Overview of the italian experience in surgical management of bladder cancer during first month of COVID-19 pandemic

Submitted: June 2, 2020
Accepted: July 20, 2020
Published: December 17, 2020
Abstract Views: 1184
PDF: 504
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Objective: Overview of bladder cancer (BC) management in Italy during the first month of the COVID-19 pandemic (March 2020) with head to head comparison of the data from March 2019, considered “usual activity” period. The aim is to analyze performance of different Italian Centers in North, Center and South, with a special eye for Lombardy (the Italian epicenter).
Patients and methods: During April 2020, a survey containing 14 multiple-choice questions focused on general staffing and surgical activity related to BC during the months of March 2019 and March 2020 was sent to 32 Italian Centers. Statistical analysis was performed using IBM SPSS Statistics (v26) software. A Medline search was performed, in order to attempt a comparative analysis with published papers.
Results: 28 Centers answered, for a response rate of 87.5%. Most of the urology staff in the Lombardy region were employed in COVID wards (p = 0.003), with a statistically significant reduction in the number of radical cystectomies (RC) performed during that time (p = 0.036). The total amount of RC across Italy remained the same between 2019 and 2020, however there was an increase in the number of surgeries performed in the Southern region. This was most likely due to travel restrictions limiting travel the North. The number of Trans-Urethral Resection of Bladder Tumors (TURBT) (p = 0.046) was higher in Academic Centers (AC) in 2020 (p = 0.037).
Conclusions: The data of our survey, although limited, represents a snap shot of the management of BC during the first month of the COVD-19 pandemic, which posed a major challenge for cancer centers seeking to provide care during an extremely dynamic clinical and political situation which requires maximum flexibility to be appropriately managed.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Cumberbatch MGK, Jubber I, Black PC, et al. Epidemiology of bladder cancer: a systematic review and contemporary update of risk factors in 2018. Eur Urol 2018; 74: 784–95. DOI: https://doi.org/10.1016/j.eururo.2018.09.001
Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin 2019; 69: 363–85. DOI: https://doi.org/10.3322/caac.21565
Goossens-Laan CA, Leliveld AM, Verhoeven RH, et al. Effects of age and comorbidity on treatment and survival of patients with muscle-invasive bladder cancer. Int J Cancer 2014;135:905–12. DOI: https://doi.org/10.1002/ijc.28716
Noon AP, Albertsen PC, Thomas F, Rosario DJ, Catto JW. Competing mortality in patients diagnosed with bladder cancer: evidence of undertreatment in the elderly and female patients. Br J Cancer 2013; 108: 1534–40. DOI: https://doi.org/10.1038/bjc.2013.106
Ficarra V, Novara G, Abrate A, et al. Urology practice during COVID-19 pandemic. Minerva Urol Nefrol. In press. https://doi. org/10.23736/S0393-2249.20.03846-1.
Decree Law n° 6, 23 February 2020 - “Urgent measures to contain and manage the epidemiological emergency due to COVID-19”. https://www.gazzettaufficiale.it/eli/id/2020/02/23/20G00020/sg.
Wallis CJD, Novara G, Marandino L, et al. Risks from Deferring Treatment for Genitourinary Cancers: A Collaborative Review to Aid Triage and Management During the COVID-19 Pandemic. Eur Urol, in press.
Naspro R, Da Pozzo L. Urology in the time of corona. Nat Rev Urol. In press. https://doi.org/10.1038/s41585-020-0312-1. DOI: https://doi.org/10.1038/s41585-020-0312-1
Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol 2020; 21: 335–7. DOI: https://doi.org/10.1016/S1470-2045(20)30096-6
Moschovas MC, Sighinolfi MC, Rocco B, et al. Balancing the Effects of COVID-19 Against Potential Progression and Mortality in High-risk Prostate Cancer. Eur Urol. 2020 Apr 21. pii: S0302-2838(20)30260-8. doi: 10.1016/j.eururo.2020.04.028. DOI: https://doi.org/10.1016/j.eururo.2020.04.028
Campi R, Amparore D, Capitanio U, et al. Assessing the Burden of Nondeferrable Major Uro-oncologic Surgery to Guide Prioritisation Strategies During the COVID-19 Pandemic: Insights from Three Italian High-volume Referral Centres. Eur Urol 2020 Apr 11. pii: S0302-2838(20)30229-3. doi: 10.1016/j.eururo.2020.03.054. DOI: https://doi.org/10.1016/j.eururo.2020.03.054
Shared protocol for the regulation of measures to contrast and contain the diffusion of COVID-19 virus in the workplace, 14th March 2020. http://www.governo.it/sites/new.governo.it/files/protocollo_condiviso_20200314.pdf.
Ti LK, Ang LS, Foong TW, et al. What we do when a COVID-19 patient needs an operation: operating room preparation and guidance. Can J Anaesth. 2020 Mar 6. doi: 10.1007/s12630-020-01617-4. DOI: https://doi.org/10.1007/s12630-020-01617-4
