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Patients were grouped as pre-COVID-19 and post-COVID-19 onset, with post-onset split into during and post periods. 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Dudas,  \nInnsbruck Medical University, Austria  \n*CORRESPONDENCE  \nKornél Dános,  \n [danos.kornel@semmelweis.hu](danos.kornel@semmelweis.hu)  \nRECEIVED 25 October 2025  \nREVISED 13 January 2026  \nACCEPTED 13 February 2026  \nPUBLISHED 20 February 2026  \nCITATION  \nBesenczi B, Horváth A, Uri I and Dános K (2026) The effect of the COVID-19 pandemic on TNM status among head and neck cancer patients in Hungary. Pathol. Oncol. Res. 32:1612298 .  \ndoi: 10.3389/pore.2026.1612298  \nCOPYRIGHT  \n© 2026 Besenczi, Horváth, Uri and Dános. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nThe effect of the COVID-19 pandemic on TNM status among head and neck cancer patients in Hungary  \nBenedek Besenczi 􀀁 , Angéla Horváth, Imre Uri 􀀁 and Kornél Dános 􀀁 *  \nDepartment of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary  \nPurpose: Hungary ranks among the countries with both the highest incidence and mortality of head and neck cancers worldwide. The COVID-19 pandemic, caused by the SARS-CoV-2 virus placed a significant burden on the healthcare system. Our study aims to investigate its impact on Hungarian head and neck cancer patients by analyzing changes in stage at presentation, patient delay and overall survival due to the viral pandemic.  \nMethods: A retrospective cohort study was performed analyzing patients’medical records from a tertiary head and neck surgical center in Hungary. The inclusion criteria required the tumor to be a squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Based on the timing of restrictive measures due to the pandemic, patients were divided into two groups: Group A: “pre-COVID-19”(3 September 2012 – 11 March 2020) and Group B: “post-COVID-19 onset”(12 March 2020 – 5 December 2022) The latter group was further subdivided into Group C: “during-COVID-19”(12 March 2020 – 13 June 2021) and Group D: “post-COVID-19” (14 June 2021 – 5 December 2022) .  \nResults: 620 patients met the inclusion criteria. Group A had 427 patients, Group B had 193, Group C had 69, and Group D had 124. Compared to Group A (54 . 1%), there was a higher proportion of N+ status patients in Group B (69 . 6%), Group C (63 . 8%), and Group D (73 . 0%), with a significant difference throughout. Changes in T status and patient delay time was not present. Analyzing symptoms, there was a significant increase in delay time for patients with hemoptysis (from 2.1 to 16.3 weeks) . No significant difference in overall survival was observed between the study groups.  \nConclusion: There are limited publications available on this topic in Europe, particularly in Hungary, especially studies that compare the periods before, during, and after the COVID-19 pandemic. Head and neck cancer patients were found to have more advanced clinical nodal disease after the COVID- 19 onset, despite no changes in patient delay time and overall survival. Our  \nPathology & Oncology Research 01 Published by Frontiers  \nfindings highlight the importance of further studies on how viral infections and pandemics affect oncology care pathways to improve preparedness for future public health crises.  \nKEYWORDS  \nCOVID-19, head and neck cancers, oncologic pathways, TNM status, viral pandemics  \nIntroduction  \nHead and neck cancers are the 7th most common type of cancer worldwide, accounting for 4.6% of annual cancer-related mortality [ 1]. Hungary ranks third globally and first in Europe in the combined incidence of oral ","cbCaivgqdbm4We7g","https://ap.wps.com/l/cbCaivgqdbm4We7g","pdf",2587535,13,"English","# Purpose\n# Methods\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"What was the study’s purpose regarding the COVID-19 pandemic?\",\"answer\":\"To investigate how the COVID-19 pandemic affected Hungarian head and neck cancer patients by analyzing changes in stage at presentation, patient delay, and overall survival.\"},{\"question\":\"How were patients grouped in the analysis?\",\"answer\":\"Patients were divided into a pre-COVID-19 group (3 September 2012 – 11 March 2020) and a post-COVID-19 onset group (12 March 2020 – 5 December 2022), with the post-onset group further split into during-COVID-19 and post-COVID-19 periods.\"},{\"question\":\"What key outcome was observed after COVID-19 onset?\",\"answer\":\"A higher proportion of N+ status patients was observed in the post-COVID-19 groups compared with the pre-COVID-19 group, while changes in T status and overall survival were not found.\"}]","The effect of the COVID-19 pandemic on TNM status among head and neck cancer patients in Hungary | PDF",1790100090,33]