Impact of the COVID-19 pandemic on diagnosis of renal cell carcinoma and disease stage at presentation

Authors

  • W.C. Ian Janes Memorial University - Faculty of Medicine
  • Mitchell G. Fagan Faculty of Medicine - Memorial University
  • J. Matthew Andrews Division of Urology, Memorial University, St. John’s, NL, Canada
  • David R. Harvey Division of Urology, Health Sciences Centre, St. John’s, NL, Canada
  • Geoff M. Warden Division of Anesthesia, Health Sciences Centre, St. John’s, NL, Canada
  • Paul H. Johnston Division of Urology, Health Sciences Centre, St. John’s, NL, Canada
  • Michael K. Organ Division of Urology, Health Sciences Centre, St. John’s, NL, Canada

DOI:

https://doi.org/10.5489/cuaj.8519

Keywords:

RCC, COVID19, Pathology, Staging, Nephrectomy

Abstract

INTRODUCTION: Renal cell carcinoma (RCC) is often associated with significant morbidity and mortality, with overall survival contingent on multiple factors — most importantly, disease stage at diagnosis. Disruptions in healthcare delivery during the COVID-19 pandemic have resulted in various reported diagnostic and treatment delays, which have had detrimental impacts on malignancies such as RCC.

METHODS: Surgically managed cases of RCC at our center were identified using a retrospective chart review of all nephrectomies conducted from March 1, 2018, to February 28, 2023. Examination of disease characteristics in three time period cohorts (before, during, and following the COVID-19 pandemic) was undertaken. Timeframes were consistent with implementation and abolition of public health restrictions in the province of Newfoundland and Labrador.

RESULTS: A total of 483 surgically managed RCC cases were identified during the study period. The median age was 65 years (interquartile range [IQR] 56–71), and 62.3% of patients were male. Demographics did not vary across timeframes. Before and during the pandemic, pathologic stage 3 (pT3) disease was reported in 38.9% and 35.4% of cases, respectively, whereas the post-pandemic period saw this presentation in 50.0% of patients. Surgical wait times increased significantly across study timeframes (p=0.003).

CONCLUSIONS: The first year following the COVID-19 pandemic saw an 11.1% increase in patients presenting with pT3 RCC. These findings are suggestive of a clinically significant stage migration, which paired with prolonged wait times for surgery, provide critical consideration in the urgency of diagnostic and treatment decisions for RCC in the immediate future.

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Published

2023-12-21

How to Cite

Janes, W. I., Fagan, M. G., Andrews, J. M., Harvey, D. R., Warden, G. M., Johnston, P. H., & Organ, M. K. (2023). Impact of the COVID-19 pandemic on diagnosis of renal cell carcinoma and disease stage at presentation. Canadian Urological Association Journal, 18(4), E113–9. https://doi.org/10.5489/cuaj.8519

Issue

Vol. 18 No. 4 (2024): CUAJ April

Section

Original Research

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