CovidNeuroOnc: a UK multi-centre, prospective cohort study of the impact of the COVID-19 pandemic on the neuro-oncology service

Fountain, Daniel M; Piper, Rory J; Poon, Michael T C; Solomou, Georgios; Brennan, Paul M; Chowdhury, Yasir A; Colombo, Francesca; Elmoslemany, Tarek; Ewbank, Frederick G; Grundy, Paul L; Hasan, Md Tanvir; Hilling, Molly; Hutchinson, Peter J; Karabatsou, Konstantina; Kolias, Angelos G; McSorley, Nathan J; Millward, Christopher P; Phang, Isaac; Plaha, Puneet; Price, Stephen J; Rominiyi, Ola; Sage, William; Shumon, Syed; Silva, Ines L; Smith, Stuart J; Surash, Surash; Thomson, Simon; Lau, Jun Yi; Watts, Colin; Jenkinson, Michael D

BACKGROUND: The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumours. METHODS: We performed a multi-centre prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumour between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used. RESULTS: There were 1357 referrals for newly diagnosed or recurrent intracranial tumours across fifteen neuro-oncology centres. Of centres with all intracranial tumours, a change in initial management was reported in 8.6% of cases (n=104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n=75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n=20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, p>0.9). CONCLUSIONS: Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.