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The impact of the COVID-19 pandemic on head and neck cancer diagnosis: a single-center study

Open Access
|Aug 2023

Figures & Tables

Figure 1.

Odds ratio plot for PEG, dyspnoea, and acute tracheostomy with 95% confidence intervals
Odds ratio plot for PEG, dyspnoea, and acute tracheostomy with 95% confidence intervals

Patient history and treatment

VariableTotal N = 172Pre-COVID group N = 86COVID group N = 86P-value
Duration of symptoms: 0.603
No symptoms16 (9.3)8 (9.3)8 (9.3)
Up to one month11 (6.4)4 (4.7)7 (8.1)
1 to 3 months29 (16.9)16 (18.6)13 (15.1)
3 to 6 months49 (28.5)24 (27.9)25 (29.1)
6 to 12 months13 (7.6)4 (4.7)9 (10.5)
12 and more months7 (4.1)5 (5.8)2 (2.3)
No data47 (27.3)25 (29.1)22 (25.6)
Smoking: 0.264
Yes93 (54.1)50 (58.1)43 (50.0)
No60 (34.9)25 (29.1)35 (40.7)
No data19 (11.0)11 (12.8)8 (9.3)
Type of treatment: 0.768
Radical118 (68.6)62 (72.1)56 (65.1)
Palliative15 (8.7)6 (7.0)9 (10.5)
Induct15 (8.7)7 (8.1)8 (9.3)
Other24 (14.0)11 (12.8)13 (15.1)
Treatment method: 0.657
Surgery38 (22.1)20 (23.3)18 (20.9)
RTh32 (18.6)14 (16.3)18 (20.9)
Surgery + RTh/RCTh33 (19.2)17 (19.8)16 (18.6)
RCTh19 (11.0)12 (14.0)7 (8.1)
CTh + surgery1 (0.6)1 (1.2)0 (0.0)
CTh21 (12.2)8 (9.3)13 (15.1)
Other28 (16.3)14 (16.3)14 (16.3)

Clinical characteristics of patients

VariableTotal N = 172pre-COVID group N = 86COVID group N = 86P-value
Tumor: 0.249
T0, n (%)12 (7.0)9 (10.5)3 (3.5)
T1, n (%)41 (23.8)23 (26.7)18 (20.9)
T2, n (%)28 (16.3)13 (15.1)15 (17.4)
T3, n (%)29 (16.9)10 (11.6)19 (22.1)
T4a, n (%)47 (27.3)24 (27.9)23 (26.7)
T4b, n (%)15 (8.7)7 (8.1)8 (9.3)
Lymph nodes: 0.693
N0, n (%)77 (44.8)40 (46.5)37 (43.0)
N1, n (%)15 (8.7)8 (9.3)7 (8.2)
N2, n (%)51 (29.6)22 (25.6)29 (33.7)
N3, n (%)29 (16.9)16 (18.6)13 (15.1)
Metastasis: 0.329
M0, n (%)162 (94.2)83 (96.5)79 (91.9)
M1, n (%)10 (5.8)3 (3.5)7 (8.1)
Grading: 0.429
G1, n (%)22 (12.8)13 (15.1)9 (10.5)
G2, n (%)98 (57.0)50 (58.1)48 (55.8)
G3, n (%)27 (15.7)14 (16.3)13 (15.1)
No data, n (%)25 (14.5)9 (10.5)16 (18.6)
Stage: 0.758
I, n (%)35 (20.3)18 (20.9)17 (19.8)
II, n (%)17 (9.9)10 (11.6)7 (8.1)
III, n (%)23 (13.4)12 (14.0)11 (12.8)
IVA, n (%)51 (29.7)25 (29.1)26 (30.2)
IVB, n (%)38 (22.1)19 (22.1)19 (22.1)
IVC, n (%)8 (4.7)2 (2.3)6 (7.0)
Histopathological diagnosis: 0.541
Squamous cell carcinoma143 (83.1)73 (84.9)70 (81.4)
Others29 (16.9)13 (15.1)16 (18.6)
Location: 0.360
Lip and Oral Cavity7 (4.1)5 (5,8)2 (2,3)
Nasopharynx4 (2.3)2 (2,3)2 (2,3)
Hypopharynx31 (18.0)12 (14,0)19 (22,1)
Oropharynx16 (9.3)6 (7,0)10 (11,6)
Larynx80 (46.5)41 (47,7)39 (45,3)
Nasal Cavity and Paranasal Sinuses8 (4.7)5 (5,8)3 (3,5)
Unknown Primary12 (7.0)9 (10,5)3 (3,5)
Major Salivary Glands14 (8.1)6 (7,0)8 (9,3)

