(P 483) DID THE COVID-19 PANDEMIC NEGATIVELY AFFECT OUTCOMES FOR PATIENTS WITH EXTREMITY SOFT TISSUE SARCOMAS?

Objective: The COVID-19 pandemic has had a major impact on the ability of global health care systems to deliver timely and appropriate care. The goal of this study was to determine the impact of the COVID-19 pandemic on outcomes for patients with extremity soft tissue sarcoma treated at a tertiary care centre.

Methods: Patients treated surgically for an extremity STS from January 2017-May 2022 were identified from our prospectively collected database and divided into pre-COVID (Jan 2017-Feb 2020) and during COVID (March 2020-May 2022) groups. Patient demographics, tumour characteristics, surgical procedures, and outcomes were compared between the 2 groups. Categorical variables were compared with Chi-square test, means with t-test and local recurrence-free survival with Kaplan-Meier method.

Results: A total of 700 patients were identified: 426 pre-COVID and 274 during COVID. There was no difference in gender (female 181 (42.5%), 109 (40%, p=0.5); presentation with metastases (30 (7%), 19 (6.9%), p=0.7); prior 'whoops' surgery (74 (17.4%), 45 (16.4%), p=0.7); need for vascular (20 (4%), 11 (4%), p=0.7), nerve (14 (2.9%), 7 (2.6%), p=0.6) or bone (32 (6.7%), 20 (7.9%), p=0.9) resection; positive margins (81 (19%), 38 (14%), p=0.2); or tumour size (mean 9.3 cm, median 7.9 cm, range 0.5-42 cm; mean 9.8 cm, median 7.7, range 1-35.4 cm, p=0.19) between patients treated before or during the pandemic, respectively.
There was a difference in the use of VAC for wound closure- 79 (18.5%) pre-COVID and 89 (32.5%) during COVID (p < 0.001). There was also a difference in wound complications: 24.5% pre-COVID compared to 17.9% during COVID (p=0.045). For patients treated with preoperative radiotherapy (224 pre-COVID, 139 during), the time from radiation completion to surgery was not different between the two time periods: pre-COVID a mean of 50 days, (median 49, range 18-149); while during COVID a mean of 50 days (median 45.5, range 13-169). Estimated 2-year local recurrence-free survival was 95.3% pre-COVID compared to 91.7% during COVID (log rank 5.6, p=0.018).

Conclusion: Surprisingly, patients with extremity STS did not present with larger tumours or a higher percentage with metastatic disease during the pandemic. VAC usage increased during the pandemic and a small decrease in local recurrence-free survival was seen. Follow-up for the COVID cohort is currently too short for a comparison of metastasis-free or overall survival between the 2 groups.