Medical Journal of the Islamic Republic Of Iran

en Comparison of Clinical and Pathological Characteristics of Thyroid Cancer Surgery in the Pandemic Era COVID 19 Original Research Original Research Background: The COVID-19 pandemic brought significant challenges for oncology centers and cancer patients, necessitating the implementation of various preventive and restrictive protocols and postponing elective surgeries. We aimed to assess and compare tumor characteristics, including the size, metastasis, and duration of hospitalizations between the periods before and during COVID-19 in patients with thyroid cancer.    Methods: The present cross-sectional study was performed at The Institute of Cancer, Tehran University of Medical Sciences, with 143 patients observed 2 years before the pandemic and 92 during March 2020 and March 2022. Clinical and pathological tumor characteristics were compared between the 2 groups, including surgical details, hospitalization and intensive care unit (ICU) admission durations, time intervals between diagnoses and surgeries, and various metastatic factors. All data were analyzed using SPSS software 21. The chi-square test was used for the statistical analysis of qualitative data, and the t test was used for the statistical analysis of continuous data. P < 0.05 was considered statistically significant.    Results: The most frequent tumor type was papillary thyroid cancer (134 [93.7%] and 82 [89.13%]; P = 0.209). The right lobe was the most prevalent tumor site both before and during COVID-19, respectively (55 [38.5%] and 29 [31.5%]; P = 0.278). Central (64 [50.8%] and 62 [49.2%]; P < 0.001), and lateral (45 [34.5%] and 45 [48.9 %]; P = 0.045) lymph node metastasis in the first surgery and recurrence (P = 0.006 and P = 0.022, respectively) were significantly higher in patients admitted during the COVID-19 pandemic, respectively. The mean interval between the first surgery and subsequent surgery due to recurrence (P < 0.001), duration of ICU admission (P = 0.010), and hospitalization after the second operation were significantly lower during the pandemic (P = 0.006).    Conclusion: During the COVID-19 pandemic, patients exhibited larger tumors, increased lymph node metastasis, and shorter intervals between surgeries. This underscores the need for healthcare decision-makers to implement effective thyroid cancer management strategies in future outbreaks. Our study stands out by analyzing hospitalization and ICU admissions and duration for each patient, unlike any other study. Moreover, we extended our observation period beyond the typical duration found in most of the literature.   Thyroid Cancer, COVID-19, Pathology, Metastasis, Thyroidectomy 697 703 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5450-5&slc_lang=en&sid=1 Asma Shafaeipour Asmashafaee459@gmail.com 200319475328460089516 0009-0008-9426-6462 No Department of General Surgery, Subdivision of Surgical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Mohammad Shirkhoda mshirkhoda@sina.tums.ac.ir 200319475328460089517 200319475328460089517 Yes Department of General Surgery, Subdivision of Surgical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Mohammad Yasin Karami yasinkarami@gmail.com 200319475328460089518 200319475328460089518 No Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran Fatemeh Moosaie moosaei.fateme@gmail.com 200319475328460089519 200319475328460089519 No Department of General Surgery, Subdivision of Surgical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Amirmohsen Jalaeefar Jalaeefar@gmail.com 200319475328460089520 200319475328460089520 No Department of General Surgery, Subdivision of Surgical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran Maziar Motiee-Langroudi maziarmotiee@gmail.com 200319475328460089521 200319475328460089521 No Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Iraj Harirchi harirchi@tums.ac.ir 200319475328460089522 200319475328460089522 No Department of General Surgery, Subdivision of Surgical Oncology, Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran