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Nasser S, Fotopoulou C, Gültekin M, Dimitrova D, Bilir E, Inci G, Morice P, Mirza MR, Martin AG, Berek J, Sehouli J. Patient care and access to clinical trials in gynaecological oncology: global implications of the early phase of the COVID-19 pandemic. Arch Gynecol Obstet 2024; 310:577-586. [PMID: 38836928 PMCID: PMC11168972 DOI: 10.1007/s00404-024-07511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/07/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Our prospective international survey evaluated the impact of the early phase of the COVID-19 pandemic on the management gynaecological malignancies from the multidisciplinary physicians' perspective with particular focus on clinical infrastructures and trial participation. METHODS Our survey consisted of 53 COVID-related questions. It was sent to healthcare professionals in gynaecological oncology centres across Europe and Pan-Arabian region via the study groups and gynaecological societies from April 2020 to October 2020. All healthcare professionals treating gynaecological cancers were able to participate in our survey. RESULTS A total of 255 answers were collected from 30 countries. The majority (73%) of participants were gynaecological oncologists from university hospitals (71%) with at least an Intensive Care Unit with cardiopulmonary support available at their institutions. Most institutions continued to perform elective surgeries only for oncological cases (98%). Patients had to wait on average 2 weeks longer for their surgery appointments compared to previous years (range 0-12 weeks). Most cases that were prioritised for surgical intervention across all gynaecological tumours were early-stage disease (74%), primary situation (61%) and good ECOG status (63%). The radicality of surgery did not change in the majority of cases (78%) across all tumour types. During the pandemic, only 38% of clinicians stated they would start a new clinical trial. Almost half of the participants stated the pandemic negatively impacted the financial structure and support for clinical trials. Approximately 20% of clinicians did not feel well-informed regarding clinical algorithm for COVID-19 patients throughout the pandemic. Thirty percent stated that they are currently having trouble in providing adequate medical care due to staff shortage. CONCLUSION Despite well-established guidelines, pandemic clearly affected clinical research and patientcare. Our survey underlines the necessity for building robust emergency algorithms tailored to gynaecological oncology to minimise negative impact in crises and to preserve access to clinical trials.
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Affiliation(s)
- Sara Nasser
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany.
| | - Christina Fotopoulou
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
- Department of Gynecological Oncology, Queen Charlotte's Hospital, Imperial College London, London, UK
| | - Murat Gültekin
- Department of Gynecology and Obstetrics, Hacettepe University Hospitals, Ankara, Turkey
| | - Desislava Dimitrova
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | - Esra Bilir
- Department of Global Health, Koç University Graduate School of Health Sciences, Istanbul, Turkey
- Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Gülhan Inci
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
| | | | - Mansoor Raza Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jonathan Berek
- Stanford Women´S Cancer Center, Stanford University, Palo Alto, CA, USA
| | - Jalid Sehouli
- Department of Gynecology and Gynecological Oncology, Charite Campus Virchow Klinikum, Augustenburgerplatz 1, 13353, Berlin, Germany
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Lu H, Wang Y, Feng G, Shen C, Zhou X, Han J. The effect of the earliest COVID-19 outbreak on survival in uninfected advanced NSCLC patients receiving chemotherapy in Jiangsu Province, China: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e34559. [PMID: 37773874 PMCID: PMC10545141 DOI: 10.1097/md.0000000000034559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 07/12/2023] [Indexed: 10/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is still rampant and uncontrolled across the globe. China's strict epidemic prevention measures have had an impact on the treatment in patients with non-small cell lung cancer (NSCLC). The aim of this study is to explore the impact of the COVID-19 outbreak on the uninfected NSCLC patients. The chemotherapeutic efficacy and survival of 89 uninfected advanced NSCLC patients were retrospectively analyzed. The endpoints were overall survival (OS), progression-free survival (PFS), and response rate. Forty and forty-nine patients with advanced NSCLC received chemotherapy during the COVID-19 outbreak and nonoutbreak periods, respectively. Mean delay time was 12.8 months for COVID-19 outbreak stage versus 5.68 months for nonoutbreak stage (P = .003). There was no significant difference in the rates of chemotherapy delay and discontinuation between the 2 groups (P = .055 and .239). Significant difference was not detected in median OS (15.8 months) for COVID-19 outbreak stage versus 16.0 months for nonoutbreak stage (adjusted hazard ratio, 1.058; 95% confidence interval, 0.593-1.888; P = .849); Median PFS was 7.9 months for COVID-19 outbreak stage versus 10.3 months for nonoutbreak stage (adjusted hazard ratio, 0.878; 95% confidence interval 0.513-1.503; P = .634). There was also no statistical difference in the disease control rate between the 2 groups (P = .137). The earliest COVID-19 outbreak had no significant impact on the PFS and OS in uninfected advanced NSCLC patients receiving chemotherapy. However, the mean delay time of receiving chemotherapy was prolonged during the COVID-19 outbreak.
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Affiliation(s)
- Heng Lu
- Department of Pathology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Yue Wang
- Department of Pathology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu, China
| | - Guoqiang Feng
- Department of Radiation Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Chaoyan Shen
- Department of Radiation Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xingqin Zhou
- Department of Radiation Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Jie Han
- Department of Radiation Oncology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Cornford P, Halpin C, Sassmann J, Frankcom I, Braybrook S. Increased use of 6-monthly gonadotropin-releasing hormone agonist therapy for prostate cancer: a capacity and cost-minimization analysis for England. J Med Econ 2023; 26:208-218. [PMID: 36749636 DOI: 10.1080/13696998.2023.2172281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIMS The National Health Service (NHS) in England is facing extreme capacity pressures. The backbone of prostate cancer care is gonadotropin-releasing hormone agonist (GnRHa) therapy, commonly administered every month or 3 months. We estimated the cost and capacity savings associated with increased use of 6-monthly GnRHa therapy in England. METHODS A capacity and cost-minimization model including a societal perspective was developed (in Microsoft Excel) to generate cost and capacity estimates for GnRHa drug acquisition and administration for "Current practice" and for a "Base case" scenario. In the "Base case" scenario, 50% of patients who were receiving monthly or 3-monthly GnRHa therapy in "Current practice" switched/transitioned to a 6-monthly formulation. Cost/capacity estimates were calculated per patient per administration and scaled to annualized population levels. Sensitivity analyses were conducted to assess the impact of individual model assumptions: 1 tested the impact of drug acquisition costs; 2 and 3 tested the level of nurse grade and the time associated with treatment administration, respectively; 4 tested the rate of switch/transition to 6-monthly GnRHa therapy; and 5 tested differing diagnostic patterns following the coronavirus disease 2019 pandemic. RESULTS Compared with "Current practice", the "Base case" scenario was associated with annual cost savings of £5,164,296 (148,478 fewer appointments/year and 37,119 fewer appointment-hours/year). The largest savings were in drug administration (£2.2 million) and acquisition (£1.6 million) costs. Annual societal cost savings totaled £1.4 million, mainly in reduced appointment-related travel, productivity and leisure time opportunity losses. Increased use of 6-monthly versus monthly or 3-monthly GnRHa therapy consistently achieved system-wide annual cost and capacity savings across all sensitivity analysis scenarios. CONCLUSIONS Our holistic model suggests that switching/transitioning men from monthly or 3- monthly GnRHa therapy to a 6-monthly formulation can reduce NHS cost and capacity pressures and the societal and environmental costs associated with prostate cancer care.
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Affiliation(s)
- Philip Cornford
- Department of Urology, Royal Liverpool University Hospitals, Liverpool, UK
| | - Caolan Halpin
- Department of Market Access and Health Economics Outcomes Research, Ipsen, Slough, UK
| | | | - Ian Frankcom
- Department of Market Access and Health Economics Outcomes Research, Ipsen, Slough, UK
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Chavda VP, Ping FF, Chen ZS. An Impact of COVID-19 on Cancer Care: An Update. Vaccines (Basel) 2022; 10:vaccines10122072. [PMID: 36560482 PMCID: PMC9780966 DOI: 10.3390/vaccines10122072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/09/2022] Open
Abstract
The world has been affected socioeconomically for the last two years due to the emergence of different variants of the COVID-19 virus. Vaccination is the major and most efficient way to prevent the widening of this pandemic. Those who are having comorbidities are more vulnerable to serious infections due to their immunocompromised state. Additionally, cancer patients could be at significant risk for COVID-19. In this pandemic era, the diagnosis and treatment of cancer were significantly affected. Clinical trials at the initial stage were performed on healthy or COVID-19 infected patients. This produces a greater level of hesitancy in cancer patients. This review article provide an update regarding the vaccination and treatment for COVID-19 in patients with cancer and future directions.
