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Delayed surgery for localised and metastatic renal cell carcinoma: a systematic review and meta-analysis for the COVID-19 pandemic.
Chan, Vinson Wai-Shun; Tan, Wei Shen; Leow, Jeffrey J; Tan, Wei Phin; Ong, William Lay Keat; Chiu, Peter Ka-Fung; Gurung, Pratik; Pirola, Giacomo Maria; Orecchia, Luca; Liew, Matthew Ping Chao; Lee, Hsiang-Ying; Wang, Yuding; Chen, I-Hsuan Alan; Castellani, Daniele; Wroclawski, Marcelo Langer; Mayor, Nikhil; Sathianathen, Niranjan J; Braga, Isaac; Liu, Zhenbang; Moon, Dora; Tikkinen, Kari; Kamat, Ashish; Meng, Max; Ficarra, Vincenzo; Giannarini, Gianluca; Teoh, Jeremy Yuen-Chun.
  • Chan VW; School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
  • Tan WS; Division of Surgery and Interventional Science, University College London, London, UK.
  • Leow JJ; S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
  • Tan WP; Department of Urology, Royal Free Hospital, London, UK.
  • Ong WLK; Division of Surgery and Interventional Science, University College London, London, UK.
  • Chiu PK; Department of Urology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Gurung P; Department of Urology, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
  • Pirola GM; Department of Urology, Rush University Medical Center, Chicago, IL, USA.
  • Orecchia L; Department of Urology, Penang General Hospital, Penang, Malaysia.
  • Liew MPC; S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
  • Lee HY; Department of Urology, University of Rochester Medical Center, New York, USA.
  • Wang Y; Urology Unit, San Donato Hospital, Arezzo, Italy.
  • Chen IA; Urology Unit, Policlinico Tor Vergata Foundation, Rome, Italy.
  • Castellani D; Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
  • Wroclawski ML; Urology Department, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.
  • Mayor N; Division of Urology, Department of Surgery, McMaster University, Hamilton, Canada.
  • Sathianathen NJ; Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Braga I; Urology Division, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica delle Marche, Ancona, Italy.
  • Liu Z; Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
  • Moon D; BP-A Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil.
  • Tikkinen K; Department of Urology, Royal Surrey County Hospital, Guildford, UK.
  • Kamat A; Department of Urology, University of Melbourne, Parkville, Victoria, Australia.
  • Meng M; Department of Urology, Instituto Portugues de Oncologia, Porto, Portugal.
  • Ficarra V; Department of Urology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Giannarini G; Department of Urology, East Lancashire Hospitals NHS Foundation Trust, Blackburn, UK.
  • Teoh JY; Departments of Urology and Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
World J Urol ; 39(12): 4295-4303, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1241604
Semantic information from SemMedBD (by NLM)
1. Patient observation METHOD_OF Nephrectomy
Subject
Patient observation
Predicate
METHOD_OF
Object
Nephrectomy
2. Patient observation METHOD_OF Nephrectomy
Subject
Patient observation
Predicate
METHOD_OF
Object
Nephrectomy
ABSTRACT

PURPOSE:

The COVID-19 pandemic has led to the cancellation or deferment of many elective cancer surgeries. We performed a systematic review on the oncological effects of delayed surgery for patients with localised or metastatic renal cell carcinoma (RCC) in the targeted therapy (TT) era.

METHOD:

The protocol of this review is registered on PROSPERO(CRD42020190882). A comprehensive literature search was performed on Medline, Embase and Cochrane CENTRAL using MeSH terms and keywords for randomised controlled trials and observational studies on the topic. Risks of biases were assessed using the Cochrane RoB tool and the Newcastle-Ottawa Scale. For localised RCC, immediate surgery [including partial nephrectomy (PN) and radical nephrectomy (RN)] and delayed surgery [including active surveillance (AS) and delayed intervention (DI)] were compared. For metastatic RCC, upfront versus deferred cytoreductive nephrectomy (CN) were compared.

RESULTS:

Eleven studies were included for quantitative analysis. Delayed surgery was significantly associated with worse cancer-specific survival (HR 1.67, 95% CI 1.23-2.27, p < 0.01) in T1a RCC, but no significant difference was noted for overall survival. For localised ≥ T1b RCC, there were insufficient data for meta-analysis and the results from the individual reports were contradictory. For metastatic RCC, upfront TT followed by deferred CN was associated with better overall survival when compared to upfront CN followed by deferred TT (HR 0.61, 95% CI 0.43-0.86, p < 0.001).

CONCLUSION:

Noting potential selection bias, there is insufficient evidence to support the notion that delayed surgery is safe in localised RCC. For metastatic RCC, upfront TT followed by deferred CN should be considered.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Carcinoma, Renal Cell / Time-to-Treatment / COVID-19 / Kidney Neoplasms Subject: Carcinoma, Renal Cell / Time-to-Treatment / COVID-19 / Kidney Neoplasms Type of study: Controlled clinical trial / Systematic review Language: English Journal: World J Urol Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Carcinoma, Renal Cell / Time-to-Treatment / COVID-19 / Kidney Neoplasms Subject: Carcinoma, Renal Cell / Time-to-Treatment / COVID-19 / Kidney Neoplasms Type of study: Controlled clinical trial / Systematic review Language: English Journal: World J Urol Clinical aspect: Etiology Year: 2021
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