Major cancer surgery during the coronavirus pandemic: experience from a tertiary referral center and COVID-19 hub in Northern Italy

Maspero, Marianna; Mazzola, Michele; Bertoglio, Camillo Leonardo; Crippa, Jacopo; Morini, Lorenzo; Magistro, Carmelo; Martini, Paolo De; Gualtierotti, Monica; Lombardi, Pietro Maria; Ferrari, Giovanni

doi:10.1002/bjs.11892

Cited by 6 publications

(6 citation statements)

References 5 publications

(5 reference statements)

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“…Similar results were reported by Ingels et al who described a limited impact on perioperative complications in eight urological centres in Paris where oncological surgery was prioritised during the first 4 weeks of the pandemic 20 . However, two other observational studies reported a decline in the number overall urological surgical procedures (including uro‐oncology surgery) during the COVID‐19 pandemic 8,21 . The IEO was not a COVID‐19 hub and thus was chosen by the region as a reference centre for other non‐operative hospitals for pandemic urgency.…”

Section: Discussionsupporting

confidence: 74%

“… 20 However, two other observational studies reported a decline in the number overall urological surgical procedures (including uro‐oncology surgery) during the COVID‐19 pandemic. 8 , 21 The IEO was not a COVID‐19 hub and thus was chosen by the region as a reference centre for other non‐operative hospitals for pandemic urgency. Several urological cancer patients were sent from these hospitals to the IEO, which may explain the increase in number of uro‐oncological procedures.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID‐19 pandemic on urological cancers: The surgical experience of two cancer hubs in London and Milan

et al. 2022

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Objective: To report on the outcomes of urological cancer patients undergoing radical surgery between March-September 2020 (compared with 2019) in the European Institute of Oncology (IEO) in Milan and the South East London Cancer Alliance (SELCA). Materials and Methods: Since March 2020, both institutions implemented a COVID-19 minimal 'green' pathway, whereby patients were required to isolate for 14 days prior to admission and report a negative COVID-19 polymerase chain reaction (PCR) test within 3 days of surgery. COVID-19 positive patients had surgery deferred until a negative swab. Surgical outcomes assessed were: American Society of Anaesthesiologists (ASA) grade; surgery time; theatre time; intensive care unit (ICU) stay >24 h; pneumonia; length of stay (LOS); re-admission. Postoperative COVID-19 infection rates and associated mortality were also recorded. Results: At IEO, uro-oncological surgery increased by 4%, as compared with the same period in 2019 (n = 515 vs. 534). The main increase was observed for renal (16%, n = 98 vs. 114), bladder (24%, n = 45 vs. 56) and testicular (27%, n = 26 vs. 33). Patient demographics were all comparable between 2019 and 2020. Only one bladder cancer patient developed COVID-19, reporting mild/moderate disease. There was no COVID-19 associated mortality. In the SELCA cohort, uro-oncological surgery declined by 23% (n = 403 vs. 312) compared with the previous year. The biggest decrease was seen for prostate (À42%, n = 156 vs. 91), penile (À100%, n = 4 vs. 0) and testicular cancers (À46%, n = 35 vs. 24). Various patient demographic Maria J. Monroy-Iglesias and Sonpreet Rai contributed equally to this work as first co-authors.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Impact of the COVID‐19 pandemic on urological cancers: The surgical experience of two cancer hubs in London and Milan

et al. 2022

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“…Moreover, a decline in the number of surgeries may reflect a gap in the early diagnosis of cancer due to COVID-19. On the other hand, the number of urological surgeries increased by 3% ( n = 491 vs. 476) in 2020 compared to 2019; this was not in line with previous studies, where urological surgeries overall (including oncological surgeries) had a decline in volume of surgeries during the COVID-19 pandemic [ 21 , 22 ]. The IEO was chosen by the region as a reference centre for other non-operative hospitals for pandemic urgency.…”

Section: Discussioncontrasting

confidence: 57%

Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan

Monroy‐Iglesias

Tagliabue

Dickinson

et al. 2021

Cancers

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The SARS-CoV-2 (COVID-19) pandemic is having a large effect on the management of cancer patients. This study reports on the approach and outcomes of cancer patients receiving radical surgery with curative intent between March and September 2020 (in comparison to 2019) in the European Institute of Oncology, IRCCS (IEO) in Milan and the South East London Cancer Alliance (SELCA). Both institutions implemented a COVID-19 minimal pathway where patients were required to self-isolate prior to admission and were swabbed for COVID-19 within 72 h of surgery. Positive patients had surgery deferred until a negative swab. At IEO, radical surgeries declined by 6% as compared to the same period in 2019 (n = 1477 vs. 1560, respectively). Readmissions were required for 3% (n = 41), and <1% (n = 9) developed COVID-19, of which only one had severe disease and died. At SELCA, radical surgeries declined by 34% (n = 1553 vs. 2336). Readmissions were required for 11% (n = 36), <1% (n = 7) developed COVID-19, and none died from it. Whilst a decline in number of surgeries was observed in both centres, the implemented COVID-19 minimal pathways have shown to be safe for cancer patients requiring radical treatment, with limited complications and almost no COVID-19 infections.

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“…Nationwide solid data on the decrease of elective surgery during the lockdown period are lacking. ( 14 , 15 , 16 )…”

Section: Introductionmentioning

confidence: 99%

Impact of coronavirus disease 2019 (COVID-19) lockdown on in-hospital mortality and surgical activity in elective digestive resections: A nationwide cohort analysis

Challine

Dousset

de’Angelis

et al. 2021

Surgery

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Major cancer surgery during the coronavirus pandemic: experience from a tertiary referral center and COVID-19 hub in Northern Italy

Cited by 6 publications

References 5 publications

Impact of the COVID‐19 pandemic on urological cancers: The surgical experience of two cancer hubs in London and Milan

Impact of the COVID‐19 pandemic on urological cancers: The surgical experience of two cancer hubs in London and Milan

Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan

Impact of coronavirus disease 2019 (COVID-19) lockdown on in-hospital mortality and surgical activity in elective digestive resections: A nationwide cohort analysis

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