Abstract
BACKGROUND: The COVID-19 pandemic caused major disruptions in healthcare services, especially affecting routine monitoring of patients with head and neck cancer (HNC) and oral potentially malignant disorders (OPMDs). Its disruption during the pandemic may have led to delayed diagnoses and worse outcomes. MATERIAL AND METHODS: This study included patients previously under follow-up at a referral center. All were invited for reassessment involving clinical examination and comparison with pre-pandemic records. Cases were categorized as stable, progressive, regressive (for OPMDs), or deceased. A biopsy was performed on any suspicious changes. Statistical analyses included chi-square, Fisher's exact test, odds ratios, and Kaplan-Meier survival estimates. RESULTS: A total of 246 patients were evaluated, including 103 patients with HNC and 143 with OPMDs. Patients were re-assessed post-pandemic and again during the latest follow-up. Among HNC, progression was more frequent in the post-pandemic period (26.9%) compared to the later appointment (24%), which was statistically significant (p=0.0011). Stability after the pandemic was linked to better prognosis (OR=4.667; p=0.0051). Survival analysis revealed significantly lower survival rates for the post-pandemic group compared to those followed during subsequent follow-up (HR=0.26; p<0.0001). For OPMDs, progression was observed in 27.28% post-pandemic and 19.14% in the other group (p=0.0214). However, prognosis in the latest follow-up was not significantly associated with post-pandemic status (p=0.1292). Outcome distribution by lesion subtype was significant over time (p=0.0046) and at the latest follow-up (p=0.0088). Patients with proliferative verrucous leukoplakia exhibited a higher rate of progression. Survival analysis also revealed a significantly lower survival rate in the first period (HR=0.52; p=0.037). CONCLUSIONS: These results underscore the lasting consequences of follow-up interruption. Delays in monitoring may lead to progression or delayed diagnosis, especially in high-risk patients.