Behavior of head and neck tumor surgery during COVID-19

Abstract

Introduction: The COVID-19 pandemic affected medical care for cancer patients in an unexpected and unprecedented way. The impact was greater in head and neck tumors due to limitations in protection during potentially aerosolizing procedures and specific upper aerodigestive tract interventions.

Objective: to determine the behavior of surgery in the treatment of these patients during the COVID-19 pandemic.

Methods: A cross-sectional descriptive study was carried out on 1170 patients, who received a surgical procedure in the Head and Neck Oncological Surgery Service of the National Institute of Oncology and Radiobiology; were divided into two groups in relation to the COVID-19 pandemic: Pre-pandemic (n=592) and Pandemic (n=578). Demographic characteristics, tumor characteristics, type of surgery, and COVID-19 surgical risk classification were compared; with the use of Chi-square and student's t. p<0.05 was considered significant.

Results: The 50–69-year-old groups predominated without significant differences (p=0.376). The male sex was more frequent in the pandemic (70.8%). Histopathologically, high malignancy was confirmed during the pandemic (92.9%), with the larynx being the most frequent location (47.8%), both without significant differences. Essential elective surgeries predominated (65.4%) and tracheostomy within emergencies (71.9%; p=0.029). 92.9% of urgent/emergency surgeries had significantly high risk.

Conclusions: Patients with head and neck mucosal malignancies require continued treatment despite the pandemic status. All stages of treatment must be monitored to minimize the risk of infection with COVID-19 for both patients and healthcare workers.