Background and Objectives: The COVID-19 pandemic significantly affected healthcare delivery, shifting focus away from nonurgent care. The aim of this study was to examine the impact of the pandemic on the practice of surgical oncology.Methods: A web-based survey of questions about changes in practice during the COVID-19 pandemic was approved by the Society of Surgical Oncology (SSO)Research and Executive Committees and sent by SSO to its members.Results: A total of 121 SSO members completed the survey, 77.7% (94/121) of whom were based in the United States. Breast surgeons were more likely than their peers to refer patients to neoadjuvant therapy (p = 0.000171). Head and neck surgeons were more likely to refer patients to definitive nonoperative treatment (p = 0.044), while melanoma surgeons were less likely to do so (p = 0.029). In all, 79.2% (95/120) of respondents are currently using telemedicine. US surgeons were more likely to use telemedicine (p = 0.004). Surgeons believed telemedicine is useful for long-term/surveillance visits (70.2%, 80/114) but inappropriate (50.4%, 57/113) for new patient visits.Conclusion: COVID-19 pandemic resulted in increased use of neoadjuvant therapy, delays in operative procedures, and increased use of telemedicine. Telemedicine is perceived to be most efficacious for long-term/surveillance visits or postoperative visits.
We present a case of a 62-year-old man who had no symptoms of venous insufficiency, with left leg swelling and pain a few days after being treated for floating deep vein thrombosis (DVT), whose condition was subsequently diagnosed as May-Thurner syndrome (MTS). This report highlights the importance of a broad differential diagnosis that includes MTS and considers anatomic abnormalities in situations of unprovoked, persistent DVT of the lower extremities.
Malignant peritoneal mesothelioma, a neoplastic process that arises from the peritoneal membranes and presents as a diffuse malignant process, has an incidence of approximately 400-600 new cases annually in the United States. Systemic chemotherapy regimens, like the combination of cisplatin and pemetrexed, have response rates of approximately 25% in peritoneal mesothelioma. Due to chemotherapy’s poor response rates, the first line approach to treating malignant peritoneal mesothelioma over the last 30 years has been surgical resection with regional intra-peritoneal chemotherapy in appropriately selected patients. Hyperthermic intraoperative intraperitoneal perfusion with chemotherapy with cisplatin or mitomycin c for 90 to 120 minutes is the most commonly reported type of regional chemotherapy that is administered during surgical cytoreduction. Favorable prognostic factors for patient outcomes after cytoreduction and hyperthermic intraperitoneal perfusion with chemotherapy tend to be favorable operative characteristics (lower peritoneal cancer index, better complete cytoreduction score), less aggressive tumor characteristics (epithelioid histology, low Ki-67, well-differentiated), and other patient characteristics (young, female, fewer comorbidities). Recently, there has been considerable interest in the utility of immune checkpoint inhibitors either alone or in combination with chemotherapy for patients with mesothelioma. Data demonstrate that programmed death-ligand 1 may be highly expressed in a large proportion of malignant peritoneal mesothelioma tumors and therefore the evaluation of checkpoint blockade in this patient population is a high clinical priority.
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