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Mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic: A multicenter population‑based retrospective study

  • Authors:
    • Emad Tashkandi
    • Amal Al‑Abdulwahab
    • Bassam Basulaiman
    • Abdullah Alsharm
    • Marwan Al‑Hajeili
    • Faisal Alshadadi
    • Lamis Halawani
    • Mubarak Al‑Mansour
    • Bushra Alquzi
    • Samar Barnawi
    • Mohammed Alghamdi
    • Nashwa Abdelaziz
    • Ruqayya Azher

  • View Affiliations

  • Published online on: February 26, 2021     https://doi.org/10.3892/mco.2021.2244
  • Article Number: 82

  • Copyright: © Tashkandi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Administration of effective anticancer treatments should continue during pandemics. However, the outcomes of curative and palliative anticancer treatments during the coronavirus disease (COVID‑19) pandemic remain unclear. The present retrospective observational study aimed to determine the 30‑day mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic. Between March 1 and June 30, 2020, all adults (n=2,504) with solid and hematological malignancies irrespective of cancer stage and type of anticancer treatments at five large comprehensive cancer centers in Saudi Arabia were included. The 30‑day mortality was 5.1% (n=127) for all patients receiving anticancer treatment, 1.8% (n=24) for curative intent, 8.6% (n=103) for palliative intent and 13.4% (n=12) for COVID‑19 cases. The 30‑day morbidity was 28.2% (n=705) for all patients, 17.9% (n=234) for curative intent, 39.3% (n=470) for palliative intent and 75% (n=77) for COVID‑19 cases. The 30‑day mortality was significantly increased with male sex [odds ratio (OR), 2.011; 95% confidence interval (CI), 1.141‑3.546; P=0.016], body mass index (BMI) <25 (OR, 1.997; 95% CI, 1.292‑3.087; P=0.002), hormone therapy (OR, 6.315; 95% CI, 0.074‑2.068; P=0.001) and number of cycles (OR, 2.110; 95% CI, 0.830‑0.948; P=0.001), but decreased with Eastern Cooperative Oncology Group performance status (ECOG‑PS) of 0‑1 (OR, 0.157; 95% CI, 0.098‑0.256; P=0.001), stage I‑II cancer (OR, 0.254; 95% CI, 0.069‑0.934; P=0.039) and curative intent (OR, 0.217; 95% CI, 0.106‑0.443; P=0.001). Furthermore, the 30‑day morbidity significantly increased with age >65 years (OR, 1.420; 95% CI, 1.075‑1.877; P=0.014), BMI <25 (OR, 1.484; 95% CI, 1.194‑1.845; P=0.001), chemotherapy (OR, 1.397; 95% CI, 1.089‑5.438; P=0.032), hormone therapy (OR, 1.527; 95% CI, 0.211‑1.322; P=0.038) and immunotherapy (OR, 1.859; 95% CI, 0.648‑4.287; P=0.038), but decreased with ECOG‑PS of 0‑1 (OR, 0.502; 95% CI, 0.399‑0.632; P=0.001), breast cancer (OR, 0.569; 95% CI, 0.387‑0.836; P=0.004) and curative intent (OR, 0.410; 95% CI, 0.296‑0.586; P=0.001). The mortality risk was lowest with curative treatments. Therefore, such treatments should not be delayed. The morbidity risk doubled with palliative treatments and was highest among COVID‑19 cases. Mortality appeared to be driven by male sex, BMI <25, hormonal therapy and number of cycles, while morbidity increased with age >65 years, BMI <25, chemotherapy, hormonal therapy and immunotherapy. Therefore, oncologists should select the most effective anticancer treatments based on the aforementioned factors.
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April-2021
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Spandidos Publications style
Tashkandi E, Al‑Abdulwahab A, Basulaiman B, Alsharm A, Al‑Hajeili M, Alshadadi F, Halawani L, Al‑Mansour M, Alquzi B, Barnawi S, Barnawi S, et al: Mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic: A multicenter population‑based retrospective study. Mol Clin Oncol 14: 82, 2021
APA
Tashkandi, E., Al‑Abdulwahab, A., Basulaiman, B., Alsharm, A., Al‑Hajeili, M., Alshadadi, F. ... Azher, R. (2021). Mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic: A multicenter population‑based retrospective study. Molecular and Clinical Oncology, 14, 82. https://doi.org/10.3892/mco.2021.2244
MLA
Tashkandi, E., Al‑Abdulwahab, A., Basulaiman, B., Alsharm, A., Al‑Hajeili, M., Alshadadi, F., Halawani, L., Al‑Mansour, M., Alquzi, B., Barnawi, S., Alghamdi, M., Abdelaziz, N., Azher, R."Mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic: A multicenter population‑based retrospective study". Molecular and Clinical Oncology 14.4 (2021): 82.
Chicago
Tashkandi, E., Al‑Abdulwahab, A., Basulaiman, B., Alsharm, A., Al‑Hajeili, M., Alshadadi, F., Halawani, L., Al‑Mansour, M., Alquzi, B., Barnawi, S., Alghamdi, M., Abdelaziz, N., Azher, R."Mortality and morbidity of curative and palliative anticancer treatments during the COVID‑19 pandemic: A multicenter population‑based retrospective study". Molecular and Clinical Oncology 14, no. 4 (2021): 82. https://doi.org/10.3892/mco.2021.2244