Maintaining surgical treatment of non-small cell lung cancer during the COVID-19 pandemic in Paris

Lung Cancer

Ann Thorac Surg. 2020 Oct 7:S0003-4975(20)31631-3. doi: 10.1016/j.athoracsur.2020.08.007. Online ahead of print.


BACKGROUND: Coronavirus Disease 2019 (COVID-19) outbreak was officially declared in France on March 14th 2020. The objective of this study is to report the incidence and outcome of COVID-19 following surgical resection of non-small cell lung cancer (NSCLC) in Paris Public Hospitals during the pandemic.

METHODS: We retrospective analyzed a prospective database including all patients who underwent NSCLC resection between March 14th 2020 and May 11th 2020 in the 5 thoracic surgery units of Paris Public Hospitals. The primary endpoint was the occurrence of SARS-CoV-2 infection during the first 30 days following surgery.

RESULTS: Study group included 115 patients (male 57%, age 64.6±10.7, adenocarcinoma 66%, cT1 62%, cN0 82%). During the first month after surgery, 6 patients (5%) were diagnosed with COVID-19. As compared to COVID negative patients, COVID positive patients were more likely to be operated on during the first month of the pandemic (100% vs. 54%, p=0.03) and to be on corticosteroids preoperatively (33% vs. 4%, p=0.03). Postoperative COVID-19 was associated with an increased rate of readmission (50% vs. 5%, p=0.004), but no difference in 30-day morbidity (for the study group: grade 2, 24%; grade 3, 7%; grade 4, 1%) or mortality (n=1 COVID negative patient, 0.9%). Immediate oncological outcomes did not differ significantly between groups (R0 resection 99%, nodal upstaging 14%, adjuvant treatment 29%).

CONCLUSIONS: During the COVID-19 pandemic, surgical treatment of NSCLC was associated with a rate of postoperative COVID-19 of 5% with a significant impact on readmissions but not on other outcomes studied.