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Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic

OBJECTIVES: While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the...

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Autores principales: Dotzauer, Robert, Böhm, Katharina, Brandt, Maximilian Peter, Sparwasser, Peter, Haack, Maximilian, Frees, Sebastian. Karl, Kamal, Mohamed Mostafa, Mager, René, Jäger, Wolfgang, Höfner, Thomas, Tsaur, Igor, Haferkamp, Axel, Borgmann, Hendrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335229/
https://www.ncbi.nlm.nih.gov/pubmed/32623500
http://dx.doi.org/10.1007/s00345-020-03333-6
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author Dotzauer, Robert
Böhm, Katharina
Brandt, Maximilian Peter
Sparwasser, Peter
Haack, Maximilian
Frees, Sebastian. Karl
Kamal, Mohamed Mostafa
Mager, René
Jäger, Wolfgang
Höfner, Thomas
Tsaur, Igor
Haferkamp, Axel
Borgmann, Hendrik
author_facet Dotzauer, Robert
Böhm, Katharina
Brandt, Maximilian Peter
Sparwasser, Peter
Haack, Maximilian
Frees, Sebastian. Karl
Kamal, Mohamed Mostafa
Mager, René
Jäger, Wolfgang
Höfner, Thomas
Tsaur, Igor
Haferkamp, Axel
Borgmann, Hendrik
author_sort Dotzauer, Robert
collection PubMed
description OBJECTIVES: While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandemic. METHODS: In this cross-sectional observational study, we designed a 12-item online survey on the global effects of the COVID-19 pandemic on clinical practice in urology. Demographic survey data, change of clinical practice, current performance of procedures, and current commencement of treatment for 5 conditions in medical urological oncology were evaluated. RESULTS: 235 urologists from 44 countries responded. Out of them, 93% indicated a change of clinical practice due to COVID-19. In a 4-tiered surgery down-escalation scheme, 44% reported to make first cancellations, 23% secondary cancellations, 20% last cancellations and 13% emergency cases only. Oncological surgeries had low cancellation rates (%): transurethral resection of bladder tumor (27%), radical cystectomy (21–24%), nephroureterectomy (21%), radical nephrectomy (18%), and radical orchiectomy (8%). (Neo)adjuvant/palliative treatment is currently not started by more than half of the urologists. COVID-19 high-risk-countries had higher total cancellation rates for non-oncological procedures (78% vs. 68%, p = 0.01) and were performing oncological treatment for metastatic diseases at a lower rate (35% vs. 48%, p = 0.02). CONCLUSION: The COVID-19 pandemic has affected clinical practice of 93% of urologists worldwide. The impact of implementing surgical prioritization protocols with moderate cancellation rates for oncological surgeries and delay or reduction in (neo)adjuvant/palliative treatment will have to be evaluated after the pandemic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00345-020-03333-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-73352292020-07-06 Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic Dotzauer, Robert Böhm, Katharina Brandt, Maximilian Peter Sparwasser, Peter Haack, Maximilian Frees, Sebastian. Karl Kamal, Mohamed Mostafa Mager, René Jäger, Wolfgang Höfner, Thomas Tsaur, Igor Haferkamp, Axel Borgmann, Hendrik World J Urol Topic Paper OBJECTIVES: While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandemic. METHODS: In this cross-sectional observational study, we designed a 12-item online survey on the global effects of the COVID-19 pandemic on clinical practice in urology. Demographic survey data, change of clinical practice, current performance of procedures, and current commencement of treatment for 5 conditions in medical urological oncology were evaluated. RESULTS: 235 urologists from 44 countries responded. Out of them, 93% indicated a change of clinical practice due to COVID-19. In a 4-tiered surgery down-escalation scheme, 44% reported to make first cancellations, 23% secondary cancellations, 20% last cancellations and 13% emergency cases only. Oncological surgeries had low cancellation rates (%): transurethral resection of bladder tumor (27%), radical cystectomy (21–24%), nephroureterectomy (21%), radical nephrectomy (18%), and radical orchiectomy (8%). (Neo)adjuvant/palliative treatment is currently not started by more than half of the urologists. COVID-19 high-risk-countries had higher total cancellation rates for non-oncological procedures (78% vs. 68%, p = 0.01) and were performing oncological treatment for metastatic diseases at a lower rate (35% vs. 48%, p = 0.02). CONCLUSION: The COVID-19 pandemic has affected clinical practice of 93% of urologists worldwide. The impact of implementing surgical prioritization protocols with moderate cancellation rates for oncological surgeries and delay or reduction in (neo)adjuvant/palliative treatment will have to be evaluated after the pandemic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00345-020-03333-6) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2020-07-04 2021 /pmc/articles/PMC7335229/ /pubmed/32623500 http://dx.doi.org/10.1007/s00345-020-03333-6 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Topic Paper
Dotzauer, Robert
Böhm, Katharina
Brandt, Maximilian Peter
Sparwasser, Peter
Haack, Maximilian
Frees, Sebastian. Karl
Kamal, Mohamed Mostafa
Mager, René
Jäger, Wolfgang
Höfner, Thomas
Tsaur, Igor
Haferkamp, Axel
Borgmann, Hendrik
Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title_full Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title_fullStr Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title_full_unstemmed Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title_short Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic
title_sort global change of surgical and oncological clinical practice in urology during early covid-19 pandemic
topic Topic Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335229/
https://www.ncbi.nlm.nih.gov/pubmed/32623500
http://dx.doi.org/10.1007/s00345-020-03333-6
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