Abstract
ABSTRACTIntroduction:There is little information on how to prioritize testis cancer (TC) patients' care during COVID-19 pandemic in order to relieve its pressure on the health care systems.Objective:To describe the recommendations for diagnosis, treatment and follow-up of patients with TC amidst COVID- 19 pandemic.Material and Methods:Pubmed search and review of the main urological association guidelines on TC.Results:The biology of TC requires immediate care of patients during diagnosis, initial surgical therapy and management of recurrent disease. Active surveillance is the first choice of management and should be offered to all compliant clinical stage I TC patients provided they understand the need to self-isolate. Active surveillance may also help decrease the demand for intensive care unit beds, ventilators, personal protective equipment, and other critical hospital and human resources by minimizing surgeries without compromising patient outcomes. Complications of therapy and symptomatic patients represent medical emergencies and should be treated immediately. Telemedicine may be useful during follow-up periods.Conclusions:Most stages of testis cancer require urgent care; however, all recommendations must be adapted to local health care priorities considering that most of these patients are at low risk of severe COVID-19 infection.
Highlights
There is little information on how to prioritize testis cancer (TC) patients’ care during COVID-19 pandemic in order to relieve its pressure on the health care systems
Non contrast-enhanced CT scan of the chest and contrast-enhanced CT scan of the abdomen and pelvis should be done in patients with a diagnosis of TC ideally before orchidectomy
Management of clinical Stage I (CSI) TC Active surveillance is the first choice of management in compliant CSI TC patients, during COVID-19 pandemic
Summary
There is little information on how to prioritize testis cancer (TC) patients’ care during COVID-19 pandemic in order to relieve its pressure on the health care systems. Objective: To describe the recommendations for diagnosis, treatment and follow-up of patients with TC amidst COVID- 19 pandemic. Results: The biology of TC requires immediate care of patients during diagnosis, initial surgical therapy and management of recurrent disease. Conclusions: Most stages of testis cancer require urgent care; all recommendations must be adapted to local health care priorities considering that most of these patients are at low risk of severe COVID-19 infection. The American Urological Association (AUA), [4] European Association of Urology (EAU) [5] and National Comprehensive Cancer Network (NCCN) [6] guidelines on TC do not make specific considerations in terms of prompt treatment or impact of treatment delay on outcome. All patients suspected of having TC are recommended to be seen urgently (within 2 weeks) by a specialist [8]
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