Zafer Tandogdu1,2, Justin Collins1, Greg Shaw1, Jennifer Rohn2, Bela Koves3, Ashwin Sachdeva4, Ahmed Ghazi5, Alexander Haese6, Alex Mottrie7, Anup Kumar8, Ananthakrishnan Sivaraman9, Ashutosh Tewari10, Benjamin Challacombe11, Bernardo Rocco12, Camilo Giedelman13, Christian Wagner14, Craig G Rogers15, Declan G Murphy16, Dmitry Pushkar17, Gabriel Ogaya-Pinies18, James Porter19, Kulthe Ramesh Seetharam20, Markus Graefen21, Marcelo A Orvieto22, Marcio Covas Moschovas20, Oscar Schatloff23, Peter Wiklund10, Rafael Coelho24, Rair Valero25, Theo M de Reijke26, Thomas Ahlering27, Travis Rogers20, Henk G van der Poel28, Vipul Patel20, Walter Artibani29, Florian Wagenlehner30, Kris Maes31, Koon H Rha32, Senthil Nathan1, Truls Erik Bjerklund Johansen33, Peter Hawkey34,35, John Kelly1,2. 1. Department of Urology, University College London Hospital, London, UK. 2. Medical School, University College London, London, UK. 3. Department of Urology, Budapest Hospital, Budapest, Hungary. 4. Department of Urology, NHS Foundation Trust, Freeman Hospital, Newcastle Upon-Tyne, UK. 5. Department of Urology, University of Rochester, Rochester, NY, USA. 6. Leitender Arzt für Roboterassistierte Urologie, Martini-Klinik am UKE GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 7. Department of Urology, OLV Hospital, Aalst, Belgium. 8. Department Urology, Robotics and Renal Transplant, Safdarjang Hospital and VMMC, New Delhi, India. 9. Department of Urology, Apollo Hospitals, Chennai, India. 10. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 11. Department of Urology, Guy's and St Thomas' Hospitals, London, UK. 12. Department of Urology AOU di Mldena, University of Modena and Reggio Emilia, Modena, Italy. 13. Marly Clinic and the San José Hospital, Bogota, Colombia. 14. Head of Robotic Urology, St. Antonius - Hospital Gronau, Gronau, Germany. 15. Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA. 16. Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia. 17. Urology, MSMSU, Moscow, Russia. 18. Hospital Universitario Rey Juan Carlos, Madrid, Spain. 19. Swedish Medical Center, Seattle, WA, USA. 20. Adventhealth Global Robotics Institute, Celebration, FL, USA. 21. Martini-Klinik, University-Hospital Hamburg-Eppendorf, Hamburg, Germany. 22. Department of Urology, Clinica Alemana, Santiago, Chile. 23. Department of Urology, Sudmedica Health, Valparaiso, Chile. 24. University of São Paulo School of Medicine, São Paulo, Brazil. 25. Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. 26. Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. 27. University of California, Irvine, Orange, CA, USA. 28. Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 29. Department of Urology, University of Verona, Verona, Italy. 30. Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, Giessen, Germany. 31. Hospital Da Luz, Lisbon, Protugal. 32. Department of Urology, Institute of Urological Science, Yonsei University, Seoul, Korea. 33. Department of Urology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 34. Institute of Microbiology and Infection, University of Birmingham, Birmingham, UK. 35. Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Abstract
OBJECTIVE: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic. METHODS: We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways. RESULTS: Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as 'COVID-19 cold' sites. CONCLUSION: Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3-6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.
OBJECTIVE:Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic. METHODS: We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways. RESULTS: Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as 'COVID-19 cold' sites. CONCLUSION: Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3-6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.
Authors: Fabio Zattoni; Giancarlo Marra; Alexander Kretschmer; Felix Preisser; Derya Tilki; Claudia Kesch; Jan Philipp Radtke; Nils Hoffmann; Alessandro Morlacco; Fabrizio Dal Moro; Timo F W Soeterik; Roderick C N van den Bergh; Francesco Barletta; Alberto Briganti; Francesco Montorsi; Giorgio Gandaglia Journal: Cent European J Urol Date: 2021-09-18
Authors: John M Uecker; Farshid Alembeigi; Christopher R Idelson; Austin Fagerberg; Naser Ahmad; Alexander Cohen; Mitchell Gilkey Journal: Surg Endosc Date: 2020-09-24 Impact factor: 4.584
Authors: Ekaterina Laukhtina; Reza Sari Motlagh; Keiichiro Mori; Fahad Quhal; Victor M Schuettfort; Hadi Mostafaei; Satoshi Katayama; Nico C Grossmann; Guillaume Ploussard; Pierre I Karakiewicz; Alberto Briganti; Mohammad Abufaraj; Dmitry Enikeev; Benjamin Pradere; Shahrokh F Shariat Journal: World J Urol Date: 2021-05-28 Impact factor: 4.226