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Affiliation(s)
- Vivek P. Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L. M. College of Pharmacy, Ahmedabad 380009, India
| | - Feng-Feng Ping
- Department of Reproductive Medicine, Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China
- Correspondence: (F.-F.P.); (Z.-S.C.)
| | - Zhe-Sheng Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John’s University, Queens, New York, NY 11439, USA
- Correspondence: (F.-F.P.); (Z.-S.C.)
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Lee KM, Bryant AK, Alba P, Anglin T, Robison B, Rose BS, Lynch JA. Impact of COVID-19 on the incidence of localized and metastatic prostate cancer among White and Black Veterans. Cancer Med 2022; 12:3727-3730. [PMID: 35984395 PMCID: PMC9538539 DOI: 10.1002/cam4.5151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic disrupted prostate-specific antigen (PSA) screening and prostate biopsy procedures. We sought to determine whether delayed screening and diagnostic workup of prostate cancer (PCa) was associated with increased subsequent rates of incident PCa and advanced PCa and whether the rates differed by race. We analyzed data from the Veterans Health Administration to assess the changes in the rates of PSA screening, prostate biopsy procedure, incident PCa, PCa with high-grade Gleason score, and incident metastatic prostate cancer (mPCa) before and after January 2020. While the late pandemic mPCa rate among White Veterans was comparable to the pre-pandemic rate (5.4 pre-pandemic vs 5.2 late-pandemic, p = 0.67), we observed a significant increase in incident mPCa cases among Black Veterans in the late pandemic period (8.1 pre-pandemic vs 11.3 late-pandemic, p < 0.001). Further investigation is warranted to fully understand the impact of the COVID-19 pandemic on the diagnosis of advanced prostate cancer.
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Affiliation(s)
- Kyung Min Lee
- VA Informatics and Computing InfrastructureVA Salt Lake City Health Care SystemSalt Lake CityUtahUSA
| | - Alex K. Bryant
- Department of Radiation OncologyVeterans Affairs Ann Arbor Healthcare SystemAnn ArborMichiganUSA,Department of Radiation OncologyUniversity of MichiganAnn ArborMichiganUSA
| | - Patrick Alba
- VA Informatics and Computing InfrastructureVA Salt Lake City Health Care SystemSalt Lake CityUtahUSA
| | - Tori Anglin
- VA Informatics and Computing InfrastructureVA Salt Lake City Health Care SystemSalt Lake CityUtahUSA
| | - Brian Robison
- VA Informatics and Computing InfrastructureVA Salt Lake City Health Care SystemSalt Lake CityUtahUSA
| | - Brent S. Rose
- VA San Diego Healthcare SystemSan DiegoCaliforniaUSA,Department of Radiation Medicine and Applied SciencesUniversity of California, San DiegoLa JollaCaliforniaUSA,Department of UrologyUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Julie A. Lynch
- VA Informatics and Computing InfrastructureVA Salt Lake City Health Care SystemSalt Lake CityUtahUSA
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Trends in Radiation Oncology Treatment Fractionation at a Single Academic Center, 2010-2020. Adv Radiat Oncol 2022; 7:101032. [PMID: 36072755 PMCID: PMC9441303 DOI: 10.1016/j.adro.2022.101032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/13/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Recent clinical trials suggest hypofractionated treatment regimens are appropriate for treatment of many cancers. It is important to understand and document hypofractionation adoption because of its implications for treatment center patient volumes. There is no recent U.S. study of trends in hypofractionation adoption that includes comparisons of multiple disease sites and data since the onset of COVID-19. In this context, this study describes trends in treatment fractionation at a single academic center from 2010 to 2020. Methods and Materials From an institutional database, records were extracted for treatment of 4 disease site categories: all cancers, breast cancer, prostate cancer, and bone metastases. For each disease site, the mean number of fractions per treatment course was reported for each year of the study period. To explore whether the COVID-19 pandemic was associated with increased hypofractionation adoption, piecewise linear regression models were used to estimate a changepoint in the time trend of mean monthly number of fractions per treatment course and to evaluate whether this changepoint coincided with pandemic onset. Results The data set included 22,865 courses of radiation treatment and 375,446 treatment fractions. The mean number of fractions per treatment course for all cancers declined from 17.5 in 2010 to 13.6 in 2020. There was increased adoption of hypofractionation at this institution for all cancers and specifically for both breast and prostate cancer. For bone metastases, hypofractionation had largely been adopted before the study period. For most disease sites, adoption of hypofractionated treatment courses occurred before pandemic onset. Bone metastases was the only disease site where a pandemic-driven increase in hypofractionation adoption could not be ruled out. Conclusions This study reveals increasing use of hypofractionated regimens for a variety of cancers throughout the study period, which largely occurred before the onset of the COVID-19 pandemic at this institution.
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7
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Turco F, Armstrong A, Attard G, Beer TM, Beltran H, Bjartell A, Bossi A, Briganti A, Bristow RG, Bulbul M, Caffo O, Chi KN, Clarke C, Clarke N, Davis ID, de Bono J, Duran I, Eeles R, Efstathiou E, Efstathiou J, Evans CP, Fanti S, Feng FY, Fizazi K, Frydenberg M, George D, Gleave M, Halabi S, Heinrich D, Higano C, Hofman MS, Hussain M, James N, Jones R, Kanesvaran R, Khauli RB, Klotz L, Leibowitz R, Logothetis C, Maluf F, Millman R, Morgans AK, Morris MJ, Mottet N, Mrabti H, Murphy DG, Murthy V, Oh WK, Ekeke Onyeanunam N, Ost P, O'Sullivan JM, Padhani AR, Parker C, Poon DMC, Pritchard CC, Rabah DM, Rathkopf D, Reiter RE, Rubin M, Ryan CJ, Saad F, Pablo Sade J, Sartor O, Scher HI, Shore N, Skoneczna I, Small E, Smith M, Soule H, Spratt D, Sternberg CN, Suzuki H, Sweeney C, Sydes M, Taplin ME, Tilki D, Tombal B, Türkeri L, Uemura H, Uemura H, van Oort I, Yamoah K, Ye D, Zapatero A, Gillessen S, Omlin A. What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021. Eur Urol 2022; 82:6-11. [PMID: 35393158 PMCID: PMC8849852 DOI: 10.1016/j.eururo.2022.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/04/2022] [Indexed: 12/19/2022]
Abstract
Patients with advanced prostate cancer (APC) may be at greater risk for severe illness, hospitalisation, or death from coronavirus disease 2019 (COVID-19) due to male gender, older age, potential immunosuppressive treatments, or comorbidities. Thus, the optimal management of APC patients during the COVID-19 pandemic is complex. In October 2021, during the Advanced Prostate Cancer Consensus Conference (APCCC) 2021, the 73 voting members of the panel members discussed and voted on 13 questions on this topic that could help clinicians make treatment choices during the pandemic. There was a consensus for full COVID-19 vaccination and booster injection in APC patients. Furthermore, the voting results indicate that the expert's treatment recommendations are influenced by the vaccination status: the COVID-19 pandemic altered management of APC patients for 70% of the panellists before the vaccination was available but only for 25% of panellists for fully vaccinated patients. Most experts (71%) were less likely to use docetaxel and abiraterone in unvaccinated patients with metastatic hormone-sensitive prostate cancer. For fully vaccinated patients with high-risk localised prostate cancer, there was a consensus (77%) to follow the usual treatment schedule, whereas in unvaccinated patients, 55% of the panel members voted for deferring radiation therapy. Finally, there was a strong consensus for the use of telemedicine for monitoring APC patients. PATIENT SUMMARY: In the Advanced Prostate Cancer Consensus Conference 2021, the panellists reached a consensus regarding the recommendation of the COVID-19 vaccine in prostate cancer patients and use of telemedicine for monitoring these patients.
