Impact of COVID-19 Pandemic on Management of Colorectal Cancer Patients in the Tertiary Care Hospital in Thailand
Punnawat Chandrachamnong¹, Suradet Buakhrun¹
Affiliation : ¹ Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Background: The global healthcare systems have undergone significant changes due to the profound impact of the COVID-19 pandemic, leading to modifications in healthcare delivery, treatment protocols, patient access, and overall outcomes.
Objective: To evaluate the influence of the COVID-19 pandemic on the management of colorectal cancer patients in Thailand.
Materials and Methods: The present study was a retrospective cohort study conducted at a tertiary referral hospital, involving patients diagnosed with colorectal cancer who underwent curative surgery between January 1, 2018, and December 31, 2021. The study period was divided into two phases, pre-COVID-19 outbreak, which was 2018 and 2019, and during the COVID-19 outbreak, which was 2020 and 2021. Retrospective data collection focused on patient demographics, medical outcomes, and a comparative analysis between the pre-COVID and COVID-19 periods was conducted to assess the impact on colorectal cancer management and patient outcomes.
Results: The number of patients studied was 413, showing no significant difference between both periods with 203 pre-COVID and 210 during COVID. During COVID-19, more colorectal cancer patients underwent emergency surgeries at 20% versus 11.3% (p=0.05) and had higher rates of advanced disease staging at 52.9% versus 40.9% (p=0.039) compared to pre-pandemic times. For rectal cancer, the COVID-19 led to prolonged surgery waiting times at 19 weeks versus 13 weeks (95% CI 2.40 to 9.73). This was potentially due to a higher number of patients receiving neoadjuvant treatment, including a larger proportion receiving total neoadjuvant treatment, which extended the overall treatment duration compared to conventional CCRT at 36 weeks versus 22 weeks (95% CI 10.23 to 17.92).
Conclusion: The present study examined the impact of COVID-19 on treating colorectal cancer. The number of surgeries increased in advanced cancer staging, which is Stage III and IV, during the COVID-19 outbreak. This may be due to the reduction in cancer case screenings, leading to patients presenting with emergencies requiring more frequent emergency operations.
Received 26 December 2024 | Revised 21 March 2025 | Accepted 28 April 2025
DOI: 10.35755/jmedassocthai.2025.8.613-621-02461
Keywords : Colorectal cancer; COVID-19 pandemic; Total neoadjuvant treatment; Concurrent chemoradiation; Surgery wait times
