COVID-19 pandemic impact on uro-oncological disease outcomes at an Italian tertiary referral center

Abstract

Purpose To assess differences in referral and pathologic outcomes for uro-oncology cases prior to and during the COVID pandemic, comparing clinical and pathological data of cancer surgeries performed at an academic referral center between 2019 and 2020. Methods We collected data of 880 prostate biopsies, 393 robot-assisted radical prostatectomies (RARP) for prostate cancer (PCa), 767 trans-urethral resections of bladder tumor (TURB) and 134 radical cystectomies (RC) for bladder cancer (BCa), 29 radical nephro-ureterectomies (RNU) for upper tract urothelial carcinoma, 130 partial nephrectomies (PN) and 12 radical nephrectomies (RN) for renal cancer, and 41 orchifunicolectomies for testicular cancer. Data of patients treated in 2019 (before COVID-19 pandemic) were compared to patients treated in 2020 (during pandemic). Results No significant decline in uro-oncological surgical activity was seen between 2019 and 2020. No significant increase in time between diagnosis and surgery was observed for all considered cancers. No differences in terms of main pathologic features were observed in patients undergoing RARP, TURB, RNU, RN/PN, or orchifunicolectomy. A higher proportion of ISUP grade 3 and 4 PCa were diagnosed in 2020 at biopsy ( p = 0.001), but this did not translate into worse pathological grade/stage at RARP. In 2020, more advanced disease features were seen after RC, including lymph node involvement ( p = 0.01) and non-organ confined disease ( p = 0.02). Conclusion Neither decline in uro-oncologic activity nor delay between diagnosis and treatment was observed at our institution during the first year of COVID-19 pandemic. No significant worsening of cancer disease features was found in 2020 except for muscle-invasive BCa. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-021-03842-y.

A retrospective cohort study of bladder cancer following the COVID-19 pandemic: Are patients presenting with more aggressive disease?

“…Furthermore, although no differences in stage or grade of disease were seen for patients undergoing TURBT, they did report a statistically significant higher rate of node positive and non-organ confined disease in radical cystectomy patients following the pandemic compared to the year before. This further supports the findings of our study, in that patients undergoing treatment for BC have worse pathological features following the pandemic [ 11 ].…”

Impact of COVID-19 pandemic on prostate cancer outcomes at an uro-oncology referral center

“…In agreement with Oderda et al ( 29 ), we also believe that the centralization of uro-oncological activity in referral centers is essential to guarantee safe and high-quality treatments, and even more so in times of crisis, such as the COVID-19 pandemic. No delay between diagnosis and surgery was observed in our study compared to the procedures of the pre-pandemic period; no significant difference in terms of main pathologic features was observed, likely as a consequence of our role as a referral center.…”

A Retrospective Analysis of the Challenges of Urothelial Cancer Management during the COVID-19 Pandemic at a Single Academic Center in Romania

“…A worrying outcome of this investigation is the increased incidence of invasive cancer in both newly diagnosed and recurrent patients during the pandemic period. This differs from the statistics provided by a study of more than 700 individuals who had surgical intervention for urothelial cancer in 2019 and 2020 and found no variations in cancer stage or severity between the two years [ 46 ]. Nevertheless, it is crucial to highlight that at baseline, 50% of patients in this study had an invasive form of cancer, and 72% had high-grade cancer, compared to 50% and 72%, respectively, in our analysis.…”