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Affiliation(s)
- Fabio Turco
- Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Division of Medical Oncology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.
| | - Andrew Armstrong
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA
| | | | - Tomasz M Beer
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Himisha Beltran
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | - Alberto Bossi
- Genito Urinary Oncology, Prostate Brachytherapy Unit, Goustave Roussy, Paris, France
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Rob G Bristow
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Christie NHS Trust and CRUK Manchester Institute and Cancer Centre, Manchester, UK
| | - Muhammad Bulbul
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | - Kim N Chi
- BC Cancer, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Clarke
- Research Department of Primary Care & Population Health, Royal Free Campus, University College London, Rowland Hill St, London, UK
| | - Noel Clarke
- The Christie and Salford Royal Hospitals, Manchester, UK
| | - Ian D Davis
- Monash University and Eastern Health, Victoria, Australia
| | - Johann de Bono
- The Institute of Cancer Research/Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Ignacio Duran
- Department of Medical Oncology. Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Cantabria, Spain
| | - Ros Eeles
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jason Efstathiou
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Stefano Fanti
- Policlinico S. Orsola, Università di Bologna, Bologna, Italy
| | - Felix Y Feng
- University of California, San Francisco, San Francisco, CA, USA
| | - Karim Fizazi
- Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - Mark Frydenberg
- Department of Surgery, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Department of Anatomy & Developmental Biology, Faculty of Nursing, Medicine & Health Sciences, Monash University, Melbourne, Australia
| | - Dan George
- Departments of Medicine and Surgery, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Martin Gleave
- Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - Susan Halabi
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Daniel Heinrich
- Department of Oncology and Radiotherapy, Innlandet Hospital Trust, Gjøvik, Norway
| | - Celestia Higano
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Hofman
- Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Maha Hussain
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | | | - Rob Jones
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Raja B Khauli
- Department of Urology and the Naef K. Basile Cancer Institute (NKBCI), American University of Beirut Medical Center, Beirut, Lebanon
| | - Laurence Klotz
- Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Raya Leibowitz
- Oncology institute, Shamir Medical Center, Zerifin, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Christopher Logothetis
- Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston, TX, USA; Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, Athens, Greece; David H. Koch Centre, Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Centre, Houston, TX, USA
| | - Fernando Maluf
- Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brazil; Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | | - Alicia K Morgans
- Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Hind Mrabti
- National Institute of Oncology, University hospital, Rabat, Morocco
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | | | - William K Oh
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
| | - Ngozi Ekeke Onyeanunam
- Department of Surgery, University of Port Harcourt Teaching Hospital, Alakahia, Port Harcourt, Nigeria
| | - Piet Ost
- Department of Radiation Oncology, Iridium Netwerk, Wilrijk (Antwerp), Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Joe M O'Sullivan
- Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland; Northern Ireland Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland
| | - Anwar R Padhani
- Mount Vernon Cancer Centre and Institute of Cancer Research, London, UK
| | | | - Darren M C Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Colin C Pritchard
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Danny M Rabah
- The Cancer Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Dana Rathkopf
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Mark Rubin
- Bern Center for Precision Medicine, Bern, Switzerland; Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Charles J Ryan
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Fred Saad
- Centre Hospitalier de Université de Montréal, Montreal, Canada
| | | | | | - Howard I Scher
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, SC, USA
| | - Iwona Skoneczna
- Rafal Masztak Grochowski Hospital in Warsaw, Warsaw, Poland; Maria Sklodowska Curie National Research Institute of Oncology, Warsaw, Poland
| | - Eric Small
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Matthew Smith
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Howard Soule
- Prostate Cancer Foundation, Santa Monica, CA, USA
| | - Daniel Spratt
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Cora N Sternberg
- Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, USA; Division of Hematology and Oncology, Meyer Cancer Center, New York Presbyterian Hospital, New York, NY, USA
| | | | - Christopher Sweeney
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Matthew Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Mary-Ellen Taplin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | | | - Levent Türkeri
- Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey
| | - Hiroji Uemura
- Yokohama City University Medical Center, Yokohama, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Inge van Oort
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kosj Yamoah
- Department of Radiation Oncology & Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, FL, USA
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Almudena Zapatero
- Department of Radiation Oncology, Hospital Universitario de La Princesa, Health Research Institute, Madrid, Spain
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Universita della Svizzera Italiana, Lugano, Switzerland; Cantonal Hospital, St. Gallen, Switzerland; University of Bern, Bern, Switzerland; Division of Cancer Science, University of Manchester, Manchester, UK
| | - Aurelius Omlin
- University of Bern, Bern, Switzerland; Department of Medical Oncology and Haematology, Cantonal Hospital, St. Gallen, Switzerland
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8
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Gomes CM, de Souza JD, Anzolch KMJ, Henriques JVT, Nogueira L, Pimentel E, Fernandes RDC, Canalini AF, de Bessa J. Is it safe to resume large scale in-person medical meetings? Int Braz J Urol 2022; 48:857-863. [PMID: 35594330 PMCID: PMC9388187 DOI: 10.1590/s1677-5538.ibju.2022.0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cristiano M. Gomes
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julia Duarte de Souza
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil,Julia Duarte de Souza, MD, Divisao de Clinica Urologica Hospital das Clinicas da Universidade de São Paulo Avenida Dr. Eneas de Carvalho Aguiar, 255 Sala 710F, 7 Andar São Paulo, SP, 05403-000, Brasil. Telephone: +55 11 2661-8080 Fax: +55 11 3064-7013 E-mail:
| | - Karin M. J. Anzolch
- Hospital Moinhos de VentoDepartamento de UrologiaPorto AlegreRSBrasilDepartamento de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - João Victor T. Henriques
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Lucas Nogueira
- Universidade Federal de Minas GeraisHospital das ClínicasDepartamento de UrologiaBelo HorizonteMGBrasilDepartamento de Urologia do Hospital das Clínicas, Universidade Federal de Minas Gerais – UFMG, Belo Horizonte, MG, Brasil
| | - Eduardo Pimentel
- Hospital de Base do Distrito FederalDepartamento de UrologiaBrasíliaDFBrasilDepartamento de Urologia, Hospital de Base do Distrito Federal, Brasília, DF, Brasil
| | - Roni de C. Fernandes
- Santa Casa de São PauloFaculdade de MedicinaSão PauloSPBrasilFaculdade de Medicina, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Alfredo F. Canalini
- Universidade do Rio de JaneiroDepartamento de UrologiaRio de JaneiroRJBrasilDepartamento de Urologia, Universidade do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - José de Bessa
- Universidade de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade de Feira de Santana, Feira de Santana, BA, Brasil
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9
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Ashkenazi MS, Huseby OL, Kroken G, Soto-Mota A, Pents M, Loschiavo A, Lewandowska R, Tran G, Kwiatkowski S. COVID-19 pandemic and the consequential effect on patients with endometriosis. Hum Reprod Open 2022; 2022:hoac013. [PMID: 35386120 PMCID: PMC8982367 DOI: 10.1093/hropen/hoac013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What was the effect of the coronavirus disease 2019 (COVID-19) pandemic on healthcare and quality of life in those suffering from endometriosis? SUMMARY ANSWER Our study reveals a clear correlation between the deterioration of the reported physical and mental state and impaired medical care for patients suffering from endometriosis during the COVID-19 pandemic. WHAT IS KNOWN ALREADY The quality of life of patients suffering from endometriosis is compromised in a variety of aspects. In response to the ongoing COVID-19 pandemic, self-isolation practices aimed at curbing the spread of COVID-19 have severely complicated the availability of proper medical care worldwide. STUDY DESIGN SIZE DURATION The study involved a cross-sectional international self-reported online survey. Responses were accepted between November 2020 and January 2021. The survey was prepared by the Department of Obstetrics and Gynaecology in a medical university setting. The survey contained 17 questions and was placed online. Cooperation with different endometriosis organizations around the world enabled distribution of the survey through their social media platforms. PARTICIPANTS/MATERIALS SETTING METHODS The study participants (n = 3024 replies) originated from 59 countries. The questionnaire was created after a literature review and is partially based on the validated quality of life questionnaires, adjusted to the study question. The survey was then translated to 15 other languages following World Health Organization recommendations as closely as possible. Chi-square tests for independence were carried out for the analysis of the two variables: suspension of health services, and the patients mental and physical well-being. MAIN RESULTS AND THE ROLE OF CHANCE Out of 3024 participants from 59 countries who submitted the questionnaire between November 2020 and January 2021, 2964 (98.01%) provided information that enabled a full analysis. For the 1174 participants who had their medical appointments cancelled, 43.7% (n = 513) reported that their symptoms had been aggravated, and 49.3% (n = 579) reported that their mental state had worsened.In comparison, of the 1180 participants who kept their appointments, only 29.4% (n = 347) stated that their symptoms had been aggravated, and 27.5% (n = 325) stated their mental health had worsened. The results showed that there was a significant link between the reported deterioration of mental and physical wellbeing and impaired medical care (cancellation) (P ≪ 0.001). A total of 610 participants did not have medical appointments scheduled, and these participants followed a similar pattern as the participants who kept their appointments, with 29.0% (n = 177) reporting aggravation of symptoms and 28.2% (n = 172) reporting that their mental state had worsened. LIMITATIONS REASONS FOR CAUTION Cultural differences among international participants are to be expected and this may have affected how participants from different countries interpreted and answered the questionnaire. Translating the questionnaire into 15 different languages, even though incorporating backwards translation, could possibly lead to different interpretations of given questions, simply based on different wording in the languages. The majority of respondents (around 90%) were from Europe and South America and therefore the findings may not be generalizable to other locations. WIDER IMPLICATIONS OF THE FINDINGS Further research is needed to assess the true impact and long-term consequences of the COVID-19 pandemic for patients living with endometriosis. STUDY FUNDING/COMPETING INTERESTS This study received no funding and the authors declare they have no relevant conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
| | | | | | - Adrian Soto-Mota
- Metabolic Diseases Research Unit of the National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Grace Tran
- Center for Criminology and Sociolegal Studies, University of Toronto, Toronto, Canada
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10
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Elkrief A, Wu JT, Jani C, Enriquez KT, Glover M, Shah MR, Shaikh HG, Beeghly-Fadiel A, French B, Jhawar SR, Johnson DB, McKay RR, Rivera DR, Reuben DY, Shah S, Tinianov SL, Vinh DC, Mishra S, Warner JL. Learning through a Pandemic: The Current State of Knowledge on COVID-19 and Cancer. Cancer Discov 2022; 12:303-330. [PMID: 34893494 PMCID: PMC8831477 DOI: 10.1158/2159-8290.cd-21-1368] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/26/2021] [Accepted: 12/09/2021] [Indexed: 12/15/2022]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has left patients with current or past history of cancer facing disparate consequences at every stage of the cancer trajectory. This comprehensive review offers a landscape analysis of the current state of the literature on COVID-19 and cancer, including the immune response to COVID-19, risk factors for severe disease, and impact of anticancer therapies. We also review the latest data on treatment of COVID-19 and vaccination safety and efficacy in patients with cancer, as well as the impact of the pandemic on cancer care, including the urgent need for rapid evidence generation and real-world study designs. SIGNIFICANCE: Patients with cancer have faced severe consequences at every stage of the cancer journey due to the COVID-19 pandemic. This comprehensive review offers a landscape analysis of the current state of the field regarding COVID-19 and cancer. We cover the immune response, risk factors for severe disease, and implications for vaccination in patients with cancer, as well as the impact of the COVID-19 pandemic on cancer care delivery. Overall, this review provides an in-depth summary of the key issues facing patients with cancer during this unprecedented health crisis.
