Interventional oncology at the time of COVID-19 pandemic: Problems and solutions

Denys, Alban; Guiu, Boris; Chevallier, P.; Digklia, Antonia; Kerviler, É. de; Baère, Thierry De

doi:10.1016/j.diii.2020.04.005

Cited by 35 publications

(34 citation statements)

References 59 publications

(69 reference statements)

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“…At academic medical centers, diagnostic radiologists were able to work remotely using home work-stations. Some Interventional Radiology practices created teams of physicians, trainees, nurses and technologists to minimize cross-contamination of a potential exposure event ( 8 , 9 , 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and Interventional Radiology Case Volume and Education in the Age of Pandemics: Impact Analysis and Potential Future Directions

Gabr

Schenning

et al. 2020

Academic Radiology

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Rationale and Objectives: To assess the immediate impact of the COVID-19 pandemic on Diagnostic and Interventional Radiology education, and to propose measures to preserve and augment trainee education during future crises. Materials and Methods: Diagnostic Radiology (DR) studies and Interventional Radiology (IR) procedures at a single tertiary-care teaching institution between 2015 and 2020 were reviewed. DR was divided by section: body, cardiothoracic, musculoskeletal (MSK), neuroradiology, nuclear medicine, pediatrics, and women's imaging. IR was divided by procedural types: arterial, venous, lymphatic, core, neuro, pediatrics, dialysis, cancer embolization or ablation, noncancer embolization, portal hypertension, and miscellaneous. Impact on didactic education was also assessed. ANOVA, t test, and multiple comparison correction were used for analysis. Results: DR and IR caseloads decreased significantly in April 2020 compared to April of the prior 5 years (both p < 0.0001). Case volumes were reduced in body (49.2%, p < 0.01), MSK (54.2%, p < 0.05), neuro (39.3%, p < 0.05), and women's imaging (75.5%, p < 0.05) in DR, and in arterial (62.6%, p < 0.01), neuro IR (57.6%, p < 0.01) and core IR (42.6%, p < 0.05) in IR. IR trainee average caseload in April 2020 decreased 51.9% compared to April of the prior 5 years (p < 0.01). Utilization of online learning increased in April. Trainees saw significant increases in overall DR didactics (31.3%, p = 0.02) and no reduction in IR didactics, all online. Twelve major national and international DR and IR meetings were canceled or postponed between March and July. Conclusion: Decreases in caseload and widespread cancellation of conferences have had significant impact on DR/IR training during COVID-19 restrictions. Remote learning technologies with annotated case recording, boards-style case reviews, procedural simulation and narrated live cases as well as online lectures and virtual journal clubs increased during this time. Whether remote learning can mitigate lost opportunities from in-person interactions remains uncertain. Optimizing these strategies will be important for potential future restricted learning paradigms and can also be extrapolated to augment trainee education during unrestricted times.

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Section: Introductionmentioning

confidence: 99%

Diagnostic and Interventional Radiology Case Volume and Education in the Age of Pandemics: Impact Analysis and Potential Future Directions

Gabr

Schenning

et al. 2020

Academic Radiology

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“…13 Furthermore, it is difficult to apply a model of combined approach to priorities for HCC patients 14 : different tumors (for location and size) in different situations (well-preserved liver function or not) require different treatment strategies (HR or AT, open or laparoscopic surgery). 15 So, our multidisciplinary team as described in other experiences 16,17 played the role to adapt the therapeutic algorithm proposed by the actual guideline to the new emergency situation to select the best patient for the best treatment for HCC and, in the same time, to reduce the risk of COVID-19 infection for the patients as well as health professionals. Recent studies 18 cirrhotic patients with COVID-19 infection showed a poor outcome for either respiratory complications or liver failure.…”

Section: Discussionmentioning

confidence: 99%

Guidelines Adaptation to the COVID-19 Outbreak for the Management of Hepatocellular Carcinoma

Santambrogio

Farina

D’Alessandro

et al. 2021

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: COVID-19 pandemic rendered the surgical approach as well as the surgical indication very complex due to the outstanding consumption of public health system' resources, especially in the intensive care subdivision. A multidisciplinary team-based strategy is necessary to adapt guidelines and medical practices to the actual situation. The aim of this study is to evaluate the changes in the therapeutic algorithm in a small group of patients with hepatocellular carcinoma (HCC) enlisted for surgery during the COVID-19 outbreak. Materials and Methods: A multidisciplinary strategy has been adopted to allocate HCC patients to a treatment that permitted to reduce the risk of complications and the hospital stay, thus preventing contamination by the virus. Nasopharyngeal swab and a chest radiograph were performed in all patients within 48 hours before the surgical procedure: in the suspected cases with negative COVID tests, we prudently postponed surgery and repeated the diagnostic tests after 15 days. Results: During the emergency state, 11 HCC patients were treated (8 laparoscopic ablations and 3 hepatic resections). We reported only 1 postoperative complication (hemothorax) and 1 death during the follow-up for COVID pneumonia. Comparing our performances with those in the same time frame in the past 4 years, we treated a similar number of HCC patients, obtaining a decrease in operative timing (P = .0409) and hospital stay (P = .0412) (Fig. 2b) with similar rates of immediate postoperative complications, without ICU admissions. Conclusions: An adapted algorithm for the treatment of HCC to COVID outbreak permitted to manage safely these patients by identifying those most at risk of evolution of the neoplastic disease.

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“…A targeted literature search was performed to identify PubMed-referenced publications pertaining to management of hepatocellular carcinoma in the setting of the COVID-19 pandemic as of May 6, 2020. 1,[3][4][5][6] A manual search of professional society websites identified existing guidelines (Table 1) as of the same date. These publications and guidelines were reviewed for recommendations related to surveillance and monitoring practices, and any available guidance was referenced to support the authors' recommendations when applicable.…”

Section: Methodsmentioning

confidence: 99%

Surveillance and Monitoring of Hepatocellular Carcinoma During the COVID-19 Pandemic

Mehta

Parikh

Kelley

et al. 2021

Clinical Gastroenterology and Hepatology

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Interventional oncology at the time of COVID-19 pandemic: Problems and solutions

Cited by 35 publications

References 59 publications

Diagnostic and Interventional Radiology Case Volume and Education in the Age of Pandemics: Impact Analysis and Potential Future Directions

Diagnostic and Interventional Radiology Case Volume and Education in the Age of Pandemics: Impact Analysis and Potential Future Directions

Guidelines Adaptation to the COVID-19 Outbreak for the Management of Hepatocellular Carcinoma

Surveillance and Monitoring of Hepatocellular Carcinoma During the COVID-19 Pandemic

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