COVID-19大流行对德国一家转诊中心泌尿肿瘤疾病治疗结果的影响。
COVID-19 Pandemic Impact on Uro-Oncological Disease Outcomes at a German Referral Center.
作者信息
Elleisy Moustafa, Dräger Desiree Louise, Zettl Heike, Hakenberg Oliver W
机构信息
Department of Urology, University Medical Center Rostock, Rostock, Germany.
Clinical Cancer Registry, University Medicine Rostock, Rostock, Germany.
出版信息
Urol Int. 2025;109(2):135-145. doi: 10.1159/000541932. Epub 2024 Oct 9.
INTRODUCTION
To assess differences in referral and pathologic outcomes for uro-oncology cases prior to, during, and after the COVID-19 pandemic, comparing clinical and pathological data from cancer surgeries performed at a university medical center between 2018 and 2023.
METHODS
We collected data of 212 patients with radical prostatectomy (RP) for prostate cancer, 157 patients with radical cystectomies (RCs) for bladder cancer, 36 patients with radical nephroureterectomies (RNUs) for upper tract urothelial carcinoma, 133 patients with partial nephrectomies (PNs), and 160 patients with radical nephrectomies (RNs) for renal cancer, 93 patients with orchifunicolectomy for testicular cancer, 39 patients with newly diagnosed penile cancer. Data from patients treated between 2018 and February 2020 (before the COVID-19 pandemic) were compared with data from patients treated between March 2020 and March 2022 (during the COVID-19 pandemic) and between April 2022 and February 2023 (after the COVID-19 pandemic).
RESULTS
No differences in terms of main pathologic features were observed in patients undergoing RP, RNU, orchifunicolectomy, or circumcision and/or penectomy. Further, a lower pathological tumor stage was diagnosed for RN after the COVID-19 pandemic (p < 0.05). A higher age at diagnosis for penile cancer was observed during the pandemic cohort in comparison to the pre-COVID-19 pandemic cohort (p < 0.05), but this did not translate into a worse pathological stage or lymph node involvement. Another notable change was the shortening of the length of stay (LOS) for orchifunicolectomy over the pandemic (p < 0.05).
CONCLUSION
Neither decline in uro-oncologic activity nor pathological features were observed at our institution before, during, and after the COVID-19 pandemic. A significantly lower pathological tumor stage for RN after the COVID-19 pandemic was seen. Penile cancer was diagnosed at a significantly higher age during the COVID-19 pandemic, and a decrease in LOS for orchifunicolectomy was observed.
INTRODUCTION
To assess differences in referral and pathologic outcomes for uro-oncology cases prior to, during, and after the COVID-19 pandemic, comparing clinical and pathological data from cancer surgeries performed at a university medical center between 2018 and 2023.
METHODS
We collected data of 212 patients with radical prostatectomy (RP) for prostate cancer, 157 patients with radical cystectomies (RCs) for bladder cancer, 36 patients with radical nephroureterectomies (RNUs) for upper tract urothelial carcinoma, 133 patients with partial nephrectomies (PNs), and 160 patients with radical nephrectomies (RNs) for renal cancer, 93 patients with orchifunicolectomy for testicular cancer, 39 patients with newly diagnosed penile cancer. Data from patients treated between 2018 and February 2020 (before the COVID-19 pandemic) were compared with data from patients treated between March 2020 and March 2022 (during the COVID-19 pandemic) and between April 2022 and February 2023 (after the COVID-19 pandemic).
RESULTS
No differences in terms of main pathologic features were observed in patients undergoing RP, RNU, orchifunicolectomy, or circumcision and/or penectomy. Further, a lower pathological tumor stage was diagnosed for RN after the COVID-19 pandemic (p < 0.05). A higher age at diagnosis for penile cancer was observed during the pandemic cohort in comparison to the pre-COVID-19 pandemic cohort (p < 0.05), but this did not translate into a worse pathological stage or lymph node involvement. Another notable change was the shortening of the length of stay (LOS) for orchifunicolectomy over the pandemic (p < 0.05).