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Affiliation(s)
- Arielle Elkrief
- Division of Medical Oncology (Department of Medicine), McGill University Health Centre, Montreal, Quebec, Canada
| | - Julie T Wu
- Stanford University, Palo Alto, California
| | - Chinmay Jani
- Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts
| | - Kyle T Enriquez
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Mansi R Shah
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | | | | | - Sachin R Jhawar
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | | | - Rana R McKay
- University of California San Diego, San Diego, California
| | - Donna R Rivera
- Division of Cancer Control and Population Services, National Cancer Institute, Rockville, Maryland
| | - Daniel Y Reuben
- Medical University of South Carolina, Charleston, South Carolina
| | - Surbhi Shah
- Hematology and Oncology, Mayo Clinic Arizona, Phoenix, Arizona
| | - Stacey L Tinianov
- Advocates for Collaborative Education, UCSF Breast Science Advocacy Core, San Francisco, California
| | - Donald Cuong Vinh
- Division of Infectious Diseases (Department of Medicine), Divisions of Medical Microbiology and of Molecular Diagnostics (OptiLab), McGill University Health Centre, Montreal, Quebec, Canada
| | - Sanjay Mishra
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeremy L Warner
- Vanderbilt University Medical Center, Nashville, Tennessee.
- Vanderbilt University, Nashville, Tennessee
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11
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Pecoraro A, Roussel E, Serni S, Campi R. Re-envisioning Patient Education and Public Awareness of Urological Cancers at the Time of the COVID-19 Pandemic. EUR UROL SUPPL 2022; 38:67-68. [PMID: 35224515 PMCID: PMC8864105 DOI: 10.1016/j.euros.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alessio Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Eduard Roussel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands
- Corresponding author. Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi di Firenze, Largo Brambilla 3, 50134 Firenze, Italy. Tel. +39 055 2758020; Fax: +39 055 2758014.
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12
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Crocerossa F, Visser W, Carbonara U, Falagario UG, Pandolfo SD, Loizzo D, Imbimbo C, Klausner AP, Porpiglia F, Damiano R, Cantiello F, Autorino R. The impact the COVID-19 pandemic on urology literature: a bibliometric analysis. Cent European J Urol 2022; 75:102-109. [PMID: 35591965 PMCID: PMC9074064 DOI: 10.5173/ceju.2021.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction The COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. The impact of these changes on peer-reviewed research journals, including those dedicated to urology, is still unknown. Material and methods The Web of Science database was queried to retrieve all COVID-19 urological articles written in English language and published between January 1st, 2020 and December 10th, 2021. Only original and review articles were considered. A bibliometric analysis of the total number of papers, citations, institutions and publishing journals was performed. Non-COVID-19 publications were also retrieved to compare the duration of publication stages. Results A total of 428 COVID-19 articles and 14,874 non-COVID-19 articles were collected. Significant differences in the duration of all the publication stages were found between COVID-19 and non-COVID-19 articles (all p <0.001). The most productive countries were the USA (100 articles), Italy (59 articles) and the United Kingdom (55 articles). The published literature has focused on four topics: COVID-19 genitourinary manifestations, management of urological diseases during the pandemic, repercussions on quality of life and impact on healthcare providers. Conclusions A significant reduction in peer review time for COVID-19 articles might raise concerns regarding the quality of peer review itself. USA, Italy and UK published the highest number of COVID-19 related articles. Restrictive measures taken by governments to reduce the spread of infection had a strong impact on mental stress and anxiety of patients and healthcare professionals. A coerced deferral of diagnosis and treatment of emergencies and uro-oncological cases represented the most challenging task from a clinical standpoint.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - William Visser
- Division of Urology, VCU Health, Richmond, Virginia, USA
| | - Umberto Carbonara
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Ugo Giovanni Falagario
- Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Savio Domenico Pandolfo
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Davide Loizzo
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | | | - Francesco Porpiglia
- Division of Urology, San Luigi Hospital University of Turin, Orbassano, Italy
| | - Rocco Damiano
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Khene ZE, Guérin S, Khene F, Pradère B, Roumiguié M, Mathieu R, Pignot G, Massard C, Neuzillet Y, Ploussard G, Bigot P, De la taille A, Rouprêt M, Bensalah K. Online Public Interest in Urological Cancers During the COVID-19 Pandemic: What Can “Dr. Google” Teach Us? EUR UROL SUPPL 2022; 37:73-79. [PMID: 35072118 PMCID: PMC8761543 DOI: 10.1016/j.euros.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 01/23/2023] Open
Abstract
Background Objective Design, setting, and participants Outcome measurements and statistical analysis Results and limitations Conclusions Patient summary
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14
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Guerrieri R, Rovati L, Dell’Oglio P, Galfano A, Ragazzoni L, Aseni P. Impact of the COVID-19 Pandemic on Urologic Oncology Surgery: Implications for Moving Forward. J Clin Med 2021; 11:171. [PMID: 35011911 PMCID: PMC8745246 DOI: 10.3390/jcm11010171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic has caused the destruction of routine hospital services globally, leading to an increase in the backlog of elective surgery cases. The aim of the study was to retrospectively investigate the pandemic's impact on the urologic oncology surgical activity of a high-volume center located in Milan, Italy. The number and type of procedures performed in 2020 during the COVID-19 pandemic was evaluated using 2019 data as control. Waiting times for each surgical procedure were compared, on a bimonthly basis, between the two different years. Overall, a 26.7% reduction in the number of urologic oncology surgeries between 2019 and 2020 was observed (2019: 720, 2020: 528). Both the main indication for surgery and the type of procedure performed significantly differed between 2019 and 2020 (all p < 0.0001), with a decrease in the number of radical prostatectomies and an increase in the number of radical cystectomies and radical nephrectomies/nephroureterectomies performed in 2020. Waiting time decreased by 20% between 2019 and 2020, with the most significant reduction seen after the first wave of the COVID-19 pandemic (July-October 2020), in particular for partial nephrectomy and radical prostatectomy, possibly due to the underdiagnosis of cases. In conclusion, in accordance with recommendations by international urological societies on prioritization strategies for oncological procedures, a higher proportion of surgeries for high-risk tumors was performed in 2020 at our center at the expense of procedures for lower risk diseases; however, future implications for patients' prognosis still need to be determined.
