# Recurrence of Head and Neck Squamous Cell Carcinoma: Did the COVID-19 Pandemic Have an Impact on Therapeutic Management?

## TL;DR

This study found that the COVID-19 pandemic did not significantly change treatment decisions for head and neck cancer recurrence, but it led to earlier treatment with less advanced staging.

## Contribution

The study is the first to investigate the impact of the pandemic on the management of recurrent head and neck squamous cell carcinoma.

## Key findings

- 24% of patients received treatment different from the recommended plan, often more palliative.
- The pandemic was associated with longer time to recurrence and shorter time to treatment initiation.
- Lymph node staging was lower in 2020, suggesting earlier detection during the pandemic.

## Abstract

Objectives: To our knowledge, no previous study has specifically investigated the impact of COVID-19 on the management of recurrent squamous cell carcinoma (HNSCC) of the upper aerodigestive tract. The aim was to investigate the impact of the COVID-19 pandemic on the adequacy of treatments decided upon in multidisciplinary team meetings (MTMs) and those actually administered to patients with recurrent tumors. Secondary objectives were to study the characteristics of this population and tumors, factors that may influence the mismatch between treatments decided upon and those administered, and treatment delays. Methods: A retrospective study conducted at a tertiary referral center included 80 patients with recurrent HNSCC diagnosed between 2019 and 2021. Results: Of the 80 patients, 19 (24%) received treatment that differed from the recommended treatment. In case of mismatching, treatments were mostly less invasive or palliative (32% of palliative treatments decides (n = 6) versus 64% of palliative treatments realized (n = 12)). No factors were identified that could explain the discrepancy between treatment decided and treatment administered. The study population was homogeneous over the 3 years, with the only difference being lower lymph node staging in 2020 (p = 0.002). The time to recurrence was longer (p < 0.001), and the time to treatment initiation was shorter during the pandemic and post-pandemic periods (p = 0.002). Conclusions: The COVID-19 pandemic did not appear to affect the consistency between treatment decisions made in MTM and the treatments ultimately delivered. The COVID-19 pandemic has enabled earlier treatment with less advanced staging in patients with recurrence.