The provision of neuro-oncology and glioma neurosurgery during the SARS-CoV-2 pandemic: a single national tertiary centre experience

Abstract

Background The COVID-19 pandemic has resulted in a significant disruption in the provision of healthcare globally. The aim of this study was to assess the implications of the COVID-19 pandemic on the provision of neuro-oncology surgery and comparison with a similar 3-month period in 2019. Methods Retrospective review of prospectively curated database of patients requiring neuro-oncology surgery at our tertiary referral centre between 1st March 2020 and 31st May 2020. We also analysed data for the same time period (1st March-31st May) in 2019 for comparison. Number and type of tumours operated on, postoperative morbidity and mortality, COVID-19related complications and delays in treatment were recorded. Results During the 3-month periods studied in 2020 and 2019, there were 127 and 139 admissions for neuro-oncological surgery, respectively. Sixty patients underwent surgery for gliomas during the 2020 period vs 56 in the 2019 period. We observed no increase in mean length of time from referral to inter-hospital transfer (mean of 76 h in 2020 vs 93 h in 2019 (p = 0.10)) or in mean length of time from admission to surgery in the acute admissions (2.39 days in 2020 vs 2.89 days in 2019). The postoperative 30-day morbidity and mortality rates were lower in 2020; 8.7% (n = 11) compared with 10.1% (n = 14) in 2019. There was one COVID-19-related death which occurred in a patient with B cell lymphoma with negative preoperative COVID-19 test. Conclusion The provision of neuro-oncological surgery can be safely continued during respiratory illness epidemic or pandemic if a rigorous testing and staffing framework is implemented.

Systematic review and meta-analysis determining the effect of implemented COVID-19 guidelines on surgical oncology volumes and clinical outcomes

“…of performed surgical procedures pre-COVID-19 No. of performed surgical procedures COVID-19 Difference in percentages Waiting time in days pre-COVID-19 Waiting time in days COVID-19 Akhtar et al, 2021 [ 16 ] India Head and neck, GI, hepatobiliary, genitourinary, thorax, breast, sarcoma, skin April–September 2019 April–September 2020 598 410 −31% NR NR Amoo et al, 2021 [ 17 ] Ireland Glial tumors 1 March – 31 May 2019 1 March – 31 May 2020 56 60 +7% 2.89 2.39 Araujo et al, 2020 [ 18 ] Brazil Not specified March–May 2019 March–May 2020 607 242 −60% NR NR Blache et al, 2021 [ 19 ] France Gynecology 21 January – 16 March 2020 17 March – 12 May 2020 127 85 −33% NR NR Cadili et al, 2020 [ 20 ] Canada Breast 16 March – 30 April 2019 16 March – 30 April 2020 99 162 +64% 23 27 Drysdale et al, 2020 [ 21 ] ...…”

“…The eligible studies delivered data on variant oncological disciplines including central nervous system (CNS), thyroid, thoracic, breast, colorectal, hepatocellular, endocrine, genitourinary, prostate cancer, skin and soft tissue sarcomas [ [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] ]. Of these included studies, eight evaluated surgical procedures for breast cancer [ 23 , 25 , 32 , 37 , [39] , [40] , [41] , [42] ].…”

Impact of COVID-19 pandemic on the management of glioma patients around the world. An evidence-based review

“… Most participated hospitals will gradually resume their activities with no specific new plans. Amoo 2020 et al [14] Ireland An Irish tertiary referral center Acute admissions were higher than usual, while elective admissions were lower than usual. There was a slight delay in admission, while faster discharge than usual.…”

Critical View of Novel Treatment Strategies for Glioblastoma: Failure and Success of Resistance Mechanisms by Glioblastoma Cells

“…Systemic immunosuppressive effects of standard anticancer medication, such as surgery and combined radioand chemotherapy is a particular concern for glioblastoma patients. These patients are at a higher risk of infection and consequent complications (Amoo et al, 2020;Bernhardt et al, 2020;Noticewala et al, 2020).…”