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Affiliation(s)
- Rossella Guerrieri
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
| | - Lucrezia Rovati
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy
| | - Paolo Dell’Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (P.D.); (A.G.)
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (P.D.); (A.G.)
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy;
| | - Paolo Aseni
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, 20157 Milano, Italy
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15
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Consultations for clinical features of possible cancer and associated urgent referrals before and during the COVID-19 pandemic: an observational cohort study from English primary care. Br J Cancer 2021; 126:948-956. [PMID: 34934176 PMCID: PMC8691390 DOI: 10.1038/s41416-021-01666-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/15/2021] [Accepted: 12/02/2021] [Indexed: 02/07/2023] Open
Abstract
Background It remains unclear to what extent reductions in urgent referrals for suspected cancer during the COVID-19 pandemic were the result of fewer patients attending primary care compared to GPs referring fewer patients. Methods Cohort study including electronic health records data from 8,192,069 patients from 663 English practices. Weekly consultation rates, cumulative consultations and referrals were calculated for 28 clinical features from the NICE suspected cancer guidelines. Clinical feature consultation rate ratios (CRR) and urgent referral rate ratios (RRR) compared time periods in 2020 with 2019. Findings Consultations for cancer clinical features decreased by 24.19% (95% CI: 24.04–24.34%) between 2019 and 2020, particularly in the 6–12 weeks following the first national lockdown. Urgent referrals for clinical features decreased by 10.47% (95% CI: 9.82–11.12%) between 2019 and 2020. Overall, once patients consulted with primary care, GPs urgently referred a similar or greater proportion of patients compared to previous years. Conclusion Due to the significant fall in patients consulting with clinical features of cancer there was a lower than expected number of urgent referrals in 2020. Sustained efforts should be made throughout the pandemic to encourage the public to consult their GP with cancer clinical features.
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16
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Zi H, He SH, Leng XY, Xu XF, Huang Q, Weng H, Zhu C, Li LY, Gu JM, Li XH, Ming DJ, Li XD, Yuan S, Wang XH, He DL, Zeng XT. Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990-2019. Mil Med Res 2021; 8:60. [PMID: 34819142 PMCID: PMC8611255 DOI: 10.1186/s40779-021-00354-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 11/01/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. METHODS We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. RESULTS Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = - 0.68 and - 0.83, respectively) and prostate cancer (EAPC = - 0.75 and - 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. CONCLUSIONS Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.
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Affiliation(s)
- Hao Zi
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Shao-Hua He
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Precision Medicine Centre, The Second People’s Hospital of Huaihua, Huaihua, 418000 China
| | - Xie-Yuan Leng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- The First School of Clinical Medicine, Anhui Medical University, Hefei, 230000 China
| | - Xiao-Feng Xu
- Department of Urology, Xianyang Central Hospital, Xianyang, 712000 China
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 China
| | - Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Hong Weng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Cong Zhu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Lu-Yao Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000 China
| | - Jia-Min Gu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Xu-Hui Li
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Dao-Jing Ming
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000 China
| | - Xiao-Dong Li
- Institutes of Evidence-Based Medicine and Knowledge Translation, Henan University, Kaifeng, 475000 China
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng, 475000 China
| | - Shuai Yuan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
| | - Xing-Huan Wang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Institute of Urology, Wuhan University, Wuhan, 430071 China
| | - Da-Lin He
- Department of Urology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 China
| | - Xian-Tao Zeng
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071 China
- Institute of Urology, Wuhan University, Wuhan, 430071 China
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Campi R, Tellini R, Grosso AA, Pecoraro A, Mari A, Raspollini MR, Gacci M, Carini M, Serni S, Minervini A. Exploring the Diversity and Predictors of Histopathological Findings Across the European Association of Urology Guidelines Office Rapid Reaction Group Priority Groups for Patients with Renal Tumors: Implications for Individualized Prioritization of Renal Cancer Care. EUR UROL SUPPL 2021; 34:5-9. [PMID: 34761237 PMCID: PMC8567362 DOI: 10.1016/j.euros.2021.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 12/17/2022] Open
Abstract
In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines Office Rapid Reaction Group (GORRG) defined priority groups to guide the prioritization of surgery for nonmetastatic renal cell carcinoma (RCC). In this study we explored the diversity and predictors of histopathological findings across the EAU GORRG priority groups using a large database of 1734 consecutive patients undergoing elective surgery for nonmetastatic renal masses between 2017 and 2020 at a referral institution. Overall, 940 (54.2%), 358 (20.6%), and 436 (25.2%) patients were classified as low-, intermediate-, and high-priority, respectively. The low-, intermediate-, and high-risk groups significantly differed regarding all primary histopathological outcomes: benign histology (21.6% vs 15.9% vs 6.4%; p < 0.001); non–organ-confined disease (5.0% vs 19.0% vs 45.4%; p < 0.001); and adverse pathological features according to validated prognostic models (including the median Leibovich score for clear-cell RCC: 0 vs 2 vs 4; p < 0.001). On multivariable analysis, beyond the EAU GORRG priority groups, specific patient and/or tumor-related characteristics were independent predictors of the aforementioned histopathological outcomes. To the best of our knowledge, our study shows for the first time the value of the EAU GORRG priority groups from a histopathological standpoint and supports implementation of such a prioritization scheme beyond the COVID-19 pandemic. Patient summary During the COVID-19 pandemic, the European Association of Urology designed a scheme to prioritize patients needing surgery for kidney cancer according to their tumor characteristics and symptoms. We used results from our hospital database to test the scheme and found that the priority classification can be used to predict cancer outcomes after surgery. This scheme may be useful in prioritizing kidney cancer surgeries after the COVID-19 pandemic.
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Affiliation(s)
- Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Riccardo Tellini
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Antonio Andrea Grosso
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Alessio Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Maria Rosaria Raspollini
- Histopathology and Molecular Diagnostics, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Marco Carini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
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18
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Amparore D, Checcucci E, Serni S, Minervini A, Gacci M, Esperto F, Fiori C, Porpiglia F, Campi R. Urology Residency Training at the Time of COVID-19 in Italy: 1 Year After the Beginning. EUR UROL SUPPL 2021; 31:37-40. [PMID: 34396350 PMCID: PMC8342892 DOI: 10.1016/j.euros.2021.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 10/29/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in urology practice and residency programs. One year ago, the first nationwide survey on this topic showed a dramatic impact of the acute phase of the pandemic on residents' training activities. Aiming to assess for the first time how the COVID-19 scenario reshaped the pattern of urology training over a whole pandemic year, a cross-sectional, 38-item, web-based survey was developed. Residents scored the percentage decrease of their involvement in various clinical and surgical activities during the period of March 2020-March 2021 (as compared with the pre-COVID period). Overall, 312/585 (53.3%) residents from 27 schools of urology were included. The proportions of those experiencing a significant decrease of training exposure were 13.6%, 28.8%, 26.7%, 46.9%, 37.6%, and 33.3% (as compared with 40.2%, 85.8%. 82.3%, 69.7%, 59.7%, and 50.2% in the previous survey) for on-call activities, outpatient visits, diagnostic procedures, endoscopic surgery, open surgery, and minimally invasive surgery, respectively. The most impactful reductions in training activities were reached by final-year residents. Our findings highlight that, even if less burdensome than expected, urology residency training (especially in endoscopic surgery) was highly affected throughout the whole past year. This critical gap of skills may jeopardize residents' training even beyond the COVID-19 pandemic. PATIENT SUMMARY In this study, we assessed whether the training activities of Italian urology residents were impacted negatively by a whole year of COVID-19 pandemic (March 2020-March 2021). We also compared our results with those reported in a previous survey evaluating how the coronavirus disease 2019 (COVID-19) pandemic changed the training pattern of urology residents during the peak of the outbreak in March 2020. We found a critical decrease in residents' activities (especially for those in their final years of residency and for surgical procedures) that, even if lower than expected, might negatively impact their education and training in the future.
