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Review
. 2023 Sep 6;46(1):226.
doi: 10.1007/s10143-023-02132-y.

Tumor size, treatment patterns, and survival in neuro-oncology patients before and during the COVID-19 pandemic

Lydia Karamani  1   2   3 , Aaron Lawson McLean  4   5   6 , Marcel A Kamp  4   5   6 , Thomas E Mayer  5   6   7 , Wolf Müller  6   8 , Nazife Dinc  4   5   6 , Christian Senft  4   5   6
Affiliations
Review

Tumor size, treatment patterns, and survival in neuro-oncology patients before and during the COVID-19 pandemic

Lydia Karamani et al. Neurosurg Rev. .

Abstract

The COVID-19 pandemic has disrupted healthcare delivery worldwide, leading to significant delays in cancer diagnosis and treatment. This study aimed to investigate the impact of the pandemic on the diagnosis and treatment of malignant brain tumors, specifically glioblastoma (GBM) and cerebral metastasis (CM), in a specialized neuro-oncology center. We analyzed data from 236 patients diagnosed with previously unknown malignant brain tumors between January 2018 and December 2021. Patients were classified into two groups: pre-COVID (January 2018 to December 2019) and COVID (January 2020 to December 2021). Tumor volumes were compared between the two groups and factors affecting tumor volumes were studied. Of 236 patients diagnosed with previously unknown malignant brain tumors, 114 were in the pre-COVID group and 122 were in the COVID group. Median tumor volumes at first diagnosis were significantly larger in the COVID group compared to the pre-COVID group (21.7 vs 15.7 cm3; p < 0.05). The survival times for the overall cohort and the GBM and CM subgroups did not differ significantly between the pre-COVID and COVID periods. Delays in diagnosis and treatment during the COVID-19 pandemic led to larger tumor volumes at diagnosis for patients with malignant brain tumors. However, these larger tumors did not result in worse survival outcomes. This counterintuitive finding highlights the crucial role of specialized neuro-oncological centers in mitigating the potential negative impact of delayed treatment and emphasizes the need for continued access to specialized care during times of crisis.

Keywords: COVID-19; Cerebral metastasis; Glioblastoma; Pandemic; Tumor volume.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Violin plot comparing tumor volumes (CM and GBM) in the pre-COVID and COVID cohorts. Tumor volumes at time of diagnosis were statistically significantly larger in the COVID group than in the pre-COVID group. The dashed lines represent median values; the dotted lines represent quartiles. The width of the bars corresponds to the number of patients with a given tumor volume
Fig. 2
Fig. 2
Kaplan–Meier curve depicting the survival time in the pre-COVID (red curve) and in the COVID group (blue curve)
Fig. 3
Fig. 3
Kaplan–Meier curve depicting the survival time of GBM and CM patients who underwent a biopsy (blue curve) and those who underwent surgical resection (red curve)
Fig. 4
Fig. 4
Kaplan–Meier curve depicting the survival time of GBM and CM patients receiving radiotherapy (red curve) and patients without radiotherapy (blue curve), including the 95% CI
See this image and copyright information in PMC

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