TrustWorcestershire Royal HospitalLister HospitalCounty HospitalThe Royal Free HospitalNorfolk and Norwich University HospitalHammersmith HospitalYsbyty Gwynedd Hospital NHS TrustGlasgow Royal InfirmaryChelsea and Westminster Hospital NHS Foundation TrustRoyal Glamorgan HospitalNottingham City HospitalRoyal Victoria Eye and Ear HospitalKettering General HospitalRoyal Blackburn Teaching HospitalTorbay and South Devon NHS Foundation TrustUniversity Hospital of North DurhamNorth Middlesex University Hospital NHS TrustSt James's University HospitalPoole HospitalSandwell General HospitalWrexham Maelor HospitalUniversity of LiverpoolRoyal Liverpool University HospitalHuddersfield Royal InfirmaryWarrington and Halton Teaching Hospitals NHS Foundation TrustRussells Hall HospitalRoyal Devon and Exeter HospitalPeterborough City HospitalAlexandra HospitalMaidstone and Tunbridge Wells NHS TrustTunbridge Wells HospitalNorthumbria Healthcare NHS Foundation Trust

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COVID-19 and healthcare impactsPancreatic and Hepatic Oncology ResearchCOVID-19 Clinical Research Studies

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