Introduction: Gastrointestinal stromal tumors (GIST) are rare neoplasms with an incidence of 7 cases per million per year in the United States. The COVID-19 pandemic led to a significant decrease in cancer screening and diagnoses. However, the impact on treatment and management in patients with GISTs has not yet been investigated.
Methods: This retrospective study analyzed the National Cancer Database (NCDB 2004-2020) data from 2017-2018 and 2020 for patients with GISTs. Descriptive statistics were used to compare time from diagnosis to initial treatment (days), AJCC (2017) TNM clinical stage distribution (S0-4) between pre-pandemic (2017-2018) and pandemic (2020) periods.
Results: There were 6,525 GIST cases pre-pandemic and 2,674 during the pandemic. The most common tumor locations were gastric (66.9%), small intestine (26.3%), rectum (2.3%), colon (1.9%), peritoneal (1.2%), esophageal (0.8%), retroperitoneal (0.3%), and anal (0.1%). Higher proportions of pandemic patients were diagnosed at later stages (I: 55.6%, II: 14.7%, III: 15.2%, IV: 14.5%) than pre pandemic patients (I: 52.2%, II:16.7%, III:17.8%, IV: 16.4%, p = .001). Tumor size was similar between the pre-pandemic and pandemic groups at 68.53 cm and 66.77 cm, respectively. There was an increase in days from diagnosis to treatment (27.5 to 29.7, p = .013) and days to definitive surgery (48.0 to 49.6), but this difference was not statistically significant.
Conclusion:
Although the pandemic appeared to delay diagnosis, time to surgery was similar between groups, showing oncological services maintained services despite the challenges of the pandemic. Further data is awaited to comprehensively understand the long-term effects of the pandemic on patients with GIST.
