Head and neck surgical oncology in the time of a pandemic: Subsite‐specific triage guidelines during the COVID‐19 pandemic

Abstract

Background: COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel.Methods: The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus. HNC subsites considered included aerodigestive tract mucosa, sinonasal, salivary, endocrine, cutaneous, and ocular.Recommendations: Each subsite is presented separately with diseasespecific recommendations. Options for alternative treatment modalities are provided if surgical treatment needs to be deferred. Conclusion: These guidelines are intended to help clinicians caring for patients with HNC appropriately allocate resources during a health care crisis, such as the COVID-19 pandemic. We continue to advocate for individual consideration of cases in a multidisciplinary fashion based on individual patient circumstances and resource availability. K E Y W O R D S oncology, otolaryngology, SARS-CoV-2

Developing a holistic contingency plan: Challenges and dilemmas for cancer patients during the COVID‐19

“…33,34 In addition, an American multiorganizational panel has published recommendations on the triage, prioritization, and treatment of breast cancer 53 and an international group has also published recommendations on the same topic. 54 Currently, cancer type specific guidance has been developed for a number of cancers including gastrointestinal cancer, 55,56 genitourinary cancers, 57,58,60 gynecological cancers, 59,60 head and neck cancer, 61,62 hematological malignancy, 63,64 hepatocellular carcinoma, 65 lung cancer, 66 neuroncology, 67 and skin cancer. 68 The Society of Surgical Oncology has published a brief guidance on surgery which is specific for each type of cancer.…”

Continuation of telemedicine in otolaryngology post-COVID-19: Applications by subspecialty

“…Unfortunately, cancer patients are also at higher risk of suffering complications related to COVID-19 infection [ 35 ]. Therefore, consideration must be taken to protect this vulnerable patient population while simultaneously taking steps to deliver timely and accurate oncologic management [ 36 ]. Judicious use of telemedicine platforms can help providers balance these risks [ 35 , 36 ].…”

“…Therefore, consideration must be taken to protect this vulnerable patient population while simultaneously taking steps to deliver timely and accurate oncologic management [ 36 ]. Judicious use of telemedicine platforms can help providers balance these risks [ 35 , 36 ]. Telemedicine can help alert the provider of any new or subtle changes in symptoms without the need for high risk face-to-face contact [ 36 ].…”

“…Judicious use of telemedicine platforms can help providers balance these risks [ 35 , 36 ]. Telemedicine can help alert the provider of any new or subtle changes in symptoms without the need for high risk face-to-face contact [ 36 ]. The MD Anderson Head and Neck Surgery Consortium has created guidelines for management of head and neck cancer by subsite and telemedicine is incorporated as an essential tool that should be used judiciously whenever feasible [ 36 ].…”

https://ecancer.org/en/journal/article/1096-cancer-treatment-during-the-covid-19-pandemic-in-the-kurdistan-region-of-northern-iraq

“…A multi institutional group of urologic oncologists from Europe and the US has evaluated evidence for worsening outcomes from delays in various urologic malignancies and provides evidence-based guidance for timing of treatment of patients with specific urologic malignancies [10]. At the University of Texas MD Anderson Cancer Center (MDACC) in Houston, disease teams have developed treatment guidelines to prioritize safe and optimal oncologic therapeutic decision-making for vulnerable populations [11][12][13][14]. By leveraging its national cancer network, MDACC has facilitated the care of its patients with collaborative health systems within its network.…”