During the 2019 coronavirus disease (COVID-19) pandemic, oncologists face new challenges, and they need to adjust their cancer management strategies as soon as possible to reduce the risk of SARS-CoV-2 infection and tumor recurrence. However, data on cancer patients with SARS-CoV-2 infection remains scarce.
We conducted a retrospective study on 223 cancer patients with SARS-CoV-2 from 26 hospitals in Hubei, China. An individualized nomogram was constructed based on multivariate Cox analysis. Considering the convenience of the nomogram application, an online tool was also created. The predictive performance and clinical application of nomogram were verified by C-index, calibration curve and decision curve analysis (DCA).
Among cancer patients with SARS-CoV-2, there were significant differences in clinical characteristics between survivors and non-survivors, and compared with patients with solid tumors including lung cancer, patients with hematological malignancies had a worse prognosis. Male, dyspnea, elevated PCT, increased heart rate, elevated D-dimers, and decreased platelets were risk factors for these patients. Furthermore, a good prediction performance of the online tool (dynamic nomogram: https://covid-19-prediction-tool.shinyapps.io/DynNomapp/ ) was also fully demonstrated with the C-indexes of 0.841 (95% CI 0.782-0.900) in the development cohort and 0.780 (95% CI 0.678-0.882) in the validation cohort.
Overall, cancer patients with SARS-CoV-2 had unique clinical features, and the established online tool could guide clinicians to predict the prognosis of patients during the COVID-19 epidemic and to develop more rational treatment strategies for cancer patients.
Journal of cancer research and clinical oncology. 2020 Oct 11 [Epub ahead of print]
Congkuan Song, Zhe Dong, Hongyun Gong, Xiao-Ping Liu, Xiaorong Dong, Aifen Wang, Yuan Chen, Qibin Song, Weidong Hu
Department of Thoracic Surgery, ZhongNan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China., Cancer Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China., Department of Urology, ZhongNan Hospital of Wuhan University, Wuhan, China., Department of Thoracic Oncology, Xiehe Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Department of Obstetrics and Gynecology, Zhangjiagang Hospital TCM, Nanjing University of Chinese Medicine, Nanjing, China., Department of Thoracic Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430000, Hubei, China. ., Cancer Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China. ., Department of Thoracic Surgery, ZhongNan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China. .