1725P Development and validation of telematic follow-up for cancer patients during the COVID-19 outbreak

Abstract

The reorganization of oncologic follow-up was crucial to maintain oncologic care and reduce patient exposure during SARS-CoV-2 pandemic. Patients scheduled for follow-up oncologic visits during the lockdown period (March 9th - May 4th 2020) were included in a program of telematic follow-up (TFU) developed at the Medical Oncology Unit of Sant’Andrea and San Bartolomeo Hospital in La Spezia, Italy. Eligibility for TFU was determined through a pre-screening of medical charts based on tumor type, risk of relapse, geographic accessibility and DFS. Pre-calls were made by skilled nurses to assess pts’ availability for next-day phone call and to assess availability of laboratory test and imaging results. A TFU form was conceived to collect pts’ clinical history, symptoms, body weight, ongoing medical therapies, DFS, blood tests and imaging results (from Hospital imaging repository or acquired in the pre-call). Pts without signs/symptoms of relapse were scheduled for the next follow-up visit and the filled-in TFU form was attached to the clinical chart. When a suspected disease relapse was found, an ambulatory visit was performed. There were 547 pts previously scheduled for in-hospital follow-up visit between March 9th and May 4th, 2020. 82 of 547 pts (15%) were considered not eligible for TFU according to the pre-screening assessment. 465 pts out of 547 (85%) were included in the TFU program. All these pts accepted calls with a compliance rate of 100%. The median age was 73 years (34-95); 152 male (33%) and 313 female (67%). The distribution by tumor type was: 179 breast cancer (38%), 86 colorectal (18%), 55 urinary tract (12%), 39 melanoma and skin (9%), 31 gynecologic (6%), 26 lung cancer(6%), 16 GEP (3%), 15 head and neck (3%), and 18 other tumors (4%). Ten patients with signs/symptoms of tumor recurrence were detected at TFU: 1 had clinical symptoms, 3 abnormal blood tests and 6 suspicious radiological findings. These patients were called for live visit and tumor relapse/progression was confirmed in 10 out of 10 cases. Medical or surgical treatment was started, or planned to start, in all 10 patients. TFU proved to be feasible with an eligibility rate of 85% and 100% patients’ compliance. The detection rate for tumor recurrence was 2.1%.