CONCLUSION
Neither decline in uro-oncologic activity nor pathological features were observed at our institution before, during, and after the COVID-19 pandemic. A significantly lower pathological tumor stage for RN after the COVID-19 pandemic was seen. Penile cancer was diagnosed at a significantly higher age during the COVID-19 pandemic, and a decrease in LOS for orchifunicolectomy was observed.
引言
为评估2019年冠状病毒病（COVID-19）大流行之前、期间和之后泌尿肿瘤病例的转诊和病理结果差异，比较2018年至2023年在一所大学医学中心进行的癌症手术的临床和病理数据。
方法
我们收集了212例接受前列腺癌根治术（RP）的患者、157例接受膀胱癌根治性膀胱切除术（RC）的患者、36例接受上尿路尿路上皮癌根治性肾输尿管切除术（RNU）的患者、133例接受部分肾切除术（PN）的患者以及160例接受肾癌根治性肾切除术（RN）的患者、93例接受睾丸癌睾丸精索切除术的患者、39例新诊断阴茎癌患者的数据。将2018年至2020年2月（COVID-19大流行之前）接受治疗的患者数据与2020年3月至2022年3月（COVID-19大流行期间）以及2022年4月至2023年2月（COVID-19大流行之后）接受治疗的患者数据进行比较。
结果
接受RP、RNU、睾丸精索切除术或包皮环切术和/或阴茎切除术的患者在主要病理特征方面未观察到差异。此外，COVID-19大流行后诊断出的RN病理肿瘤分期较低（p<0.05）。与COVID-19大流行前队列相比，在大流行队列中观察到阴茎癌的诊断年龄较高（p<0.05），但这并未转化为更差的病理分期或淋巴结受累情况。另一个显著变化是在大流行期间睾丸精索切除术的住院时间缩短（p<0.05）。
结论
在我们机构，COVID-19大流行之前、期间和之后均未观察到泌尿肿瘤活动下降或病理特征改变。COVID-19大流行后RN的病理肿瘤分期显著降低。在COVID-19大流行期间，阴茎癌的诊断年龄显著更高，并且观察到睾丸精索切除术的住院时间缩短。
引言
为评估2019年冠状病毒病（COVID-19）大流行之前、期间和之后泌尿肿瘤病例的转诊和病理结果差异，比较2018年至2023年在一所大学医学中心进行的癌症手术的临床和病理数据。
方法
我们收集了212例接受前列腺癌根治术（RP）的患者、157例接受膀胱癌根治性膀胱切除术（RC）的患者、36例接受上尿路尿路上皮癌根治性肾输尿管切除术（RNU）的患者、133例接受部分肾切除术（PN）的患者以及160例接受肾癌根治性肾切除术（RN）的患者、93例接受睾丸癌睾丸精索切除术的患者、39例新诊断阴茎癌患者的数据。将2018年至2020年2月（COVID-19大流行之前）接受治疗的患者数据与2020年3月至2022年3月（COVID-19大流行期间）以及2022年4月至2023年2月（COVID-19大流行之后）接受治疗的患者数据进行比较。
结果
接受RP、RNU、睾丸精索切除术或包皮环切术和/或阴茎切除术的患者在主要病理特征方面未观察到差异。此外，COVID-19大流行后诊断出的RN病理肿瘤分期较低（p<0.05）。与COVID-19大流行前队列相比，在大流行队列中观察到阴茎癌的诊断年龄较高（p<0.05），但这并未转化为更差的病理分期或淋巴结受累情况。另一个显著变化是在大流行期间睾丸精索切除术的住院时间缩短（p<0.05）。
结论
在我们机构，COVID-19大流行之前、期间和之后均未观察到泌尿肿瘤活动下降或病理特征改变。COVID-19大流行后RN的病理肿瘤分期显著降低。在COVID-19大流行期间，阴茎癌的诊断年龄显著更高，并且观察到睾丸精索切除术的住院时间缩短。
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