Abstract P16: Continuity of cancer care: The surgical experience of two large Cancer Hubs in London and Milan

Abstract

Abstract Introduction: A better understanding of the reality for cancer patients during COVID-19 will help us readapt current predication models. To further inform future clinical guidelines, we need a deep dive into rich data sources from apex Cancer Centres. We report on the outcomes of cancer patients receiving radical surgery between March-September 2020 (as well as 2019) in the European Institute of Oncology (EIO) in Milan and the South East London Cancer Alliance (SELCA). Methods: IEO is one of the largest cancer hospitals in Italy. SELCA includes 3 major hospital trust, treating about 8,000 new cancer patients per annum. Both institutions implemented a COVID-19 minimal pathway, whereby patients were required to shield for 14 days prior to admission and were swabbed for COVID-19 within 3 days of surgery. Positive patients had surgery deferred until a negative swab. Surgical outcomes assessed were: ASA grade, surgery time, theatre time, ICU stay>24h, pneumonia, length of stay (LOS), and admissions. For COVID-19, we focused on infection rate and mortality. Results: At IEO the number of radical surgeries (270 for gynaecological, 339 for head and neck, 377 for thoracic, and 491 for urological cancers) declined by 6% as compared to the same period in 2019 (n=1477 vs 1560). The main decline was observed for thoracic surgery (377 vs 460, i.e. -18%). Age, sex, SES, ethnicity, comorbidities, and performance status were all comparable between both periods (e.g. 58% male, 38% aged 70+, 48% high SES, 15% with existing cardiovascular diseases). Readmissions were required for 39%, and <1% (n=9) developed COVID-19, of which only 1 had severe disease and died. 11 died of other causes during follow-up (1%). At SELCA, the number of radical surgeries (321 for breast, 129 for colorectal, 114 for gynaecological, 152 for head and neck, 92 for liver, 56 for plastics/skin, 305 for thoracic, 72 for upper gastrointestinal, and 312 for urology) declined by 29% (n=1553 vs 2182). Even though a different geographical setting, characteristics were fairly comparable with the IEO: 58% males, 30% aged 70+, 34% high SES, 16% with existing cardiovascular diseases. Readmissions were required for 22%, <1% (n=7) developed COVID-19, and none died from it. 19 died of other causes within 30 days (1%). Conclusion: Milan and London were both at the epicentre of the first COVID-19 wave. Whilst a decline in number of surgeries was observed, the implemented COVID-19 minimal pathways have shown to be safe for cancer patients requiring radical treatment, with limited complications and almost no COVID-19 infections. Citation Format: Marta Tagliabue, Harvey Dickinson, Rita de Berardinis, Graham Roberts, Beth Russell, Charlotte Moss, Sophie Irwin, Jonathon Olsburgh, Jain Urvashi, Hisham Ahmed, Francesca Cocco, Alexis Schizas, Sarah McCrindle, Nath Rahul, Tommy Tomari, Aina Brunet, Ricard Simo, Parthi Srinivasan, Andreas Prachalias, RuJun Ma, Andrew Davies, Jenny Geh, Stephanie Fraser, Tom Routledge, Ella Doerge, Ben Challacombe, Raj Nair, Marios Hadjipavlou, Rosaria Scarpinata, Paolo Sorelli, Saoirse Dolly, Mohssen Ansarin, Alessandro Francesco Mistretta, Gennaro Musi, Ottavio De Cobell, Monica Tessitore, Lorenzo Spaggiar, Aloisi Alessia, Andrea Dell'Acqua, Angelo Maggioni, Fabrizio Mastrilli, Sara Gandini, Kate Haire, Mieke Van Hemelrijck. Continuity of cancer care: The surgical experience of two large Cancer Hubs in London and Milan [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr P16.