Influence of the COVID-19 Pandemic Restrictions on the Incidence of Upper Tract Urothelial Cell Carcinoma: A Canadian Single-Center Experience

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic substantially disrupted healthcare systems worldwide and acted as a source of investigation into how oncologic care is affected during periods of significant healthcare suppression.We analyzed the impact of COVID-19-associated healthcare restrictions on wait times for the surgical resection of upper tract urothelial cell carcinoma (UTUCC) and the incidence of adverse final pathology in Newfoundland and Labrador (NL). MethodsRetrospective chart review was performed for patients undergoing surgical management for UTUCC between January 1, 2018, and November 30, 2024, at our center.Patients were placed into three cohorts based on local healthcare-enforced restrictions: a baseline pre-pandemic phase, a phase of pandemic-related healthcare disruption, and a post-pandemic phase following the relaxation of restrictions.Wait times for surgery, final pathological stage, and clinical outcomes were analyzed across cohorts to assess for patient adversities in relation to COVID-19 healthcare restrictions. ResultsThe study included 64 patients (mean age: 70.8 ± 9.7 years; 54.7% men), with no significant demographic differences across cohorts.Before the pandemic, 71.4% of patients experienced pT3 UTUCC disease on final pathology, compared with lower proportions during the pandemic (30.4%) and post-pandemic (33.3%) cohorts.Surgical wait times showed the greatest variance during the pandemic (mean: 88.7 ± 116.6 days); however, no significant differences were observed across cohorts (p = 0.574). ConclusionsDespite a greater variance in operative wait times during the peak of the pandemic, we did not experience an increased incidence of adverse UTUCC pathology.Continued research is required to better define how pandemic-related healthcare disruptions impacted individual urogenital malignancies.