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10.1016/j.annonc.2020.05.009 http://scihub22266oqcxt.onion/10.1016/j.annonc.2020.05.009 32442581!7237184!32442581     free     free     free Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Ann+Oncol 2020 ; 31 (8): 1065-1074 Nephropedia Template TP {{tp|p=32442581|t=2020. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic |pdf=|usr=}}{{32442581}} gab.com Text Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic JO: Ann Oncol http://www.kidney.de/pget.php?&tw=1&pmid=32442581 #FOAvip BACKGROUND: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients' long-term survival. PATIENTS AND METHODS: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations. RESULTS: Per year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Per-patient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs. CONCLUSIONS: Modest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued. Twit Text FOAVip Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic ????Ann Oncol http://www.kidney.de/pget.php?&tw=1&pmid=32442581 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=32442581 #FOAvip English Wikipedia <ref>{{Cite pmid|32442581}}</ref> Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic #MMPMID32442581 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 Ann Oncol 2020[Aug]; 31 (8): 1065-1074 PMID32442581show ga BACKGROUND: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease 2019 (COVID-19) pandemic. Progression of cancers during delay will impact on patients' long-term survival. PATIENTS AND METHODS: We generated per-day hazard ratios of cancer progression from observational studies and applied these to age-specific, stage-specific cancer survival for England 2013-2017. We modelled per-patient delay of 3 and 6 months and periods of disruption of 1 and 2 years. Using health care resource costing, we contextualise attributable lives saved and life-years gained (LYGs) from cancer surgery to equivalent volumes of COVID-19 hospitalisations. RESULTS: Per year, 94 912 resections for major cancers result in 80 406 long-term survivors and 1 717 051 LYGs. Per-patient delay of 3/6 months would cause attributable death of 4755/10 760 of these individuals with loss of 92 214/208 275 life-years, respectively. For cancer surgery, average LYGs per patient are 18.1 under standard conditions and 17.1/15.9 with a delay of 3/6 months (an average loss of 0.97/2.19 LYGs per patient), respectively. Taking into account health care resource units (HCRUs), surgery results on average per patient in 2.25 resource-adjusted life-years gained (RALYGs) under standard conditions and 2.12/1.97 RALYGs following delay of 3/6 months. For 94 912 hospital COVID-19 admissions, there are 482 022 LYGs requiring 1 052 949 HCRUs. Hospitalisation of community-acquired COVID-19 patients yields on average per patient 5.08 LYG and 0.46 RALYGs. CONCLUSIONS: Modest delays in surgery for cancer incur significant impact on survival. Delay of 3/6 months in surgery for incident cancers would mitigate 19%/43% of LYGs, respectively, by hospitalisation of an equivalent volume of admissions for community-acquired COVID-19. This rises to 26%/59%, respectively, when considering RALYGs. To avoid a downstream public health crisis of avoidable cancer deaths, cancer diagnostic and surgical pathways must be maintained at normal throughput, with rapid attention to any backlog already accrued. |*Betacoronavirus[MESH] |Adult[MESH] |Aged[MESH] |Aged, 80 and over[MESH] |COVID-19[MESH] |Coronavirus Infections/diagnosis/*epidemiology/therapy[MESH] |Female[MESH] |Hospitalization/trends[MESH] |Humans[MESH] |Male[MESH] |Middle Aged[MESH] |Neoplasms/diagnosis/*epidemiology/*surgery[MESH] |Pandemics/*prevention & control[MESH] |Pneumonia, Viral/diagnosis/*epidemiology/therapy[MESH] |SARS-CoV-2[MESH] |Time-to-Treatment/*trends[MESH]Collateral damage: the impact on outcomes from cancer surgery of the C(epmc).pdf DeepDyve Pubget Overpricing