Abstract
Simple SummaryA better understanding of the reality for cancer patients during the SARS-CoV-2 (COVID-19) pandemic will help us readapt current prediction models. There is a need to dive into rich data sources from apex cancer centres. The aim of our retrospective study was to report on the outcomes of cancer patients receiving radical surgery with curative intent during the first wave of the COVID-19 pandemic. Data from two cancer centres that were at the epicentre of the outbreak from March to September 2020 (as well as a comparator group in 2019) were utilised for this study. We observed that while there was a decline in number of surgeries performed, the implemented COVID-19 minimal pathways were safe for cancer patients requiring surgical treatment.The SARS-CoV-2 (COVID-19) pandemic is having a large effect on the management of cancer patients. This study reports on the approach and outcomes of cancer patients receiving radical surgery with curative intent between March and September 2020 (in comparison to 2019) in the European Institute of Oncology, IRCCS (IEO) in Milan and the South East London Cancer Alliance (SELCA). Both institutions implemented a COVID-19 minimal pathway where patients were required to self-isolate prior to admission and were swabbed for COVID-19 within 72 h of surgery. Positive patients had surgery deferred until a negative swab. At IEO, radical surgeries declined by 6% as compared to the same period in 2019 (n = 1477 vs. 1560, respectively). Readmissions were required for 3% (n = 41), and <1% (n = 9) developed COVID-19, of which only one had severe disease and died. At SELCA, radical surgeries declined by 34% (n = 1553 vs. 2336). Readmissions were required for 11% (n = 36), <1% (n = 7) developed COVID-19, and none died from it. Whilst a decline in number of surgeries was observed in both centres, 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.
Highlights
The new severe acute respiratory syndrome SARS-CoV-2 (COVID-19) was declared a pandemic on 11 March 2020 by the World Health Organisation [1]
The IEO in Milan and South East London Cancer Alliance (SELCA) hospitals in London were both at the epicentre of the first
Milan and London, respectively, the current study has shown that the implemented COVID19 minimal pathways are safe for cancer patients requiring radical treatment
Summary
The new severe acute respiratory syndrome SARS-CoV-2 (COVID-19) was declared a pandemic on 11 March 2020 by the World Health Organisation [1] This is why healthcare organisations in many countries across the globe have made many significant changes to their healthcare services aiming to face the challenges of the COVID-19 pandemic, leading to a significant disruption in the provision of cancer treatments [2]. The Italian National Health System (INHS) interrupted all non-urgent surgeries, outpatient consultations, and rehabilitation services [5]. This was initially intended to free up the necessary resources and enable surgical staff to treat COVID-19 patients. Various studies have reported an important decrease in cancer referrals, creating a concern that many cancer patients had a delay in their diagnosis and treatment, resulting in further advancement of their disease [6,7]
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