Case Study: Impact of COVID-19 on Pancreatic Cancer Surgery Outcomes

A study published in In Vivo evaluated the impact of COVID-19 infection on postoperative outcomes in patients with pancreatic cancer.

The case study included three patients who underwent pancreatoduodenectomy for the treatment of pancreatic head cancer and later developed postoperative COVID-19 between April and September 2020. Patients tested negative for COVID-19 prior to surgery. Their postoperative outcomes were compared with a control group with similar pathologies but without COVID-19 infection.

The investigators found no significant differences in pre- and intraoperative outcomes between patients without and without COVID-19. No patients in the study cohort died postoperatively.

One patient with COVID-19 developed postoperative pancreatic fistula which necessitated early reintervention. Patients with COVID-19 presented with infection-associated hematological signs, such as lymphopenia, and intubation was required for one patient. These patients also had higher mean hospital length of stay compared with those without COVID-19, or 28 days (range, 17-32 days) versus 14 days (range, 8-19 days). COVID-19 infection also required readmission to the intensive care unit, with a mean stay of 18 days (range, 9-25 days). No patients without COVID-19 infection were readmitted.

“During the pandemic period, multiple therapeutic strategies have been proposed in pancreatic cancer patients. However, it should not be omitted the fact that this is a very aggressive malignancy and each postponement of any therapeutic gesture might significantly decrease the overall survival,” wrote the study authors in conclusion. “Therefore, we suggest that resection should be taken in consideration whenever is feasible; meanwhile, attention should be focused on early identification of any clinical signs which might preclude COVID infection; in this way, an early recognition of the viral infection might provide the chance for best supportive care and in the meantime might decrease the risk of postoperative mortality.”