Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 28;3(1):vdab014.
doi: 10.1093/noajnl/vdab014. eCollection 2021 Jan-Dec.

CovidNeuroOnc: A UK multicenter, prospective cohort study of the impact of the COVID-19 pandemic on the neuro-oncology service

Daniel M Fountain  1   2 , Rory J Piper  3 , Michael T C Poon  4 , Georgios Solomou  5 , Paul M Brennan  6 , Yasir A Chowdhury  7 , Francesca Colombo  1   2 , Tarek Elmoslemany  8   9 , Frederick G Ewbank  10 , Paul L Grundy  10 , Md T Hasan  1   2 , Molly Hilling  11 , Peter J Hutchinson  12 , Konstantina Karabatsou  1   2 , Angelos G Kolias  12 , Nathan J McSorley  13 , Christopher P Millward  8 , Isaac Phang  14 , Puneet Plaha  3 , Stephen J Price  12 , Ola Rominiyi  15 , William Sage  16 , Syed Shumon  17 , Ines L Silva  11 , Stuart J Smith  16 , Surash Surash  17 , Simon Thomson  18 , Jun Y Lau  3 , Colin Watts  7   19 , Michael D Jenkinson  8   9 ; British Neurosurgical Trainee Research Collaborative (BNTRC)
Collaborators, Affiliations

CovidNeuroOnc: A UK multicenter, prospective cohort study of the impact of the COVID-19 pandemic on the neuro-oncology service

Daniel M Fountain et al. Neurooncol Adv. .

Abstract

Background: The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumors.

Methods: We performed a multicenter prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumor between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used.

Results: There were 1357 referrals for newly diagnosed or recurrent intracranial tumors across 15 neuro-oncology centers. Of centers with all intracranial tumors, a change in initial management was reported in 8.6% of cases (n = 104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n = 75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n = 20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, P > .9).

Conclusions: Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.

Keywords: COVID-19; SARS-CoV-2; brain tumor; intracranial tumor; neuro-oncology.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
MDT referrals by week stratified by primary outcome with overlay of weekly COVID-19 cases in the United Kingdom (n = 1210, note week commencing 27th May was 5 days).
Figure 2.
Figure 2.
Sankey diagram of change in management decision as a result of the COVID-19 pandemic (n = 1210). Delay = delay or defer treatment, Chemo = chemotherapy, RT = radiotherapy, SRS = stereotactic radiosurgery, Monitor = interval monitoring, None = no treatment required, BSC = best supportive care.
Figure 3.
Figure 3.
Sankey diagram of change in management decision as a result of the COVID-19 pandemic for patients with newly diagnosed high-grade glioma (n = 315), recurrent glioma (n = 157), and newly diagnosed metastasis (n = 395). Delay = delay or defer treatment, Chemo = chemotherapy, RT = radiotherapy, SRS = stereotactic radiosurgery, Monitor = interval monitoring, None = no treatment required, BSC = best supportive care.
See this image and copyright information in PMC

References

    1. Lai AG, Pasea L, Banerjee A, et al. Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ Open. 2020;10:e043828. doi:10.1136/bmjopen-2020-043828 - DOI - PMC - PubMed
    1. COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107(11):1440–1449. doi:10.1002/bjs.11746 - DOI - PMC - PubMed
    1. Cancer Research UK. Over 2 Million People Waiting for Cancer Screening, Tests and Treatments. Oxford, United Kingdom: Cancer Research UK; 2020.
    1. Sud A, Jones ME, Broggio J, et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol. 2020;31(8):1065–1074. - PMC - PubMed
    1. El-Ghandour NMF, Elsebaie EH, Salem AA, et al. Letter: the impact of the coronavirus (COVID-19) pandemic on neurosurgeons worldwide. Neurosurgery. 2020;87(2):E250–E257. - PMC - PubMed

LinkOut - more resources