Diagnostic pathway and stage migration of sinonasal malignancies in the era of the COVID-19 pandemic

Christian M Meerwein; Thomas M Stadler; Panagiotis Balermpas; Michael B Soyka; David Holzmann

doi:10.1002/lio2.640

Diagnostic pathway and stage migration of sinonasal malignancies in the era of the COVID-19 pandemic

Laryngoscope Investig Otolaryngol. 2021 Sep 4;6(5):904-910. doi: 10.1002/lio2.640. eCollection 2021 Oct.

Authors

Christian M Meerwein^{1

2}, Thomas M Stadler^{1

2}, Panagiotis Balermpas^{2

3}, Michael B Soyka^{1

2}, David Holzmann^{1

2}

Affiliations

¹ Department of Otorhinolaryngology, Head & Neck Surgery University Hospital Zurich Zurich Switzerland.
² University of Zurich Zurich Switzerland.
³ Department of Radiation Oncology University Hospital Zurich Zurich Switzerland.

Abstract

Objectives: The COVID-19 pandemic bears the risk of delayed cancer diagnoses.

Methods: Study on the diagnostic pathway of sinonasal malignancies during the COVID-19 pandemic.

Results: Median time from first symptom to treatment initiation was not increased during the pandemic: 137 days (interquartile range [IQR] 104-193) vs 139 days (IQR 103-219) (P = .60). Median time from first appointment at our institution to treatment initiation was even reduced in 2020: 18 days (IQR 11-25) vs 11 days (IQR 7-17) (P = .02). A trend toward advanced tumor stages during the pandemic was seen: 11/30 patients (36.7%) ≥ stage 4 in 2018 to 2019 vs 12/19 patients (63.2%) ≥ stage 4 in 2020 (P = .064).

Conclusion: Both, time to diagnosis and time to treatment initiation were similar during the pandemic. However, a higher proportion of advanced tumors stages was observed. Despite the pandemic, we provided a swift diagnostic workflow, including a virtual tumor board decision and a prompt treatment initiation. Level of Evidence: 4.

Keywords: delay; malignancy; nasal vestibule carcinoma; nasopharyngeal carcinoma; pandemic; sinonasal; tumor.