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

Abstract

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.

Chronological development of in-patient oncology in times of COVID-19: a retrospective analysis of hospitalized oncology and COVID-19 patients of a German University Hospital

“…Other prominent sub-disciplines overcome the pandemic effects in the second year of observation (i.e., − 6% and + 2% for breast cancer C50; − 8% and + 1% for respiratory and thoracic cancer C30-39 ) or seem to be not affected at all (i.e., + 7% and + 3% for malignant skin cancer C43-C44; + 1% and + 2% for haemato- and lymphoid oncology C81-C96) . International findings are coherent with these developments and confirm this noxious but divergent developments (Jacob et al 2022 ; Kuzuu et al 2021 ; Monroy‐Iglesias et al 2022 ). Changes in sub-disciplines with small overall share (≤ 5% of overall oncology cases) tend to be biased by structural changes, managerial decisions, or changes in assigning out-patient physicians and practices, and display counterintuitive development (i.e., + 190% and 145% for bone and cartilage cancer C40-41, + 29% and + 25% for mesothelial cancer C45-C49).…”

Impact of COVID-19 on Uro-Oncological Patients: A Comprehensive Review of the Literature

“…Elderly and frailty patients could need an easier platform to be able to use such a useful tool in time of need. Vaccinations and implementation of COVID-19 pathways were essential to guarantee elective surgeries and follow up to uro-oncological patients [ 93 ]. Among the groups of people most susceptible to developing severe types of COVID-19 are oncological patients.…”

Seasonal events and journal milestones

“…On the topic of Covid-19 and our evolving understanding of global response strategies in health care, Monroy-Iglesias et al[3] present the outcomes of urologic cancer patients treated in the early pandemic months. To prevent catastrophic infections for patients about to have general anaesthesia, patients had to isolate for 14 days pre-surgery and have a negative Covid test.…”