S Bennett1, K Søreide2, S Gholami3, P Pessaux4, C Teh5, E Segelov6, H Kennecke3, H Prenen7, S Myrehaug1, D Callegaro1,8, J Hallet1. 1. Canada: Department of Surgery, University of Toronto, Toronto, ON (Bennett, Callegaro, Hallet); Department of Radiation Oncology, University of Toronto, Toronto, ON (Myrehaug); Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON (Hallet). 2. Norway: Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, and Department of Clinical Medicine, University of Bergen, Bergen. 3. United States: Division of Surgical Oncology, Department of Surgery, University of California, Davis, CA (Gholami); Virginia Mason Cancer Institute, Seattle, WA (Kennecke). 4. France: Department of Surgery, Institut Hospitalo-Universitaire de Strasbourg, Strasbourg. 5. Philippines: Institute of Surgery, St. Luke's Medical Center, Quezon City; Department of Surgery, Makati Medical Center, Makati; and Department of General Surgery, National Kidney and Transplant Institute, Quezon City. 6. Australia: Monash University and Monash Health, Melbourne. 7. Belgium: Department of Oncology, University Hospital Antwerp, Antwerp. 8. Italy: Department of Surgery, Fondazione irccs Istituto Nazionale Tumori, Milan.
Abstract
Objective: We aimed to review data about delaying strategies for the management of hepatobiliary cancers requiring surgery during the covid-19 pandemic. Background: Given the covid-19 pandemic, many jurisdictions, to spare resources, have limited access to operating rooms for elective surgical activity, including cancer, thus forcing deferral or cancellation of cancer surgeries. Surgery for hepatobiliary cancer is high-risk and particularly resource-intensive. Surgeons must critically appraise which patients will benefit most from surgery and which ones have other therapeutic options to delay surgery. Little guidance is currently available about potential delaying strategies for hepatobiliary cancers when surgery is not possible. Methods: An international multidisciplinary panel reviewed the available literature to summarize data relating to standard-of-care surgical management and possible mitigating strategies to be used as a bridge to surgery for colorectal liver metastases, hepatocellular carcinoma, gallbladder cancer, intrahepatic cholangiocarcinoma, and hilar cholangiocarcinoma. Results: Outcomes of surgery during the covid-19 pandemic are reviewed. Resource requirements are summarized, including logistics and adverse effects profiles for hepatectomy and delaying strategies using systemic, percutaneous and radiation ablative, and liver embolic therapies. For each cancer type, the long-term oncologic outcomes of hepatectomy and the clinical tools that can be used to prognosticate for individual patients are detailed. Conclusions: There are a variety of delaying strategies to consider if availability of operating rooms decreases. This review summarizes available data to provide guidance about possible delaying strategies depending on patient, resource, institution, and systems factors. Multidisciplinary team discussions should be leveraged to consider patient- and tumour-specific information for each individual case. 2020 Multimed Inc.
Objective: We aimed to review data about delaying strategies for the management of hepatobiliary cancers requiring surgery during the covid-19 pandemic. Background: Given the covid-19 pandemic, many jurisdictions, to spare resources, have limited access to operating rooms for elective surgical activity, including cancer, thus forcing deferral or cancellation of cancer surgeries. Surgery for hepatobiliary cancer is high-risk and particularly resource-intensive. Surgeons must critically appraise which patients will benefit most from surgery and which ones have other therapeutic options to delay surgery. Little guidance is currently available about potential delaying strategies for hepatobiliary cancers when surgery is not possible. Methods: An international multidisciplinary panel reviewed the available literature to summarize data relating to standard-of-care surgical management and possible mitigating strategies to be used as a bridge to surgery for colorectal liver metastases, hepatocellular carcinoma, gallbladder cancer, intrahepatic cholangiocarcinoma, and hilar cholangiocarcinoma. Results: Outcomes of surgery during the covid-19 pandemic are reviewed. Resource requirements are summarized, including logistics and adverse effects profiles for hepatectomy and delaying strategies using systemic, percutaneous and radiation ablative, and liver embolic therapies. For each cancer type, the long-term oncologic outcomes of hepatectomy and the clinical tools that can be used to prognosticate for individual patients are detailed. Conclusions: There are a variety of delaying strategies to consider if availability of operating rooms decreases. This review summarizes available data to provide guidance about possible delaying strategies depending on patient, resource, institution, and systems factors. Multidisciplinary team discussions should be leveraged to consider patient- and tumour-specific information for each individual case. 2020 Multimed Inc.
Authors: M Lemke; C H L Law; J Li; E Dixon; M Tun Abraham; R Hernandez Alejandro; S Bennett; G Martel; P J Karanicolas Journal: Br J Surg Date: 2017-01-12 Impact factor: 6.939
Authors: Gajanan D Wagholikar; Anu Behari; Narendra Krishnani; Ashok Kumar; Sadiq S Sikora; Rajan Saxena; Vinay K Kapoor Journal: J Am Coll Surg Date: 2002-02 Impact factor: 6.113
Authors: Andrea Gori; Daniele Dondossola; Barbara Antonelli; Davide Mangioni; Laura Alagna; Paolo Reggiani; Alessandra Bandera; Giorgio Rossi Journal: Am J Transplant Date: 2020-04-12 Impact factor: 8.086
Authors: Masumi Ueda; Renato Martins; Paul C Hendrie; Terry McDonnell; Jennie R Crews; Tracy L Wong; Brittany McCreery; Barbara Jagels; Aaron Crane; David R Byrd; Steven A Pergam; Nancy E Davidson; Catherine Liu; F Marc Stewart Journal: J Natl Compr Canc Netw Date: 2020-03-20 Impact factor: 11.908
Authors: Humaid O Al-Shamsi; Waleed Alhazzani; Ahmad Alhuraiji; Eric A Coomes; Roy F Chemaly; Meshari Almuhanna; Robert A Wolff; Nuhad K Ibrahim; Melvin L K Chua; Sebastien J Hotte; Brandon M Meyers; Tarek Elfiki; Giuseppe Curigliano; Cathy Eng; Axel Grothey; Conghua Xie Journal: Oncologist Date: 2020-04-27
Authors: William A Cambridge; Cameron Fairfield; James J Powell; Ewen M Harrison; Kjetil Søreide; Stephen J Wigmore; Rachel V Guest Journal: Ann Surg Date: 2021-02-01 Impact factor: 13.787