Epidemiological Assessment of Oral and Oropharyngeal Squamous Cell Carcinomas Before, During, and After the COVID-19 Pandemic, 2018–2024

Vollständiger Abstract

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Background/Objectives: Evidence regarding changes in oral and oropharyngeal squamous cell carcinoma (SCC) care across the COVID-19 pandemic remains limited, particularly in Eastern Europe. This study evaluated temporal changes in surgical admission volume, operative complexity, and comorbidity burden before, during, and after the pandemic at a Romanian tertiary maxillofacial center. Methods: This retrospective mixed-methods study included 248 admissions for oral and oropharyngeal SCC between 2018 and 2024. A structured administrative database was deterministically linked to narrative discharge summaries. Admissions were grouped into pre-pandemic (n = 117), pandemic (n = 93), and post-pandemic (n = 38) periods. Statistical analyses included between-period comparisons, segmented interrupted time-series analysis, and multivariable logistic regression. Qualitative thematic analysis was used to contextualize surgical and perioperative complexity. Results: Mean monthly admissions decreased from 4.9 before the pandemic to 2.6 during the pandemic and 1.6 in the post-pandemic period. Interrupted time-series analysis identified a significant declining baseline monthly trend (IRR 0.973, 95% CI 0.950–0.996; p = 0.024), without a significant immediate level change or post-onset slope change. Neck dissection increased from 23.9% before the pandemic to 39.8% during the pandemic (p = 0.045) and was independently associated with the pandemic/post-pandemic period (adjusted OR 1.87, 95% CI 1.06–3.29; p = 0.030). Qualitative findings identified recurrent codes related to surgical complexity, reconstruction, extensive nodal surgery, comorbidity burden, and perioperative management. Conclusions: Oral and oropharyngeal SCC surgical admissions showed a significant declining baseline trend between 2018 and 2024, while patients treated during and after the pandemic had higher adjusted odds of undergoing neck dissection. The findings support sustained oncological surveillance, timely referral, and multidisciplinary perioperative planning. Further multicenter studies incorporating standardized tumor–node–metastasis (TNM) staging and human papillomavirus (HPV) documentation are required to confirm these observations.