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1.
Int J Clin Pract ; 75(9): e14490, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1266327

ABSTRACT

PURPOSE: To evaluate the impact of delay in cystoscopic surveillance on recurrence and progression rates in non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: A total of 407 patients from four high-volume centres with NMIBC that applied for follow-up cystoscopy were included in our study prospectively. Patients' demographics and previous tumour characteristics, the presence of tumour in follow-up cystoscopy, the pathology results of the latest transurethral resection of bladder tumour (if tumour was detected) and the delay in cystoscopy time were recorded. Our primary outcomes were tumour recurrences detected by follow-up cystoscopy and progression. Multivariate logistic regression analysis was performed using the possible factors identified with univariate analyses (P values ≤ .2). RESULTS: A total of 105 patients (25.8%) had tumour recurrence in follow-up cystoscopy, and 20 (5.1%) of these patients had disease progression according to grade or stage. In multivariate analysis, the number of recurrences (OR: 1.307, P < .001) and the cystoscopy delay time (62-147 days, OR: 2.424, P = .002; >147 days, OR: 4.883, P < .001) were significant risk factors for tumour recurrence on follow-up cystoscopy; the number of recurrences (OR: 1.255, P = .024) and cystoscopy delay time (>90 days, OR: 6.704, P = .002) were significant risk factors for tumour progression. CONCLUSIONS: This study showed that a 2-5 months of delay in follow-up cystoscopy increases the risk of recurrence by 2.4-fold, and delay in cystoscopy for more than 3 months increases the probability of progression by 6.7-fold. We suggest that cystoscopic surveillance should be done during the COVID-19 pandemic according to the schedule set by relevant guidelines.


Subject(s)
COVID-19 , Urinary Bladder Neoplasms , Cystoscopy , Humans , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Pandemics , SARS-CoV-2 , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/surgery
2.
Urologia ; 88(1): 3-8, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1105635

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) pandemic has dramatically hit all Europe and Northern Italy in particular. The reallocation of medical resources has caused a sharp reduction in the activity of many medical disciplines, including urology. The restricted availability of resources is expected to cause a delay in the treatment of urological cancers and to negatively influence the clinical history of many cancer patients. In this study, we describe COVID-19 impact on uro-oncological management in Piedmont/Valle d'Aosta, estimating its future impact. METHODS: We performed an online survey in 12 urological centers, belonging to the Oncological Network of Piedmont/Valle d'Aosta, to estimate the impact of COVID-19 emergency on their practice. On this basis, we then estimated the medical working capacity needed to absorb all postponed uro-oncological procedures. RESULTS: Most centers (77%) declared to be "much"/"very much" affected by COVID-19 emergency. If uro-oncological consultations for newly diagnosed cancers were often maintained, follow-up consultations were more than halved or even suspended in around two out of three centers. In-office and day-hospital procedures were generally only mildly reduced, whereas major uro-oncological procedures were more than halved or even suspended in 60% of centers. To clear waiting list backlog, the urological working capacity should dramatically increase in the next months; delays greater than 1 month are expected for more than 50% of uro-oncological procedures. CONCLUSIONS: COVID-19 emergency has dramatically slowed down uro-oncological activity in Piedmont and Valle d'Aosta. Ideally, uro-oncological patients should be referred to COVID-19-free tertiary urological centers to ensure a timely management.


Subject(s)
COVID-19/epidemiology , Continuity of Patient Care , Health Services Accessibility , Medical Oncology/statistics & numerical data , Pandemics , SARS-CoV-2 , Urologic Surgical Procedures/statistics & numerical data , Urology/statistics & numerical data , Appointments and Schedules , Female , Health Care Surveys , Humans , Italy/epidemiology , Kidney Neoplasms/epidemiology , Kidney Neoplasms/surgery , Male , Medical Oncology/organization & administration , Procedures and Techniques Utilization , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/surgery , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/surgery , Urologic Neoplasms/epidemiology , Urologic Neoplasms/surgery , Urology/organization & administration
4.
Hum Vaccin Immunother ; 17(2): 416-417, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1093444

ABSTRACT

It has been theorized that Calmette-Guérin bacillus may prevent or reduce the severity of COVID-19 through a nonspecific stimulation of the immune system. A preliminary assessment of SARS-CoV-2 infection rates and outcomes among 2803 individuals affected with high risk non-muscle-invasive bladder cancer and treated with intra-bladder instillation of BCG, showed no evidence of a protective effect. However, the interpretation of these data need some caution, due to the low prevalence of infection (<1%) observed within this population, along with the fact that intra-bladder administration cannot mirror the usual intradermal administration of BCG, in particular in patients partially immunocompromised. Confirmation by larger prospective studies is required.


Subject(s)
BCG Vaccine/administration & dosage , COVID-19/epidemiology , COVID-19/prevention & control , Administration, Intravesical , Aged , Aged, 80 and over , BCG Vaccine/metabolism , COVID-19/metabolism , Female , Hospitalization/trends , Humans , Italy/epidemiology , Male , Middle Aged , Risk Factors , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/metabolism
5.
Actas Urol Esp (Engl Ed) ; 45(3): 207-214, 2021 Apr.
Article in English, Spanish | MEDLINE | ID: covidwho-1064691

ABSTRACT

INTRODUCTION: The suspension of most elective surgeries during COVID-19 pandemic caused the lengthening of urology surgical waiting lists. The objective of this study is to evaluate the impact of COVID-19 pandemic on urology surgical waiting list in a high-volume hospital. METHODS: An observational descriptive study was designed. All patients included in the urology surgical waiting list of our high-volume center on May 1st 2020 (46 days after the suspension of elective surgery) were analyzed. Baseline variables, priority on the waiting list, main urological disease, type of scheduled surgery, and waiting time were recorded. Other variables recorded were the presence of a urinary catheter, number of accesses to the emergency department, evidence of COVID-19 infection, number of deaths and their cause. The waiting time for each disease was compared with the time to surgery in 2019. RESULTS: A total of 350 patients were included. The mean (SD) time on the waiting list was 97.33 (55.47) days. Priority 1 patients, who normally should undergo surgery within 30 days, were on the waiting list for a mean (SD) time of 60.51 (20.14) days. They were mainly patients with ureteral lithiasis (25.6%), high-risk or muscle-invasive bladder cancer (20.9%) and high-risk prostate cancer (13.9%). The mean waiting time had already significantly exceeded the mean time to surgery in 2019 for radical cystectomy (p = 0.04) and URS (p = 0.003). CONCLUSIONS: The suspension of most elective surgeries due to COVID-19 had a significant impact on urology surgical waiting list of our high-volume center, especially in priority 1 group.


Subject(s)
COVID-19/epidemiology , Pandemics , Urologic Surgical Procedures/statistics & numerical data , Waiting Lists , Aged , Analysis of Variance , Cystectomy/statistics & numerical data , Elective Surgical Procedures , Female , Health Priorities , Hospitals, High-Volume , Humans , Kidney Neoplasms/epidemiology , Male , Prostatic Hyperplasia/epidemiology , Prostatic Neoplasms/epidemiology , Spain/epidemiology , Statistics, Nonparametric , Time Factors , Ureteral Calculi/epidemiology , Urinary Bladder Neoplasms/epidemiology , Withholding Treatment/statistics & numerical data
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