Impact of the first surge of the COVID-19 pandemic on a tertiary referral centre for kidney cancer

Autor:	Ekaterini Boleti, Marta Marchetti, Ravi Barod, Joana B. Neves, Lee Alexander Grant, Pedro Silva, David Cullen, Soha El-Sheihk, John D. Kelly, Faiz Mumtaz, Miles Walkden, Thomas Powles, Nicholas Campain, Maxine G. B. Tran, Navin Ramachandran, Prasad Patki, Teele Kuusk, Axel Bex, My-Anh Tran-Dang
Rok vydání:	2021
Předmět:	medicine.medical_specialty renal cell carcinoma Referral Urology Psychological intervention Cancer Care Facilities Asymptomatic Nephrectomy Time-to-Treatment Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine COVID‐19 medicine Infection control Humans 030212 general & internal medicine Kidney surgery Elective surgery Watchful Waiting Carcinoma Renal Cell Referral and Consultation Neoplasm Staging Retrospective Studies Patient Care Team business.industry General surgery Patient Selection Cancer COVID-19 Original Articles prioritization medicine.disease Kidney Neoplasms centralization of care 030220 oncology & carcinogenesis Disease Progression Original Article medicine.symptom business Kidney cancer Hospitals High-Volume
Zdroj:	Bju International
ISSN:	1464-410X
Popis:	OBJECTIVE: To analyse the impact of the COVID-19 pandemic on a centralized specialist kidney cancer care pathway. MATERIALS AND METHODS: We conducted a retrospective analysis of patient and pathway characteristics including prioritization strategies at the Specialist Centre for Kidney Cancer located at the Royal Free London NHS Foundation Trust (RFH) before and during the surge of COVID-19. RESULTS: On 18 March 2020 all elective surgery was halted at RFH to redeploy resources and staff for the COVID-19 surge. Prioritizing of patients according to European Association of Urology guidance was introduced. Clinics and the specialist multidisciplinary team (SMDT) meetings were maintained with physical distancing, kidney surgery was moved to a COVID-protected site, and infection prevention measurements were enforced. During the 7 weeks of lockdown (23 March to 10 May 2020), 234 cases were discussed at the SMDT meetings, 53% compared to the 446 cases discussed in the 7 weeks pre-lockdown. The reduction in referrals was more pronounced for small and asymptomatic renal masses. Of 62 low-priority cancer patients, 27 (43.5%) were deferred. Only one (4%) COVID-19 infection occurred postoperatively, and the patient made a full recovery. No increase in clinical or pathological upstaging could be detected in patients who underwent deferred surgery compared to pre-COVID practice. CONCLUSION: The first surge of the COVID-19 pandemic severely impacted diagnosis, referral and treatment of kidney cancer at a tertiary referral centre. With a policy of prioritization and COVID-protected pathways, capacity for time-sensitive oncological interventions was maintained and no immediate clinical harm was observed.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e57fa52cb28e5a038c719dcfd461b4ee https://pubmed.ncbi.nlm.nih.gov/33964109 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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