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Affiliation(s)
- Daniele Amparore
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Enrico Checcucci
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - Sergio Serni
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesco Esperto
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
- Department of Urology, Campus Biomedico University, Rome, Italy
| | - Cristian Fiori
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Riccardo Campi
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
| | - on behalf of the European Society of Residents in Urology (ESRU)
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
- European Society of Residents in Urology (ESRU), Arnhem, The Netherlands
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Urological Oncologic Minimally-Invasive Robotic Surgery and Andrology, University of Florence, Careggi Hospital, Florence, Italy
- Department of Urology, Campus Biomedico University, Rome, Italy
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19
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Frumer M, Aharony SM, Shoshany O, Kedar D, Baniel J, Golan S. Trends in urological emergencies in the Era of COVID-19. Int Braz J Urol 2021; 47:997-1005. [PMID: 34260177 PMCID: PMC8321443 DOI: 10.1590/s1677-5538.ibju.2020.1092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate trends in emergency room (ER) urological conditions during COVID-19 pandemic lockdown. MATERIALS AND METHODS Retrospective analyses of renal colic, hematuria, and urinary retention in ER's admissions of a tertiary hospital during the lockdown period (March 19 to May 4, 2020) in Israel. Patient's demographics and clinical characteristics were compared to those in corresponding periods during 2017-2019, with estimated changes in ER arrival and waiting times, utilization of imaging tests, numbers of hospitalizations, and urgent procedure rates. RESULTS The number of ER visits for renal colic, hematuria, and urinary retention decreased by 37%, from an average of 451 (2017-2019) to 261 patients (2020). Clinical severity was similar between groups, with no major differences in patient's age, vital signs, or laboratory results. The proportion of ER visits during night hours increased significantly during lockdown (44.8% vs. 34.2%, p=0.002). There was a decrease in renal colic admission rate from 19.8% to 8.4% (p=0.001) without differences in urgent procedures rates, while the 30-day revisit rate decreased from 15.8% to 10.3% during lockdown (p=0.02). CONCLUSIONS General lockdown was accompanied by a significant decrease in common urological presentations to the ER. This change occurred across the clinical severity spectrum of renal colic, hematuria, and urinary retention. In the short term, it appears that patients who sought treatment did not suffer from complications that could be attributed to late arrival or delay in treatment. The long-term implications of abstinence from seeking emergent care are not known and require further investigation.
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Affiliation(s)
- Michael Frumer
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
| | - Shachar M. Aharony
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ohad Shoshany
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Kedar
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jack Baniel
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Golan
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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20
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Bertholet J, Aznar MC, Garibaldi C, Thwaites D, Gershkevitsh E, Thorwarth D, Verellen D, Heijmen B, Hurkmans C, Muren L, Redalen KR, Siebert FA, Schwarz M, Van Elmpt W, Georg D, Jornet N, Clark CH. Professional practice changes in radiotherapy physics during the COVID-19 pandemic. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2021; 19:25-32. [PMID: 34179522 PMCID: PMC8216850 DOI: 10.1016/j.phro.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/29/2021] [Accepted: 06/12/2021] [Indexed: 11/11/2022]
Abstract
The experience of 433 medical physicists during COVID-19 was analysed. Changes in clinical practice had an impact on treatment planning and quality assurance tasks. The effects of the changes were perceived differently by management vs clinical medical physicists. There is a clear willingness to learn from this experience.
Background and purpose The COVID-19 pandemic has imposed changes in radiotherapy (RT) departments worldwide. Medical physicists (MPs) are key healthcare professionals in maintaining safe and effective RT. This study reports on MPs experience during the first pandemic peak and explores the consequences on their work. Methods A 39-question survey on changes in departmental and clinical practice and on the impact for the future was sent to the global MP community. A total of 433 responses were analysed by professional role and by country clustered on the daily infection numbers. Results The impact of COVID-19 was bigger in countries with high daily infection rate. The majority of MPs worked in alternation at home/on-site. Among practice changes, implementation and/or increased use of hypofractionation was the most common (47% of the respondents). Sixteen percent of respondents modified patient-specific quality assurance (QA), 21% reduced machine QA, and 25% moved machine QA to weekends/evenings. The perception of trust in leadership and team unity was reversed between management MPs (towards increased trust and unity) and clinical MPs (towards a decrease). Changes such as home-working and increased use of hypofractionation were welcomed. However, some MPs were concerned about pressure to keep negative changes (e.g. weekend work). Conclusion COVID-19 affected MPs through changes in practice and QA procedures but also in terms of trust in leadership and team unity. Some changes were welcomed but others caused worries for the future. This report forms the basis, from a medical physics perspective, to evaluate long-lasting changes within a multi-disciplinary setting.
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Affiliation(s)
- Jenny Bertholet
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Division of Medical Radiation Physics, Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Corresponding author.
| | - Marianne C. Aznar
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Cristina Garibaldi
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Unit of Radiation Research, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - David Thwaites
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia
- Medical Physics, Leeds Institute of Cancer and Pathology, School of Medicine, Leeds University, Leeds, UK
| | - Eduard Gershkevitsh
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- North Estonia Medical Centre, Tallinn, Estonia
| | - Daniela Thorwarth
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Section for Biomedical Physics, Department of Radiation Oncology, University Hospital Tübingen, Germany
| | - Dirk Verellen
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Iridium Network, Antwerp University (Faculty of Medicine and Health Sciences), Antwerp, Belgium
| | - Ben Heijmen
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, The Netherlands
| | - Coen Hurkmans
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Catharina Hospital, Department of Radiation Oncology, Eindhoven, The Netherlands
| | - Ludvig Muren
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Kathrine Røe Redalen
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frank-André Siebert
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Clinic of Radiotherapy, University Hospital of Schleswig-Holstein, Campus Kiel, Germany
| | - Marco Schwarz
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Proton Therapy Department, Trento Hospital, TIFPA-INFN, Trento, Italy
| | - Wouter Van Elmpt
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Department of Radiation Oncology (MAASTRO), GROW – School for Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Dietmar Georg
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Division Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna, AKH Wien, Austria
| | - Nuria Jornet
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Servei de Radiofísica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Catharine H. Clark
- European Society for Radiotherapy and Oncology (ESTRO), Physics Committee, Brussels, Belgium
- Department of Radiotherapy Physics, University College London Hospital, UK
- Department of Medical Physics and Bioengineering, University College London, UK
- National Physical Laboratory, London, UK
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21
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Bersanelli M, Porta C. Impact of SARS-CoV-2 Pandemic on Kidney Cancer Management. KIDNEY CANCER 2021. [DOI: 10.3233/kca-210112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The SARS-CoV-2 pandemic still has a huge impact on the management of many chronic diseases such as cancer. Few data are presently available reagarding how the management of renal cell carcinoma (RCC) has changed due to this unprecedented situation. OBJECTIVE: To discuss the challenges and issues of the diagnosis and treatment of RCC in the COVID-19 era, and to provide recommendations based on the collected literature and our personal experience. METHODS: Systematic review of the available Literature regarding the management of RCC during the SARS-CoV-2 pandemic. RESULTS: Our review showed a prevalence of narrative publications, raising the issue of the real relevance of the evidence retrieved. Indeed, the only original data about RCC and COVID-19 found were a small retrospective case series and two surveys, providing either patients’ or physicians’ viewpoints. CONCLUSIONS: The expected delayed diagnosis of RCC could lead to an increase of advanced/metastatic cases; thus, proper therapeutic choices for patients with small renal masses should be carefully evaluated case by case, in order to avoid negative effects on long-term survival rates. The controversial interaction between immune checkpoint blockade and COVID-19 pathogenesis is more hypothetical than evidence-based, and thus immunotherapy should not be denied, whenever appropriate. To avoid treatments which won’t have an impact on patients’ survival, a honest and accurate evaluation of the cost/benefit ratio of each treatment option should be always performed. Finally, SARS-CoV-2 swab positivity should not prevent the continuation of ongoing active treatments in asymptomatic cases, or or after symptoms’ resolution.
