Impact of the COVID-19 pandemic on urological cancers: The surgical experience of two cancer hubs in London and Milan.

Autor: Monroy-Iglesias MJ; Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR) King's College London London UK., Rai S; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Mistretta FA; Division of Urology European Institute of Oncology IRCCS Milan Italy., Roberts G; South East London Cancer Alliance London UK., Dickinson H; South East London Cancer Alliance London UK., Russell B; Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR) King's College London London UK., Moss C; Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR) King's College London London UK., De Berardinis R; Division of Otolaryngology and Head and Neck Surgery European Institute of Oncology IRCCS Milan Italy., Ferro M; Division of Urology European Institute of Oncology IRCCS Milan Italy., Musi G; Division of Urology European Institute of Oncology IRCCS Milan Italy.; Department of Oncology and Haemato-oncology University of Milan Milan Italy., Brown C; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Nair R; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Thurairaja R; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Fernando A; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Cathcart P; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Khan A; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Dasgupta P; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Malde S; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Hadijpavlou M; Department of Urology Guy's and St Thomas' NHS Foundation Trust London UK., Dolly S; Department of Medical Oncology Guy's and St Thomas' NHS Foundation Trust London UK., Haire K; South East London Cancer Alliance London UK., Tagliabue M; Division of Otolaryngology and Head and Neck Surgery European Institute of Oncology IRCCS Milan Italy.; Department of Biomedical Sciences University of Sassari Sassari Italy., de Cobelli O; Division of Urology European Institute of Oncology IRCCS Milan Italy.; Department of Oncology and Haemato-oncology University of Milan Milan Italy., Challacombe B; Division of Urology European Institute of Oncology IRCCS Milan Italy., Van Hemelrijck M; Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR) King's College London London UK.
Jazyk: angličtina
Zdroj: BJUI compass [BJUI Compass] 2022 Jan 27; Vol. 3 (4), pp. 277-286. Date of Electronic Publication: 2022 Jan 27 (Print Publication: 2022).
DOI: 10.1002/bco2.135
Abstrakt: Objective: To report on the outcomes of urological cancer patients undergoing radical surgery between March-September 2020 (compared with 2019) in the European Institute of Oncology (IEO) in Milan and the South East London Cancer Alliance (SELCA).
Materials and Methods: Since March 2020, both institutions implemented a COVID-19 minimal 'green' pathway, whereby patients were required to isolate for 14 days prior to admission and report a negative COVID-19 polymerase chain reaction (PCR) test within 3 days of surgery. COVID-19 positive patients had surgery deferred until a negative swab. Surgical outcomes assessed were: American Society of Anaesthesiologists (ASA) grade; surgery time; theatre time; intensive care unit (ICU) stay >24 h; pneumonia; length of stay (LOS); re-admission. Postoperative COVID-19 infection rates and associated mortality were also recorded.
Results: At IEO, uro-oncological surgery increased by 4%, as compared with the same period in 2019 ( n  = 515 vs. 534). The main increase was observed for renal (16%, n  = 98 vs. 114), bladder (24%, n  = 45 vs. 56) and testicular (27%, n  = 26 vs. 33). Patient demographics were all comparable between 2019 and 2020. Only one bladder cancer patient developed COVID-19, reporting mild/moderate disease. There was no COVID-19 associated mortality. In the SELCA cohort, uro-oncological surgery declined by 23% ( n  = 403 vs. 312) compared with the previous year. The biggest decrease was seen for prostate (-42%, n  = 156 vs. 91), penile (-100%, n  = 4 vs. 0) and testicular cancers (-46%, n  = 35 vs. 24). Various patient demographic characteristics were notably different when comparing 2020 versus 2019. This likely reflects the clinical decision of deferring COVID-19 vulnerable patients. One patient developed COVID-19, with no COVID-19 related mortality.
Conclusion: The COVID-19 minimal 'green' pathways that were put in place have shown to be safe for uro-oncological patients requiring radical surgery. There were limited complications, almost no peri-operative COVID-19 infection and no COVID-19-related mortality in either cohort.
(© 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)
Databáze: MEDLINE
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