Kalemci Serdar, Ergun Kasim Emre, Akyol Alp, Kizilay Fuat
Urology, Ege University Faculty of Medicine, Izmir, TUR.
Cureus. 2022 Jul 1;14(7):e26500. doi: 10.7759/cureus.26500. eCollection 2022 Jul.
The coronavirus disease 2019 (COVID-19) pandemic disrupted all routine health care services and resulted in a significant reconfiguration of urologic cancer services and care pathways across the globe. This study aimed to retrospectively determine the pandemic's impact on the urologic oncological surgery outcomes at a high-volume referral center.
We compared the number and histopathological outcomes of urologic oncological procedures in a referral center coded during the pandemic and data of the period before the pandemic as control. Data were extracted from patient files and hospital records. The pathological examination included a complete histopathological staging according to TNM stage.
A total of 683 patients were included in the study, 424 (62%) of which were operated in the pre-pandemic period. There was a 39% decline in urologic oncological surgical activity in the pandemic, mostly in renal and prostate cancer. The mean tumor size was larger in renal cancer patients who underwent surgery during the pandemic (5.6 cm vs 4.5 cm, p=0.002). During the pandemic, more lymph node involvement was seen after radical cystectomy and prostatectomy (50% vs 27.8%, p=0.024 and 12.5% vs 4.5%, p=0.026, respectively). No differences in terms of main pathologic features were observed in patients undergoing radical orchiectomy.
COVID-19 appeared to adversely effect oncologic outcomes in patiens undergone surgery for prostate and bladder cancer. Tumor development induced by a delay in diagnosis may cause severe consequences for patients. Reprioritizion of non-deferrable urologic oncological seems crucial.
2019年冠状病毒病（COVID-19）大流行扰乱了所有常规医疗服务，并导致全球范围内泌尿生殖系统癌症服务和护理途径的重大重新配置。本研究旨在回顾性确定该大流行对一家大型转诊中心泌尿生殖系统肿瘤手术结果的影响。
我们比较了该转诊中心在大流行期间编码的泌尿生殖系统肿瘤手术的数量和组织病理学结果，并将其与大流行前时期的数据作为对照。数据从患者档案和医院记录中提取。病理检查包括根据TNM分期进行完整的组织病理学分期。
本研究共纳入683例患者，其中424例（62%）在大流行前接受了手术。大流行期间泌尿生殖系统肿瘤手术活动下降了39%，主要是肾癌和前列腺癌。在大流行期间接受手术的肾癌患者中，平均肿瘤大小更大（5.6厘米对4.5厘米，p=0.002）。在大流行期间，根治性膀胱切除术和前列腺切除术后发现更多淋巴结受累（分别为50%对27.8%，p=0.024和12.5%对4.5%，p=0.026）。接受根治性睾丸切除的患者在主要病理特征方面未观察到差异。
COVID-19似乎对接受前列腺癌和膀胱癌手术的患者的肿瘤学结果产生不利影响。诊断延迟导致的肿瘤进展可能给患者带来严重后果。重新安排不可推迟的泌尿生殖系统肿瘤手术的优先级似乎至关重要。
