Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: an international accelerated consensus statement
Articolo
Data di Pubblicazione:
2021
Citazione:
Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: an international accelerated consensus statement / Z. Tandogdu, J. Collins, G. Shaw, J. Rohn, B. Koves, A. Sachdeva, A. Ghazi, A. Haese, A. Mottrie, A. Kumar, A. Sivaraman, A. Tewari, B. Challacombe, B. Rocco, C. Giedelman, C. Wagner, C.G. Rogers, D.G. Murphy, D. Pushkar, G. Ogaya-Pinies, J. Porter, K.R. Seetharam, M. Graefen, M.A. Orvieto, M.C. Moschovas, O. Schatloff, P. Wiklund, R. Coelho, R. Valero, T.M. de Reijke, T. Ahlering, T. Rogers, H.G. van der Poel, V. Patel, W. Artibani, F. Wagenlehner, K. Maes, K.H. Rha, S. Nathan, T.E. Bjerklund Johansen, P. Hawkey, J. Kelly. - In: BJU INTERNATIONAL. - ISSN 1464-4096. - 127:6(2021), pp. 729-741. [10.1111/bju.15299]
Abstract:
Objective: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic. Methods: We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways. Results: Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as ‘COVID-19 cold’ sites. Conclusion: Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3–6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
pandemic; consensus; nosocomial; coronavirus; surgery; #PCSM; #ProstateCancer; #uroonc; #COVID19; #Coronavirus
Elenco autori:
Z. Tandogdu, J. Collins, G. Shaw, J. Rohn, B. Koves, A. Sachdeva, A. Ghazi, A. Haese, A. Mottrie, A. Kumar, A. Sivaraman, A. Tewari, B. Challacombe, B. Rocco, C. Giedelman, C. Wagner, C.G. Rogers, D.G. Murphy, D. Pushkar, G. Ogaya-Pinies, J. Porter, K.R. Seetharam, M. Graefen, M.A. Orvieto, M.C. Moschovas, O. Schatloff, P. Wiklund, R. Coelho, R. Valero, T.M. de Reijke, T. Ahlering, T. Rogers, H.G. van der Poel, V. Patel, W. Artibani, F. Wagenlehner, K. Maes, K.H. Rha, S. Nathan, T.E. Bjerklund Johansen, P. Hawkey, J. Kelly
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