COVID-19 Pandemic Impact on Uro-Oncological Disease Outcomes at a German Referral Center

Abstract

Introduction: To assess differences in referral and pathologic outcomes for uro-oncology cases prior to, during, and after the COVID-19 pandemic, comparing clinical and pathological data from cancer surgeries performed at a university medical center between 2018 and 2023. Methods: We collected data of 212 patients with radical prostatectomy (RP) for prostate cancer, 157 patients with radical cystectomies (RCs) for bladder cancer, 36 patients with radical nephroureterectomies (RNUs) for upper tract urothelial carcinoma, 133 patients with partial nephrectomies (PNs), and 160 patients with radical nephrectomies (RNs) for renal cancer, 93 patients with orchifunicolectomy for testicular cancer, 39 patients with newly diagnosed penile cancer. Data from patients treated between 2018 and February 2020 (before the COVID-19 pandemic) were compared with data from patients treated between March 2020 and March 2022 (during the COVID-19 pandemic) and between April 2022 and February 2023 (after the COVID-19 pandemic). Results: No differences in terms of main pathologic features were observed in patients undergoing RP, RNU, orchifunicolectomy, or circumcision and/or penectomy. Further, a lower pathological tumor stage was diagnosed for RN after the COVID-19 pandemic (p < 0.05). A higher age at diagnosis for penile cancer was observed during the pandemic cohort in comparison to the pre-COVID-19 pandemic cohort (p < 0.05), but this did not translate into a worse pathological stage or lymph node involvement. Another notable change was the shortening of the length of stay (LOS) for orchifunicolectomy over the pandemic (p < 0.05). Conclusion: Neither decline in uro-oncologic activity nor pathological features were observed at our institution before, during, and after the COVID-19 pandemic. A significantly lower pathological tumor stage for RN after the COVID-19 pandemic was seen. Penile cancer was diagnosed at a significantly higher age during the COVID-19 pandemic, and a decrease in LOS for orchifunicolectomy was observed.