How Musculoskeletal Tumor Management Changed During the COVID-19 Pandemic: Data from a Nationwide Questionnaire Survey of Hospitals Specializing in Musculoskeletal Tumors in Japan.

BACKGROUND

While changes in clinical practice during the COVID-19 pandemic in Japan have been widely studied, data specific to bone and soft tissue tumor care remain limited.

METHODS

A nationwide web-based survey was conducted among hospitals specializing in musculoskeletal tumors. It assessed the occurrence of COVID-19-related events (patient infections, outbreak clusters, and staff infections), delays in referral and diagnosis, postponement or cancellation of specific treatments, and changes in institutional management strategies.

RESULTS

Seventy-eight hospitals (91.7% of all specialized centers) responded. Patient infections, outbreak clusters, and staff infections were reported by 28.2%, 48.7%, and 53.8% of hospitals, respectively. While radiological exams and biopsies were largely maintained, patient referrals decreased significantly. Surgical treatment was more affected than chemotherapy or radiotherapy. Strategy changes included surgery delays or cancellations (48.7%) and prolonged follow-up intervals (20.5%). Among COVID-19-related factors, only direct patient infections were significantly associated with institutional changes in treatment policy.

CONCLUSIONS

The pandemic substantially disrupted outpatient services and surgical care in musculoskeletal oncology. Patient infection was the main driver of treatment strategy modifications.