Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Impact of the COVID-19 pandemic on epithelial ovarian cancer diagnosis, management patterns and survival in Victoria: insights from the National Gynae-Oncology Registry (#87)

Aleesha Whitely 1 , Robert Rome 2 , Sharnel Perera 1 , Sherine Sandhu 1 , Mahendra Naidoo 1 , Simon Hyde 3 , Adam Pendlebury 3 , Orla McNally 4 , Deborah Neesham 4 , Tom Jobling 5 , Tran Nguyen 1 , Tahlia Knights 1 , John Zalcberg 1
  1. School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  2. Epworth HealthCare, East Melbourne, VIC, Australia
  3. Department of Gynaecological Oncology, Mercy Hospital for Women, Heidelberg, VIC, Australia
  4. Oncology and Dysplasia Service, Royal Women's Hospital, Parkville, VIC, Australia
  5. Department of Gynaecological Oncology, Monash Health, Bentleigh East, VIC, Australia

Background: The COVID-19 pandemic caused significant disruption to healthcare delivery in Victoria, Australia. However, specific impacts on ovarian cancer care and survival have not been elucidated.

Aim: To determine the impact of the COVID-19 pandemic on ovarian cancer diagnosis, management and survival in Victoria, Australia.

Methods: Data were extracted from the National Gynae-Oncology Registry (NGOR). Patients with epithelial ovarian, tubal or peritoneal (OTP) cancer initially diagnosed between 2017 and 2023, who received first-line treatment at six major treatment centres in Victoria, were analysed. Descriptive, regression and survival analyses were performed. All relevant ethics and governance approvals were obtained prior to data collection.

Results: Complete data were available for 1,255 patients who met the inclusion criteria. After adjusting for stage, those diagnosed with OTP cancer between 1 January 2020 and 31 December 2021 had lower odds of 18-month survival (OR 0.65, 95% CI 0.47-0.91, p = 0.013) compared to those diagnosed from 2017-2019; however, no significant change in odds was observed for one-year survival (OR 0.83, 95% CI 0.56-1.21, p = 0.321). Patients diagnosed in 2021 had higher odds of being diagnosed with stage III-IV disease, compared to patients diagnosed from 2017-2020 and 2022-23, and the proportion of stage III-IV ovarian cancer diagnoses was largest in the first quarter of 2021 (52 of 64 patients; 81.3%). No impact on timeliness of primary surgery, interval surgery, adjuvant chemotherapy or neoadjuvant chemotherapy was detected for those diagnosed during a COVID-19 lockdown in Victoria. Subgroup analyses revealed no significant differences in survival or timeliness of treatment between patients diagnosed during COVID who were residing in metropolitan areas, compared to rural and remote areas.

Conclusions: Timeliness of first-line treatment did not appear to be impacted by COVID-19 in Victoria, whilst NGOR data indicates that 18-month survival and stage III-IV ovarian cancer incidence was affected.