Impact of the COVID-19 Epidemic on the Hospital Journey of Patients With Cancer of the Digestive System

NCT04616950 | Completed

• 1 other identifier: KOVID
• Study Type: observational
• Target: 274
• Locations: 1 country
• Sites: 1

Brief Summary

The hospital care of patients with cancerous pathology is part of a multidisciplinary care path that includes many stages. The treatment conditions in this course vary depending on the reasons that led to suspect the existence of a cancerous pathology: accidental discovery, screening, warning signs (sometimes expressed in an acute form) or referral for treatment in charge after the diagnosis has already been made. As soon as the patient presents to the hospital, various expertises are mobilized to establish the diagnosis, carry out the extension assessment and assess the comorbidities and conditions that may have an impact on the choice of treatments. During this initial evaluation, each file is evaluated in a Multidisciplinary Consultation Meeting to define the optimal therapeutic strategy which will often include several stages involving surgery, radiotherapy, medical oncology (chemotherapy, immunotherapy, targeted therapy, etc. hormone therapy), interventional radiology, and / or supportive oncological care (nutrition, pain treatment, correction of metabolic abnormalities, palliative care, etc.). This treatment path is considered to be very complex and the fluidity of its organization determines the processing times. The management of patients in a cancer department may vary depending on the organization specific to each hospital. The health crisis induced by the COVID-19 epidemic, associated with the containment measures put in place from March 19 to May 11, 2020, have limited the use of patients in hospitals, even for emergency activities. It has also led to a reorganization of scheduled activities within establishments, with a concentration of resources around unscheduled care, in particular COVID patients. In many establishments, the other activities were, for many, deprogrammed with postponed appointments. The impact of this epidemic on the hospital journey of patients with cancerous pathology is the subject of questions at the national level. The delays in diagnosis and treatment induced have possibly had an impact on the quality of the care and on the delays with, as a corollary, a possible loss of opportunity for the patient.

Conditions

Covid19; Cancer

Outcome Measures

Primary Outcomes (1)

• Hospital course of patients with cancer of the digestive system

  This outcome corresponds to the basis of the delay, measured as a continuous quantitative variable, in number of days between entry into the course and the first inpatient treatment in the medical oncology department.

  Day 1

Secondary Outcomes (1)

• Modeling of the hospital journey based on observations made during the period preceding the COVID-19 epidemic

  Day 1

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with primary cancer of the digestive system: cancer of the esophagus, stomach, small intestine, colon, rectosigmoid junction, rectum, anal canal, liver , gall bladder, bile ducts and pancreas; were hospitalized for the first time in the oncology department within the Paris Saint Joseph Hospital Group, between January 1, 2019 and October 31, 2020.

You may qualify if:

• Patients aged ≥ 18 years
• Patients with primary cancer of the digestive system: cancer of the esophagus, stomach, small intestine, colon, rectosigmoid junction, rectum, anal canal, liver , gall bladder, bile ducts and pancreas;
• Patients hospitalized for the first time in the medical oncology department in full hospitalization, week or day;
• Patients hospitalized between January 1, 2019 and October 31, 2020
• French-speaking patient

You may not qualify if:

• Patients with secondary cancer or a relapse of cancer of the digestive system
• Patients who do not require hospitalization in medical oncology
• Patient under guardianship or curatorship
• Patient deprived of liberty
• Patient under legal protection
• Patient objecting to the use of their medical data in the context of this study.

Sponsors & Collaborators

• Fondation Hôpital Saint-Joseph: lead

Study Sites (1)

Groupe Hospitalier Paris Saint-Joseph

Paris, Groupe Hospitalier Paris Saint-Joseph, 75014, France

Location

Related Publications (5)

• Belle A, Barret M, Bernardini D, Tarrerias AL, Bories E, Costil V, Denis B, Gincul R, Karsenti D, Koch S, Laquiere A, Lecomte T, Quentin V, Rahmi G, Robaszkiewicz M, Vaillant E, Vanbiervliet G, Vienne A, Dumeiran F, Gronier O, Chaussade S; French Society of Digestive Endoscopy (Societe Francaise d'Endoscopie Digestive). Impact of the COVID-19 pandemic on gastrointestinal endoscopy activity in France. Endoscopy. 2020 Dec;52(12):1111-1115. doi: 10.1055/a-1201-9618. Epub 2020 Jul 8.

  PMID: 32557489 RESULT

• Soreide K, Hallet J, Matthews JB, Schnitzbauer AA, Line PD, Lai PBS, Otero J, Callegaro D, Warner SG, Baxter NN, Teh CSC, Ng-Kamstra J, Meara JG, Hagander L, Lorenzon L. Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg. 2020 Sep;107(10):1250-1261. doi: 10.1002/bjs.11670. Epub 2020 Apr 30.

  PMID: 32350857 RESULT

• Grosclaude P, Azria D, Guimbaud R, Thibault S, Daubisse-Marliac L, Cartron G, Renaudie MJ, Dalbies PA, Delord JP, Bauvin E. [COVID-19 impact on the cancer care structuration: Example of the multidisciplinary team meeting dedicated to oncology in Occitanie]. Bull Cancer. 2020 Jul-Aug;107(7-8):730-737. doi: 10.1016/j.bulcan.2020.05.001. Epub 2020 May 18. French.

  PMID: 32425210 RESULT

• Sud A, Jones ME, Broggio J, Loveday C, Torr B, Garrett A, Nicol DL, Jhanji S, Boyce SA, Gronthoud F, Ward P, Handy JM, Yousaf N, Larkin J, Suh YE, Scott S, Pharoah PDP, Swanton C, Abbosh C, Williams M, Lyratzopoulos G, Houlston R, Turnbull C. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol. 2020 Aug;31(8):1065-1074. doi: 10.1016/j.annonc.2020.05.009. Epub 2020 May 19.

  PMID: 32442581 RESULT

• Gelman A, Rubin DB. Markov chain Monte Carlo methods in biostatistics. Stat Methods Med Res. 1996 Dec;5(4):339-55. doi: 10.1177/096228029600500402.

  PMID: 9004377 RESULT

MeSH Terms

Conditions

COVID-19; Neoplasms

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Anne BURONFOSSE, MD

  Fondation Hôpital Saint-Joseph

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 4, 2020
• First Posted: November 5, 2020
• Study Start: December 1, 2020
• Primary Completion: June 30, 2021
• Study Completion: April 26, 2023
• Last Updated: April 27, 2023

Record last verified: 2023-04

Locations

FR (1)