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Impact of the first surge of the COVID-19 pandemic on a tertiary referral centre for kidney cancer.
Kuusk, Teele; Cullen, David; Neves, Joana Briosa; Campain, Nicholas; Barod, Ravi; Boleti, Ekaterini; El-Sheihk, Soha; Grant, Lee; Kelly, John; Marchetti, Marta; Mumtaz, Faiz; Patki, Prasad; Ramachandran, Navin; Silva, Pedro; Tran-Dang, My-Anh; Walkden, Miles; Tran, Maxine G B; Powles, Thomas; Bex, Axel.
  • Kuusk T; Department of Urology, Dartford and Gravesham NHS Trust, Darent Valley Hospital, Dartford, UK.
  • Cullen D; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Neves JB; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Campain N; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Barod R; UCL Division of Surgery and Interventional Science, London, UK.
  • Boleti E; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • El-Sheihk S; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Grant L; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Kelly J; Department of Oncology, Royal Free London NHS Foundation Trust, London, UK.
  • Marchetti M; Department of Pathology, Royal Free London NHS Foundation Trust, London, UK.
  • Mumtaz F; Department of Radiology, Royal Free London NHS Foundation Trust, London, UK.
  • Patki P; Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
  • Ramachandran N; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Silva P; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Tran-Dang MA; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Walkden M; Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK.
  • Tran MGB; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Powles T; Department of Pathology, Royal Free London NHS Foundation Trust, London, UK.
  • Bex A; Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK.
BJU Int ; 128(6): 752-758, 2021 12.
Article in English | MEDLINE | ID: covidwho-1219502
ABSTRACT

OBJECTIVE:

To analyse the impact of the COVID-19 pandemic on a centralized specialist kidney cancer care pathway. MATERIALS AND

METHODS:

We conducted a retrospective analysis of patient and pathway characteristics including prioritization strategies at the Specialist Centre for Kidney Cancer located at the Royal Free London NHS Foundation Trust (RFH) before and during the surge of COVID-19.

RESULTS:

On 18 March 2020 all elective surgery was halted at RFH to redeploy resources and staff for the COVID-19 surge. Prioritizing of patients according to European Association of Urology guidance was introduced. Clinics and the specialist multidisciplinary team (SMDT) meetings were maintained with physical distancing, kidney surgery was moved to a COVID-protected site, and infection prevention measurements were enforced. During the 7 weeks of lockdown (23 March to 10 May 2020), 234 cases were discussed at the SMDT meetings, 53% compared to the 446 cases discussed in the 7 weeks pre-lockdown. The reduction in referrals was more pronounced for small and asymptomatic renal masses. Of 62 low-priority cancer patients, 27 (43.5%) were deferred. Only one (4%) COVID-19 infection occurred postoperatively, and the patient made a full recovery. No increase in clinical or pathological upstaging could be detected in patients who underwent deferred surgery compared to pre-COVID practice.

CONCLUSION:

The first surge of the COVID-19 pandemic severely impacted diagnosis, referral and treatment of kidney cancer at a tertiary referral centre. With a policy of prioritization and COVID-protected pathways, capacity for time-sensitive oncological interventions was maintained and no immediate clinical harm was observed.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Care Team / Referral and Consultation / Carcinoma, Renal Cell / COVID-19 / Kidney Neoplasms Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: BJU Int Journal subject: Urology Year: 2021 Document Type: Article Affiliation country: Bju.15441

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Care Team / Referral and Consultation / Carcinoma, Renal Cell / COVID-19 / Kidney Neoplasms Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: BJU Int Journal subject: Urology Year: 2021 Document Type: Article Affiliation country: Bju.15441