Applicability of COVID-19 Pandemic Recommendations for Urology Practice: Data from Three Major Italian Hot Spots (BreBeMi)

Dell’Oglio, Paolo; Cacciamani, Giovanni; Muttin, Fabio; Mirabella, Giovanni; Secco, Silvia; Roscigno, Marco; Rovati, Federico Alessandro; Barbieri, Michele; Naspro, Richard; Peroni, Angelo; Saccà, Antonino; Pellucchi, Federico; Bocciardi, Aldo Massimo; Simeone, Claudio; Pozzo, Luigi Da; Galfano, Antonio

doi:10.1016/j.euros.2021.01.012

Cited by 8 publications

(9 citation statements)

References 21 publications

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“…Niguarda Hospital, one of the largest public hospitals in the Lombardy region of Italy, was designated as a COVID-19 hub by the regional government and focused mainly on the treatment of COVID-19 patients. However, being a high-volume oncologic referral center, the regulatory authorities allowed the urology surgery team to keep performing major cancer surgery at Niguarda Hospital and, in part, in another medical structure, the European Institute of Oncology (IEO) [ 12 ]. However, surgical and postoperative care were undertaken by the same staff at both hospitals, reducing differences in patients’ management.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings might be explained by the fact that, during the months of the COVID-19 pandemic, fewer cancer diagnoses were performed at our center, leading to a shorter patients’ waiting list for surgery. In particular, the decrease in the rate of prostatic biopsies (5% of the usual volume), cystoscopies (20% of the usual volume) and urological consultations (15% of the usual volume) performed during the COVID-19 pandemic could have led to an underdiagnosis of cases of asymptomatic and localized cancers [ 12 ]. Indeed, recent studies are highlighting the relevance of the decrease in screening procedures during the COVID-19 pandemic, which might lead to increased cancer mortality [ 31 , 32 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…The changes in the management of urologic activities caused by COVID-19 have already been reported by some authors [ 7 , 8 , 9 , 10 , 11 ]. In particular, the urology team of our institution has described a reduction in all urologic activities performed during the first COVID-19 wave in the three largest public hospitals in Lombardy (Brescia, Bergamo and Milan) [ 12 ]. In accordance with recommendations by international urological societies, some urologic oncology surgical procedures have undergone a significant reduction in volume based on specific prioritization strategies, leading to an increased backlog of cases and possibly a worse prognosis for some patients [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Urologic Oncology Surgery: Implications for Moving Forward

Guerrieri

Rovati

Dell’Oglio

et al. 2021

JCM

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The COVID-19 pandemic has caused the destruction of routine hospital services globally, leading to an increase in the backlog of elective surgery cases. The aim of the study was to retrospectively investigate the pandemic’s impact on the urologic oncology surgical activity of a high-volume center located in Milan, Italy. The number and type of procedures performed in 2020 during the COVID-19 pandemic was evaluated using 2019 data as control. Waiting times for each surgical procedure were compared, on a bimonthly basis, between the two different years. Overall, a 26.7% reduction in the number of urologic oncology surgeries between 2019 and 2020 was observed (2019: 720, 2020: 528). Both the main indication for surgery and the type of procedure performed significantly differed between 2019 and 2020 (all p < 0.0001), with a decrease in the number of radical prostatectomies and an increase in the number of radical cystectomies and radical nephrectomies/nephroureterectomies performed in 2020. Waiting time decreased by 20% between 2019 and 2020, with the most significant reduction seen after the first wave of the COVID-19 pandemic (July-October 2020), in particular for partial nephrectomy and radical prostatectomy, possibly due to the underdiagnosis of cases. In conclusion, in accordance with recommendations by international urological societies on prioritization strategies for oncological procedures, a higher proportion of surgeries for high-risk tumors was performed in 2020 at our center at the expense of procedures for lower risk diseases; however, future implications for patients’ prognosis still need to be determined.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Urologic Oncology Surgery: Implications for Moving Forward

Guerrieri

Rovati

Dell’Oglio

et al. 2021

JCM

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“…Although several previous reports have addressed the impact of the COVID-19 pandemic on a variety of facets related to urological practice [2] , [3] , [4] , the perspective of contemporary patients and the general public on the trade-off between COVID-19-related and genitourinary cancer–related risks remains underinvestigated.…”

mentioning

confidence: 99%

“…Considering the influence of COVID-19 on patient perspectives [6] and the delivery of urological care [2] , [4] , a change in perspective is needed to promote new strategies for patient education and public awareness of urological cancers during long-lasting worldwide “emergency” scenarios. Renewed strategic plans will be needed not only to optimize the management of genitourinary cancers (through telemedicine, virtual care, telemonitoring, and personalized decision-making and prioritization schemes) [4] but also to enhance patient empowerment, engagement, and education.…”

mentioning

confidence: 99%