Clinical Remission Rates in Patients With Epithelial Ovarian Cancer Before and After the Onset of the COVID 19 Pandemic in an Integrated Healthcare Delivery System.

Abstract

Purpose: Evidence on the impact of the coronavirus disease 2019 (COVID-19) pandemic on outcomes in patients with ovarian cancer patients is limited. We compared remission outcomes in patients with ovarian cancer before and during the pandemic.

Patients and methods: This retrospective cohort study included patients diagnosed with epithelial ovarian cancer between 01/01/2017 and 06/30/2021 at Kaiser Permanente Southern California. Pre and post pandemic periods were designated using March 4, 2020, as the cut-off. Stage I-IV patients who completed chemotherapy and/or surgery as first-line treatment were included. Data on remission outcomes (complete and clinical remission) were abstracted by manual chart reviews. Complete remission was defined as no evidence of disease; clinical remission included both complete and partial response to treatment. Modified Poisson regression was used to evaluate the association of pandemic and remission. Effect modification by race/ethnicity was evaluated.

Results: Of 748 ovarian cancer patients included, 72.7% and 27.3% patients were diagnosed before and during the pandemic, respectively. Complete remission was observed in 75.7% and 73.5% patients before and during the pandemic, respectively (p = 0.53). No statistically significant association of pandemic period with remission outcomes was observed in the adjusted models. However, race/ethnicity modified the association of pandemic period with complete remission (p-value < 0.01). White patients, but not other racial/ethnic groups, were 13% more likely to achieve complete remission during the pandemic than during the pre-pandemic [adjusted rate ratio (95% confidence interval): 1.13 (1.00-1.28)].

Conclusion: Patients diagnosed with ovarian cancer achieved similar complete and clinical remission rates before and during the pandemic. Association of the pandemic period with complete remission varied for White vs non-White patients.