Impact of the COVID-19 pandemic on ovarian cancer diagnosis, treatment, and survival in a Swiss tertiary care hospital - a conclusion five years after the outbreak of the pandemic

Introduction: The outbreak of SARS-CoV-2 in 2020 and the resulting lockdowns had a major impact on general healthcare provision. This study aimed to investigate whether the COVID-19 pandemic affected diagnosis, treatment, and survival of ovarian cancer patients at our institution. Methods: This retrospective cohort study included patients diagnosed with primary ovarian cancer and borderline ovarian tumor (BOT) at Bern University Hospital between January 2019 and December 2022. Clinical data were collected in a standardized database. Results: A total of 218 patients were included. Annual distribution of primary ovarian cancer diagnoses was 52 (2019), 32 (2020), 39 (2021), and 57 (2022), while borderline ovarian tumor diagnoses remained stable: 10 (2019, 2020, 2022) and 8 (2021). FIGO stage distribution remained unchanged during the study period (p= .520). Among 131 patients with advanced-stage ovarian cancer, 84% underwent cytoreductive surgery without significant changes over time (p= .838). However, a shift in surgical strategy was observed with interval debulking surgery increasing significantly during the COVID-19 pandemic years (2020 - 2021) (p= .030). Complete cytoreduction was achieved in 89% of cases, remaining constant (p= .355). Chemotherapy was administered to 94% of advanced-stage patients, with no changes during the COVID-19 pandemic years (p= .139). Cox regression analysis revealed no increased risk of recurrence (p= .142) or death (p= .587) for patients diagnosed during the COVID-19 pandemic years (2020-2021) compared to those in 2019 and 2022. Conclusion: While BOT diagnoses remained stable throughout the COVID-19 pandemic years, primary ovarian cancer diagnoses decreased in 2020 and 2021. No shift in disease stage was observed. However, more patients received interval debulking surgery during the pandemic. Overall, the SARS-CoV-2 outbreak did not negatively affect the oncological outcomes of patients with advanced-stage ovarian cancer at our institution.