Major urological cancer surgery for patients is safe and surgical training should be encouraged during the COVID-19 pandemic: A multi-centre analysis of 30-day outcomes

Wei Shen Tan, Ranjan Arianayagam, Pramit Khetrapal, Edward Rowe, Samantha Kearley, Ahmed Mahrous, Raj Pal, William Fowler, Rakesh Heer, Mohamed Elajnaf, Jayne Douglas-Moore, TR Leyshon Griffiths, James Voss, Daniel Wilby, Omar Al Kadhi, Jonathan Noel, Nikhil Vasdev, Alastair McKay, Imran Ahmad, Islam Abu-NaylaBenjamin Lamb, George T Hill, Krishna Narahari, Howard Kynaston, Arzu Yousuf, Venkata RM Kusuma, Joanne Cresswell, Pete Cooke, Aniruddha Chakravarti, Ravi Barod, Axel Bex, John D Kelly

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Abstract

COVID-19 has resulted in the deferral of major surgery for genitourinary (GU) cancers with the exception of cancers with a high risk of progression. We report outcomes for major GU cancer operations, namely radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy performed at 13 major GU cancer centres across the UK between March 1 and May 5, 2020. A total of 598 such operations were performed. Four patients (0.7%) developed COVID-19 postoperatively. There was no COVID-19–related mortality at 30 d. A minimally invasive approach was used in 499 cases (83.4%). A total of 228 cases (38.1%) were described as training procedures. Training case status was not associated with a higher American Society of Anesthesiologists (ASA) score (p = 0.194) or hospital length of stay (LOS; p > 0.05 for all operation types). The risk of contracting COVID-19 was not associated with longer hospital LOS (p = 0.146), training case status (p = 0.588), higher ASA score (p = 0.295), or type of hospital site (p = 0.303). Our results suggest that major surgery for urological cancers remains safe and training should be encouraged during the ongoing COVID-19 pandemic provided appropriate countermeasures are taken. These real-life data are important for policy-makers and clinicians when counselling patients during the current pandemic. Patient summary: We collected outcome data for major operations for prostate, bladder, and kidney cancers during the COVID-19 pandemic. These surgeries remain safe and training should be encouraged during the ongoing pandemic provided appropriate countermeasures are taken. Our real-life results are important for policy-makers and clinicians when counselling patients during the COVID-19 pandemic.

Original languageEnglish
Pages (from-to)39-43
Number of pages5
JournalEuropean Urology Open Science
Volume25
Early online date9 Jan 2021
DOIs
Publication statusPublished - Mar 2021

Keywords

  • COVID-19
  • Cystectomy
  • Mortality
  • Nephrectomy
  • Outcomes
  • Prostatectomy

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