Evidence-Based Strategies for the Treatment of Peritoneal Malignancies during Health Care Resource Restriction: The COVID-19 Pandemic
| Autor: | Antoine Bouchard-Fortier, Andrea J MacNeill, Pamela Hebbard, Lloyd A. Mack, Carman A. Giacomantonio, Rami Younan, Ronald Burkes, Rebecca M. Prince, Farhana Shariff, Lucas Sideris, Trevor D. Hamilton, Alexandre Brind’Amour, Anand Govindarajan, Erika Haase, Andrea McCart, Walley J. Temple, Pierre Dubé, Danielle A. Bischof, Cindy Boulanger-Gobeil |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Evidence-based practice peritoneal malignancies Review Disease 03 medical and health sciences 0302 clinical medicine Resource (project management) Multidisciplinary approach Pandemic Health care Medicine Humans 030212 general & internal medicine Deferral Intensive care medicine Pandemics RC254-282 Peritoneal Neoplasms Evidence-Based Medicine business.industry SARS-CoV-2 Patient Selection Neoplasms. Tumors. Oncology. Including cancer and carcinogens COVID-19 Cytoreduction Surgical Procedures pandemic triage strategies Triage Combined Modality Therapy Surgical Oncology 030220 oncology & carcinogenesis Health Resources business |
| Zdroj: | Current Oncology Current Oncology, Vol 28, Iss 6, Pp 40-51 (2021) |
| ISSN: | 1718-7729 |
| Popis: | Background: The COVID-19 pandemic has put enormous pressure on hospital resources, and has affected all aspects of patient care. As operative volumes decrease, cancer surgeries must be triaged and prioritized with careful thought and attention to ensure maximal benefit for the maximum number of patients. Peritoneal malignancies present a unique challenge, as surgical management can be resource intensive, but patients have limited non-surgical treatment options. This review summarizes current data on outcomes and resource utilization to help inform decision-making and case prioritization in times of constrained health care resources. Methods: A rapid literature review was performed, examining surgical and non-surgical outcomes data for peritoneal malignancies. Narrative data synthesis was cross-referenced with relevant societal guidelines. Peritoneal malignancy surgeons and medical oncologists reviewed recommendations to establish a national perspective on case triage and mitigating treatment strategies. Results and Conclusions: Triage of peritoneal malignancies during this time of restricted health care resource is nuanced and requires multidisciplinary discussion with consideration of individual patient factors. Prioritization should be given to patients where delay may compromise resectability of disease, and where alternative treatment options are lacking. Mitigating strategies such as systemic chemotherapy and/or surgical deferral may be utilized with close surveillance for disease stability or progression, which may affect surgical urgency. Unique hospital capacity, and ability to manage the complex post-operative course for these patients must also be considered to ensure patient and system needs are aligned. |
| Databáze: | OpenAIRE |
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