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Affiliation(s)
- Melissa Bersanelli
- Medicine and Surgery Department, University of Parma and Medical Oncology Unit, University Hospital of Parma, Parma, Italy
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari ‘A. Moro’ and Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
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22
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Margolin EJ, Pina Martina LA, Miles CH, Wenske S, McKiernan JM, DeCastro GJ, Hyams ES, Drake CG, Lim EA, Stein MN, Deutsch I, Anderson CB. Telemedicine in management of genitourinary malignancies: Patient and physician perspectives. Urol Oncol 2021; 39:480-486. [PMID: 34092480 DOI: 10.1016/j.urolonc.2021.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/22/2021] [Accepted: 04/01/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE The rapid expansion of telemedicine has presented a challenge for the care of patients with genitourinary malignancies. We sought to assess patient and physician perspectives on the use of telemedicine for genitourinary cancer care. METHODS We conducted a prospective cross-sectional study of patients who had telemedicine visits with urology, medical oncology, or radiation oncology for management of genitourinary malignancies from July-August 2020. Patients and physicians each received a questionnaire regarding the telemedicine experience. Responses were scored on a 5-point Likert scale. The primary outcomes of the study were patient and physician satisfaction. RESULTS Of the 115 patients who enrolled, we received 96 patient responses and 46 physician responses. Overall, 77% of patients and 70% of physicians reported being "extremely satisfied" with the telemedicine encounter. Satisfaction was high among all components of the encounter including patient-physician communication, counseling, shared decision making, time spent, timeliness and efficiency, and convenience. Additionally, 78% of patients and 85% of physicians "strongly agreed" that they were able to discuss sensitive topics about cancer care as well as they could at an in-person visit. Nine telemedicine visits (9%) encountered technological barriers. Technological barriers were associated with lower overall satisfaction scores among both patients and physicians (p ≤ 0.01). CONCLUSION We observed high levels of patient and physician satisfaction for telemedicine visits for management of genitourinary malignancies. Technological barriers were encountered by 9% of patients and were associated with decreased satisfaction.
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Affiliation(s)
- Ezra J Margolin
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Luis A Pina Martina
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Caleb H Miles
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Sven Wenske
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - James M McKiernan
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - G Joel DeCastro
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Elias S Hyams
- Department of Urology, Columbia University Irving Medical Center, New York, NY
| | - Charles G Drake
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Emerson A Lim
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Mark N Stein
- Division of Hematology and Oncology, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Israel Deutsch
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
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23
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Rabinowitz MJ, Kohn TP, Ellimoottil C, Alam R, Liu JL, Herati AS. The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic. Sex Med 2021; 9:100366. [PMID: 34049265 PMCID: PMC8240353 DOI: 10.1016/j.esxm.2021.100366] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Telemedicine has the potential to improve access to care; however, its utility in the field of sexual medicine remains in question. AIM To examine the importance of video visits for the treatment of male sexual medicine at our academic center during the period of peak telemedicine use in April 2020. METHODS We collected and compared deidentified data from all nonprocedure, adult outpatient encounters conducted as either office visits in April 2019 (n = 1,949) or video visits in April 2020 (n = 608). The primary International Classification of Diseases codes (ICD-10) labeled as diagnoses from all encounters were collected, with most encounters linked to several disease codes (n = 4,584). Demographic data were also collected. We performed comparative analyses on Stata (College Station, TX, USA) with significance set at α = .05. MAIN OUTCOME MEASURES Disease codes were categorized based on their use and classification in urological care and the proportion that each category made up within the outpatient practice was calculated. RESULTS In comparison to the office visits, which took place in April 2019, male sexual medicine visits in April 2020, during the peak of telemedicine use, made up a significantly larger overall share of our practice (P = .012), defined by relative rises in encounters pertaining to male hypogonadism, infertility, penile abnormalities, and testicular abnormalities. Outpatients seen over video visits were also younger than outpatients seen during the previous year over office visits (58.9 vs 60.8, P = .008). Further, race and ethnicity characteristics in the outpatient population were unaffected during the period of telemedicine use. CONCLUSIONS During the period of historically high telemedicine use following the SARS-CoV-2 outbreak, encounters associated with male sexual medicine made up a significantly larger portion of our outpatient practice. Although the full influence of the COVID-19 pandemic cannot be delineated, our findings suggest telemedicine use is compatible with the field of sexual medicine. Rabinowitz MJ, Kohn TP, Ellimoottil C, et al. The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic. Sex Med 2021;9:100366.
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Affiliation(s)
- Matthew J Rabinowitz
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chad Ellimoottil
- Department of Urology, Michigan Medicine, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Ridwan Alam
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James L Liu
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amin S Herati
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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24
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Laukhtina E, Sari Motlagh R, Mori K, Quhal F, Schuettfort VM, Mostafaei H, Katayama S, Grossmann NC, Ploussard G, Karakiewicz PI, Briganti A, Abufaraj M, Enikeev D, Pradere B, Shariat SF. Oncologic impact of delaying radical prostatectomy in men with intermediate- and high-risk prostate cancer: a systematic review. World J Urol 2021; 39:4085-4099. [PMID: 34047825 PMCID: PMC8160557 DOI: 10.1007/s00345-021-03703-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/16/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE To summarize the available evidence on the survival and pathologic outcomes after deferred radical prostatectomy (RP) in men with intermediate- and high-risk prostate cancer (PCa). METHODS The PubMed database and Web of Science were searched in November 2020 according to the PRISMA statement. Studies were deemed eligible if they reported the survival and pathologic outcomes of patients treated with deferred RP for intermediate- and high-risk PCa compared to the control group including those patients treated with RP without delay. RESULTS Overall, nineteen studies met our eligibility criteria. We found a significant heterogeneity across the studies in terms of definitions for delay and outcomes, as well as in patients' baseline clinicopathologic features. According to the currently available literature, deferred RP does not seem to affect oncological survival outcomes, such as prostate cancer-specific mortality and metastasis-free survival, in patients with intermediate- or high-risk PCa. However, the impact of deferred RP on biochemical recurrence rates remains controversial. There is no clear association of deferring RP with any of the features of aggressive disease such as pathologic upgrading, upstaging, positive surgical margins, extracapsular extension, seminal vesicle invasion, and lymph node invasion. Deferred RP was not associated with the need for secondary treatments. CONCLUSIONS Owing to the different definitions of a delayed RP, it is hard to make a consensus regarding the safe delay time. However, the current data suggest that deferring RP in patients with intermediate- and high-risk PCa for at least around 3 months is generally safe, as it does not lead to adverse pathologic outcomes, biochemical recurrence, the need for secondary therapy, or worse oncological survival outcomes.
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Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Reza Sari Motlagh
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Victor M Schuettfort
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Satoshi Katayama
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Nico C Grossmann
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, Toulouse, France
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - Alberto Briganti
- Department of Urology, Vita Salute San Raffaele University, Milan, Italy
| | - Mohammad Abufaraj
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. .,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. .,Department of Urology, Weill Cornell Medical College, New York, NY, USA. .,Department of Urology, University of Texas Southwestern, Dallas, TX, USA. .,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. .,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. .,European Association of Urology Research Foundation, Arnhem, Netherlands.
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25
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To N, Bekker HL, Henry K, Melling P, Turley J, Lodge JPA, Young AL. COVID-19 restrictions on multidisciplinary team meeting decision-making: service evaluation in a major UK cancer centre. Br J Surg 2021; 108:e162-e163. [PMID: 33778851 PMCID: PMC8083657 DOI: 10.1093/bjs/znab009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/03/2020] [Accepted: 12/27/2020] [Indexed: 11/12/2022]
Affiliation(s)
- N To
- Department of Pancreatic Surgery, St James's University Hospital, Leeds, UK
| | - H L Bekker
- Department of Medical Decision-making, University of Leeds, UK
| | - K Henry
- Cancer Team, St James's University Hospital, Leeds, UK
| | - P Melling
- Cancer Team, St James's University Hospital, Leeds, UK
| | - J Turley
- Cancer Team, St James's University Hospital, Leeds, UK
| | - J P A Lodge
- Cancer Team, St James's University Hospital, Leeds, UK.,Department of Hepatobiliary Surgery, St James's University Hospital, Leeds, UK
| | - A L Young
- Department of Pancreatic Surgery, St James's University Hospital, Leeds, UK
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26
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Al-Zahrani MA, Alkhamees M, Almutairi S, Aljuhayman A, Alkhateeb S. Impact of COVID-19 on Urology Practice in Saudi Arabia. Risk Manag Healthc Policy 2021; 14:1379-1392. [PMID: 33854387 PMCID: PMC8039194 DOI: 10.2147/rmhp.s277135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
From the moment the World Health Organization (WHO) declared COVID-19 to be a pandemic disease, COVID-19 began to affect the lives of many healthcare providers worldwide. In response to this pandemic, urology departments and training residency programs implemented urgent measures to reduce outpatient clinics, adopted the use of telemedicine, regulated emergency and outpatient urological procedures, promoted the use of operating theatres, and developed the use of sustainable e-learning alternatives to traditional urology educational activities. We reviewed the response of urologists in Saudi Arabia to the COVID-19 pandemic and how they react to the emerging pandemic both for patients and for healthcare of urologist personnel.