Number (percentage) of patients in the subgroups, differing in the timing of treatment and dyspnea, emergency tracheotomy and PEG, the result of the independence test and the value of the odds ratio and its 95% confidence interval

DyspnoeaP-valueOR (95% CI)
Yes (N = 18)No (N = 154)
During a pandemic11 (61.1)75 (48.7)0.4551.66 (0.61; 4.49)
Before the pandemic7 (38.9)79 (51.3)1.00 (ref.)
Emergency tracheotomy
Yes (N = 16)No (N = 156)
During a pandemic10 (62.5)76 (48.7)0.2941.75 (0.61; 5.06)
Before the pandemic6 (37.5)80 (51.3)1.00 (ref.)
PEG
Yes (N = 19)No (N = 153)
During a pandemic14 (73.7)72 (47.1)0.0493.15 (1.08; 9.18)
Before the pandemic5 (26.3)81 (52.9)1.00 (ref.)

General characteristics of patients

VariableTotal N = 172pre-COVID group N = 86COVID group N = 86P-value
Gender: 0.141
Female, n (%)38 (22.1)15 (17.4)23 (26.7)
Male, n (%)134 (77.9)71 (82.6)63 (73.3)
Age (years): 0.703
M ± SD63.8 ± 10.663.5 ± 10.964.1 ± 10.3
Me [Q1; Q3]63 [59; 71]63 [58; 71]64 [60; 70]
Min - Max30 – 8630 – 8634 – 85
BMI (kg/m2): 0.235
M ± SD25.4 ± 5.125.9 ± 5.424.8 ± 4.9
Me [Q1; Q3]25 [22; 28]26 [22; 30]25 [22; 27]
Min - Max16 – 4716 – 3916 – 47
BMI: 0.168
Thinness (Less than 17), n (%)4 (2.3)2 (2.3)2 (2.3)
Underweight (17.0 – 18.4), n (%)3 (1.7)1 (1.2)2 (2.3)
Normal weight (18.5 – 24.9), n (%)48 (27.9)24 (27.9)24 (27.9)
Overweight (25.0 – 29.9), n (%)37 (21.5)16 (18.6)21 (24.4)
Obesity (30 and more), n (%)19 (11.0)15 (17.4)4 (4.7)
No data, n (%)61 (35.5)28 (32.6)33 (38.4)
Distance (km): 0.203
M ± SD25.4 ± 5.125.9 ± 5.424.8 ± 4.9
Me [Q1; Q3]25 [22; 28]26 [22; 30]25 [22; 27]
Min - Max16 – 4716 – 3916 – 47
Distance: 0.321
a) 0 – 9 km38 (22.1)22 (25.6)16 (18.6)
b) 10 – 24 km18 (10.5)8 (9.3)10 (11.6)
c) 25 – 49 km24 (14.0)13 (15.1)11 (12.8)
d) 50 – 74 km41 (23.8)24 (27.9)17 (19.8)
e) 75 – 99 km32 (18.6)12 (14.0)20 (23.3)
f) 100 – 252 km19 (11.0)7 (8.1)12 (14.0)
Language: English
Page range: 65 - 71
Submitted on: Feb 2, 2023
Accepted on: Jun 12, 2023
Published on: Aug 25, 2023
Published by: Hirszfeld Institute of Immunology and Experimental Therapy
In partnership with: Paradigm Publishing Services
Publication frequency: 1 times per year

© 2023 Marcin Turski, Karolina Dorobisz, Katarzyna Pazdro-Zastawny, Tomasz Zatoński, published by Hirszfeld Institute of Immunology and Experimental Therapy
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.