Gulia Ashish, Tiwari Akshay, Arora Ramandeep Singh, Gupta Srinath, Raja Anand
Dept of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institure (HBNI), Mumbai, India.
Musculoskeletal Oncology, Max Institute of Cancer Care, Saket, New Delhi, India.
Indian J Orthop. 2020 Jul 31;54(Suppl 2):350-357. doi: 10.1007/s43465-020-00206-3. eCollection 2020 Dec.
Amidst the COVID-19 pandemic, management of cancer has been one of the most intensely debated topics across the globe. We conducted an online survey to determine the consistency/or the lack of it, in the management of sarcoma patients between centres and the changes in policies.
A twenty-five question online survey was conducted among practicing physicians over a period of 10 days using online portal (surveymonkey.com). It was followed by a critical analysis based on responses to each question.
Of 194 medical professionals who participated, 80% were surgeons and 53% were working in government institutes. Most respondents (81%) continued their practice with some modifications. In OP majority (67%) relied only on symptom, contact enquiry and temperature recording for screening. COVID-19 testing was done more (43%) in IP patients. Most of institutes (83%) followed rotational policy to reduce the number of staff at risk while 57% offered an alternate accommodation. 52.3% continued chemotherapy for all patients while radiotherapy for all was offered by 45%. In metastatic cases, majority preferred either no treatment or non-surgical intervention (71%).84.5% believed in adapting changes (42%-avoid supra major surgeries, 27%-Operating only emergency cases and 15.5%-High grade sarcomas with curative intent) in surgical management of sarcomas. For benign bone tumors, majority (71%) agreed on adapting changes while 25% agreed on deferring all cases. 69% preferred teleconsultations for follow-up. Complete PPE were being used for all aerosol generating procedures by 44%. Only two thirds agreed with their institutes policy of PPE usage and COVID-19 testing.
This survey has highlighted disparity on COVID-19 screening and management in various institutes across the country. This will act as a reference point for tracking future trends in bone and soft tissue tumor management guidelines, as the COVID-19 scenario unfolds globally and particularly in India.
在新冠疫情期间，癌症管理一直是全球范围内讨论最为激烈的话题之一。我们开展了一项在线调查，以确定各中心在肉瘤患者管理方面的一致性或缺乏一致性情况以及政策变化。
通过在线平台（surveymonkey.com），在10天时间里对执业医师进行了一项包含25个问题的在线调查。随后根据对每个问题的回答进行批判性分析。
在参与调查的194名医学专业人员中，80%为外科医生，53%在政府机构工作。大多数受访者（81%）在进行了一些调整后继续执业。在门诊，大多数（67%）仅依靠症状、接触询问和体温记录进行筛查。住院患者中进行新冠病毒检测的更多（43%）。大多数机构（83%）遵循轮班政策以减少面临风险的工作人员数量，57%提供替代住宿。52.3%对所有患者继续进行化疗，45%对所有患者进行放疗。在转移性病例中，大多数倾向于不治疗或非手术干预（71%）。84.5%认为在肉瘤手术管理中应适应变化（42% - 避免超大型手术，27% - 仅处理急诊病例，15.5% - 对有治愈意图的高级别肉瘤进行手术）。对于良性骨肿瘤，大多数（71%）同意适应变化，25%同意推迟所有病例。69%倾向于通过远程会诊进行随访。44%在所有产生气溶胶的操作中都使用了完整的个人防护装备。只有三分之二的人同意其所在机构的个人防护装备使用和新冠病毒检测政策。
这项调查凸显了该国各机构在新冠病毒筛查和管理方面的差异。随着全球尤其是印度新冠疫情形势的发展，这将作为跟踪骨与软组织肿瘤管理指南未来趋势的参考点。