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Affiliation(s)
- Meshari A Al-Zahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mohammad Alkhamees
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Sulaiman Almutairi
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Ahmed Aljuhayman
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Sultan Alkhateeb
- Department of Urology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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27
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Dell’Oglio P, Cacciamani GE, Muttin F, Mirabella G, Secco S, Roscigno M, Rovati FA, Barbieri M, Naspro R, Peroni A, Saccà A, Pellucchi F, Bocciardi AM, Simeone C, Da Pozzo L, Galfano A. Applicability of COVID-19 Pandemic Recommendations for Urology Practice: Data from Three Major Italian Hot Spots (BreBeMi). EUR UROL SUPPL 2021; 26:1-9. [PMID: 33554150 PMCID: PMC7846227 DOI: 10.1016/j.euros.2021.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Lombardy has been the first and one of the most affected European regions during the first and second waves of the novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]). OBJECTIVE To evaluate the impact of coronavirus disease 2019 (COVID-19) on all urologic activities over a 17-wk period in the three largest public hospitals in Lombardy located in the worst hit area in Italy, and to assess the applicability of the authorities' recommendations provided for reorganising urology practice. DESIGN SETTING AND PARTICIPANTS A retrospective analysis of all urologic activities performed at three major public hospitals in Lombardy (Brescia, Bergamo, and Milan), from January 1 to April 28, 2020, was performed. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Join-point regression was used to identify significant changes in trends for all urologic activities. Average weekly percentage changes (AWPCs) were estimated to summarise linear trends. Uro-oncologic surgeries performed during the pandemic were tabulated and stratified according to the first preliminary recommendations by Stensland et al (Stensland KD, Morgan TM, Moinzadeh A, et al. Considerations in the triage of urologic surgeries during the COVID-19 pandemic. Eur Urol 2020;77:663-6) and according to the level of priority recommended by European Association of Urology guidelines. RESULTS AND LIMITATIONS The trend for 2020 urologic activities decreased constantly from weeks 8-9 up to weeks 11-13 (AWPC range -41%, -29.9%; p < 0.001). One-third of uro-oncologic surgeries performed were treatments that could have been postponed, according to the preliminary urologic recommendations. High applicability to recommendations was observed for non-muscle-invasive bladder cancer (NMIBC) patients with intermediate/emergency level of priority, penile and testicular cancer patients, and upper tract urothelial cell carcinoma (UTUC) and renal cell carcinoma (RCC) patients with intermediate level of priority. Low applicability was observed for NMIBC patients with low/high level of priority, UTUC patients with high level of priority, prostate cancer patients with intermediate/high level of priority, and RCC patients with low level of priority. CONCLUSIONS During COVID-19, we found a reduction in all urologic activities. High-priority surgeries and timing of treatment recommended by the authorities require adaptation according to hospital resources and local incidence. PATIENT SUMMARY We assessed the urologic surgeries that were privileged during the first wave of coronavirus disease 2019 (COVID-19) in the three largest public hospitals in Lombardy, worst hit by the pandemic, to evaluate whether high-priority surgeries and timing of treatment recommended by the authorities are applicable. Pandemic recommendations provided by experts should be tailored according to hospital capacity and different levels of the pandemic.
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Affiliation(s)
- Paolo Dell’Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Giovanni Enrico Cacciamani
- University of Southern California Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Fabio Muttin
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Silvia Secco
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Michele Barbieri
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Angelo Peroni
- Department of Urology, ASST Spedali Civili, Brescia, Italy
| | - Antonino Saccà
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Luigi Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - on behalf of COVID-19 Niguarda Working Group
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Interventional Molecular Imaging laboratory, Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
- University of Southern California Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
- Department of Urology, ASST Spedali Civili, Brescia, Italy
- School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy
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28
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Woodruff P, Wallis CJD, Albers P, Klaassen Z. Virtual Conferences and the COVID-19 Pandemic: Are We Missing Out with an Online Only Platform? Eur Urol 2021; 80:127-128. [PMID: 33840557 PMCID: PMC8006189 DOI: 10.1016/j.eururo.2021.03.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 01/12/2023]
Abstract
Virtual conferences rapidly became the norm during the COVID-19 pandemic. Although necessary, there are shortfalls to strictly virtual meetings, including less enthusiasm for submitting abstracts. An approach that combines in-person attendance and virtual platforms may be an optimal compromise both during the ongoing pandemic and moving forward.
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Affiliation(s)
- Phillip Woodruff
- Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA; St. George's University School of Medicine, St. George's, Grenada
| | | | - Peter Albers
- Department of Urology, University Hospital Düsseldorf, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA, USA.
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29
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Available active surveillance follow-up protocols for small renal mass: a systematic review. World J Urol 2021; 39:2875-2882. [PMID: 33452911 DOI: 10.1007/s00345-020-03581-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To evaluate follow-up strategies for active surveillance of renal masses and to assess contemporary data. METHODS We performed a comprehensive search of electronic databases (Embase, Medline, and Cochrane). A systematic review of the follow-up protocols was carried out. A total of 20 studies were included. RESULT Our analysis highlights that most of the series used different protocols of follow-up without consistent differences in the outcomes. Most common protocol consisted in imaging and clinical evaluation at 3, 6, and 12 months and yearly thereafter. Median length of follow-up was 42 months (range 1-137). Mean age was 74 years (range 67-83). Of 2243 patients 223 (10%) died during the follow-up and 19 patients died of kidney cancer (0.8%). The growth rate was the most used parameter to evaluate disease progression eventually triggering delayed intervention. Maximal axial diameter was the most common method to evaluate growth rate. CT scan is the most used, probably because it is usually more precise than kidney ultrasound and more accessible than MRI. Performing chest X-ray at every check does not seem to alter the clinical outcome during AS. CONCLUSION The minimal cancer-specific mortality does not seem to correlate with the follow-up scheme. Outside of growth rate and initial size, imaging features to predict outcome of RCC during AS are limited. Active surveillance of SRM is a well-established treatment option. However, standardized follow-up protocols are lacking. Prospective, randomized, trials to evaluate the best follow-up strategies are pending.
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30
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Investigating the Benefit of Combined Androgen Modulation and Hypofractionation in Prostate Cancer. Int J Mol Sci 2020; 21:ijms21228447. [PMID: 33182844 PMCID: PMC7698244 DOI: 10.3390/ijms21228447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 12/24/2022] Open
Abstract
Hypofractionation is currently considered a valid alternative to conventional radiotherapy for the treatment of patients with organ-confined prostate cancer. Recent data have demonstrated that extreme hypofractionation, which involves the use of a high radiation dose per delivered fraction and concomitant reduction of sessions, is a safe and effective treatment, even though its radiobiological rationale is still lacking. The present work aims to investigate the biological basis sustaining this approach and to evaluate the potential of a hypofractionated regimen in combination with androgen deprivation therapy, one of the major standards of care for prostate cancer. Findings show that androgen receptor (AR) modulation, by use of androgens and antiandrogens, has a significant impact on cell survival, especially in hypoxic conditions (4% O2). Subsequent experiments have revealed that AR activity as a transcription factor is involved in the onset of malignant senescence-associated secretory phenotype (SASP) and activation of DNA repair cascade. In particular, we found that AR stimulation in hypoxic conditions promotes the enhanced transcription of ATM gene, the cornerstone kinase of the DNA damage repair genes. Together, these data provide new potential insights to justify the use of androgen deprivation therapy, in particular with second-generation anti-androgens such as enzalutamide, in combination with radiotherapy.
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31
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Westerman ME, Tabakin AL, Sexton WJ, Chapin BF, Singer EA. Impact of CoVID-19 on resident and fellow education: Current guidance and future opportunities for urologic oncology training programs. Urol Oncol 2020; 39:357-364. [PMID: 33160843 PMCID: PMC7524707 DOI: 10.1016/j.urolonc.2020.09.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/19/2020] [Accepted: 09/26/2020] [Indexed: 12/20/2022]
Abstract
Coronavirus Disease 2019 has impacted all aspects of urologic training. Didactics have shifted to a virtual platform and new approaches to surgical training have been undertaken. There has been a shift in research away from the laboratory space, with an increased focus on clinical outcomes and multi-institutional collaborations. Finally, there have been impacts on home life, questions about time away from work, case logs and case minimums, as well as how to manage resident and fellow reassignment. Herein, we review the current state of urologic education in the United States, focusing specifically on urologic oncology and highlight opportunities for the future.
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Affiliation(s)
- Mary E Westerman
- Department of Urology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX
| | - Alexandra L Tabakin
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Wade J Sexton
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Brian F Chapin
- Department of Urology, The University of Texas, M.D. Anderson Cancer Center, Houston, TX
| | - Eric A Singer
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
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