ABSTRACT
Background: The COVID-19 global pandemic required a great organizational effort to reduce the n. of patient contacts in Hospital. Based on a recent Italian survey 80% of cancer centers adopted alternative modalities to get in touch with patients. However there are no data on the remote management in follow-up. Material and methods: In this study we collected data regarding oncological patients in follow-up whose control visit was scheduled between 11/03 and 15/05 at AOUC. Categorical data were analysed by chi square or Fisher exact test;statistical analysis of continuous variables was performed by Mann Whitney U test. Results: 222 patients were enrolled: 99 man, 123 women (median age 68 yrs). The 43.6% were affected by gastrointestinal tumors, 21.1% genitourinary, 17.5% gynecological/ breast, 8.5% thoracic and 7.2% melanoma. 35% were stage I, 30% stage II, 23% stage III and 12% stage IV. The median time from diagnosis was 3 years. 192 out of 222 (86%) did not underwent the planned medical examination;28% of them postponed (9% managed by call, 1 by email and 89 both). 51% of them were contacted through the caregiver. The % of patients that underwent medical examination was 4.4, 11.7 e 24.25 in March, April and May respectively, suggesting a different compliance with respect to remote management, correlated to a perception of the risk of infection. The median postponement time of was 28 days (5-51). For almost all patients (95.5%) there was no evidence of disease, for 2.7% was registered a relapse and for 1.8% additional examination was ongoing: a correlation was observed between in-person visit and the recurrence (p=0.012) and between elderly patients and caregiver mediated contact (p=0.002). Conclusions: This experience shows that the remote management of cancer patients in follow-up is feasible. Many aspects need to be clarified: lates outcomes, patient satisfaction, type of patients who can benefit. Almost all patients were managed both by telephonic interview and by e-mail, resulting in longer consultation time. Likely, a preventive and exhaustive patient information and a better technological equipment would improve the quality and the duration of the tele-consultation. The incremental percentage of in-person visits is another aspect to be investigated. Lastly, greater attention and training should be addressed to caregivers. The correlation emerged between in person in-visit and recurrence could be explained by a proper physician screening.