Stensland KD, Morgan TM, Moinzadeh A, et al. Considerations in the Triage of Urologic Surgeries During the COVID-19 Pandemic. Eur Urol 2020 Apr 9. pii: S0302-2838(20)30202-5. doi: 10.1016/j.eururo.2020.03.027. DOI: https://doi.org/10.1016/j.eururo.2020.03.027
Goldman HB, Haber GP. Recommendations for Tiered Stratification of Urological Surgery Urgency in the COVID-19 Era. J Urol 2020 Apr 21:101097JU0000000000001067. doi: 10.1097/JU.0000000000001067 DOI: https://doi.org/10.1097/JU.0000000000001067
Montorsi F. We Should Not Ignore What Scientific Articles are Telling US: A Lesson from the Italian COVID-19 Experience. J Urol. 2020 Apr 3:101097JU0000000000001069. doi: 10.1097/JU.0000000000001069. DOI: https://doi.org/10.1097/JU.0000000000001069
Lei S, Jiang F, Su W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection, EClinicalMedicine. In press. https://doi.org/ 10.1016/j.eclinm.2020.100331.
Gabrielson AT, Kohn TP, Clifton MM. COVID-19 and the Urology Match: Perspectives and a Call to Action. J Urol 2020 Mar 31:101097JU0000000000001037. doi: 10.1097/JU.0000000000001037. DOI: https://doi.org/10.1097/JU.0000000000001037
Vargo E, Ali M, Henry F, Kmetz D, et al. Cleveland Clinic Akron General Urology Residency Program's COVID-19 Experience. Urology 2020 Apr 2. pii: S0090-4295(20)30341-1. doi: 10.1016/j.urology.2020.04.001. DOI: https://doi.org/10.1016/j.urology.2020.04.001
Leonardi R, Bellinzoni P, Broglia L, et al. Hospital care in Departments defined as Covid-free: A proposal for a safe hospitalization protecting healthcare professionals and patients not affected by Covid 19. Archiv Ital Urol Androl 2020; 92, 2DOI: 10.4081/aiua.2020.2.
Puliatti S, Eissa A, Eissa R, et al. COVID-19 and Urology: A Comprehensive Review of the Literature. BJU Int 2020 Apr 6. doi: 10.1111/bju.15071. DOI: https://doi.org/10.1111/bju.15071
Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020 Apr;21(4):e181. doi: 10.1016/S1470-2045(20)30149-2. Epub 2020 Mar 3. DOI: https://doi.org/10.1016/S1470-2045(20)30149-2
Klaassen Z, Kamat AM, Kassouf W, et al. Treatment strategy for newly diagnosed T1 high-grade bladder urothelial carcinoma: new insights and updated recommendations. Eur Urol 2018; 74: 597–608. DOI: https://doi.org/10.1016/j.eururo.2018.06.024
Thomas F, Noon AP, Rubin N, Goepel JR, Catto JW. Comparative outcomes of primary, recurrent, and progressive high-risk non-muscle-invasive bladder cancer. Eur Urol 2013; 63: 145–54. DOI: https://doi.org/10.1016/j.eururo.2012.08.064
Lenfant L, Seisen T, Loriot Y, Rouprêt M.Adjustments in the Use of Intravesical Instillations of Bacillus Calmette-Guérin for High-risk Non-muscle-invasive Bladder Cancer During the COVID-19 Pandemic. Eur Urol. 2020 Apr 24. pii: S0302-2838(20)30302-X. doi: 10.1016/j.eururo.2020.04.039. DOI: https://doi.org/10.1016/j.eururo.2020.04.039
Oderda M, Roupret M, Marra G, et al.The Impact of COVID-19 Outbreak on Uro-oncological Practice Across Europe: Which Burden of Activity Are We Facing Ahead? Eur Urol. 2020 Apr 24. pii: S0302-2838(20)30299-2. doi: 10.1016/j.eururo.2020.04.036. DOI: https://doi.org/10.1016/j.eururo.2020.04.036
Ueda M, Martins R, Hendrie PC, et al. Managing Cancer Care During the COVID-19 Pandemic: Agility and Collaboration Toward a Common Goal. J Natl Compr Canc Netw 2020 Mar 20:1-4. doi: 10.6004/jnccn.2020.7560. DOI: https://doi.org/10.6004/jnccn.2020.7560
Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006; 49: 466–5; discussion 475–7. DOI: https://doi.org/10.1016/j.eururo.2005.12.031
Gontero P, Sylvester R, Pisano F, et al. Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with bacillus Calmette-Guerin: results of a retrospective multicenter study of 2451 patients. Eur Urol 2015; 67:74–82. DOI: https://doi.org/10.1016/j.eururo.2014.06.040
Veskimae E, Espinos EL, Bruins HM, et al. What is the prognostic and clinical importance of urothelial and nonurothelial histological variants of bladder cancer in predicting oncological outcomes in patients with muscle-invasive and metastatic bladder cancer? A European Association of Urology Muscle Invasive and Metastatic Bladder Cancer Guidelines Panel Systematic Review. Eur Urol Oncol 2019; 2 (6):625-642. DOI: https://doi.org/10.1016/j.euo.2019.09.003
Giovanni Petralia, Urology Unit, Niguarda Hospital, Milan

Urology Unit

Roberto Contieri, Department of Urology, Istituto Clinico Humanitas IRCCS Clinical and Research Hospital, Rozzano (MI)

Department of Urology

How to Cite

Maccagnano, C., Rocchini, L., Montanari, E., Conti, G. N., Petralia, G., Dehò, F., Bryan, K.-A., Contieri, R., & Hurle, R. (2020). Overview of the italian experience in surgical management of bladder cancer during first month of COVID-19 pandemic. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.275