Sciarra Alessandro, Salciccia Stefano, Maggi Martina, Del Giudice Francesco, Busetto Gian Maria, Musio Daniela, Ciardi Antonio, Catalano Carlo, Cortesi Enrico, Panebianco Valeria
Department of Urology, University Sapienza, Rome, Italy.
Department of Radiological Sciences, Oncology & Pathology, University Sapienza, Rome, Italy.
Prostate Cancer Prostatic Dis. 2020;23(3):407-409. doi: 10.1038/s41391-020-0240-4. Epub 2020 May 18.
On March 29th 2020, 97,689 cases of COVID-19 have been diagnosed only in Italy, with 73,880 actually positive cases, a daily increase of 3815 cases, 27,386 hospitalized and 3906 patients in intensive care units, causing a total of 10,779 known deaths. In all urological departments, quickly inpatient and outpatient services have been significantly reduced. Even in this COVID-19 situation, urological neoplasm care must go on, but significant changes need to be made in the way some care is delivered. We compared diagnostic and therapeutic elective procedures requested and performed for PC management from our multidisciplinary team (MDT) during 1 month activity in the highest national level of COVID-19 infection (March 2020) and under restrictions for all the population, with the management performed in a no-COVID-19 month (March 2019) 1 year ago. The only management that did not received a significant reduction are medical therapies for advanced hormone sensitive (HS) or castration resistant (CR) PC. We describe our MDT identifications of elective undeferrable PC management in this COVID-19 time. These suggestions have been considered for a country (ITALY) under a rapid increase of COVID-19 cases and complications, but in a region with an actual lower impact (2914 actual positive and 1079 hospitalized cases) from the infection and in an hospital not completely converted to COVID-19 management. Indications should be different and restricted only to emergencies on the basis of COVID-19 pandemic situation and hospital involvement.
2020年3月29日,仅在意大利就确诊了97689例新冠肺炎病例,其中实际阳性病例73880例,日增3815例,27386人住院,3906名患者进入重症监护病房,导致共计10779例已知死亡病例。在所有泌尿外科科室,住院和门诊服务迅速大幅减少。即便处于新冠肺炎疫情之下,泌尿系统肿瘤护理仍须继续,但在某些护理的提供方式上需要做出重大改变。我们比较了在全国新冠肺炎感染最高水平(2020年3月)且全体民众都受限的情况下,我们的多学科团队(MDT)在1个月活动期间针对前列腺癌(PC)管理所要求并实施的诊断和治疗性择期手术,以及1年前在无新冠肺炎的月份(2019年3月)所进行的管理。唯一未显著减少的管理措施是针对晚期激素敏感(HS)或去势抵抗(CR)前列腺癌的药物治疗。我们描述了我们的多学科团队在这个新冠肺炎时期对不可推迟的前列腺癌择期管理的认定。这些建议是针对一个新冠肺炎病例和并发症快速增加的国家(意大利)提出的,但处于一个实际受感染影响较低(2914例实际阳性病例和1079例住院病例)的地区,且所在医院并未完全转变为新冠肺炎管理模式。根据新冠肺炎疫情形势和医院情况,适应症应有所不同且仅限于紧急情况。