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Clinical and Surgical Assistance in Prostate Cancer during the COVID-19 Pandemic: Implementation of assistance protocols.
Sanchez, Lara Rodriguez; Cathelineau, Xavier; Pinto, Alexis M Alva; Borque-Fernando, Ángel; Gil, Maria Jesús; Yee, Chi-Hang; Sanchez-Salas, Rafael.
  • Sanchez LR; Department of Urology, L'Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France.
  • Cathelineau X; Department of Urology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Pinto AMA; Department of Urology, L'Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France.
  • Borque-Fernando Á; Department of Urology, Clínica Oncosalud, Lima, Peru.
  • Gil MJ; Department of Urology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Yee CH; IIS-Aragon, Zaragoza, Spain.
  • Sanchez-Salas R; Department of Urology, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Int Braz J Urol ; 46(suppl.1): 50-61, 2020 07.
Article in English | MEDLINE | ID: covidwho-601969
Semantic information from SemMedBD (by NLM)
1. Surgical assistance TREATS Malignant neoplasm of prostate
Subject
Surgical assistance
Predicate
TREATS
Object
Malignant neoplasm of prostate
2. Malignant neoplasm of prostate COEXISTS_WITH COVID-19
Subject
Malignant neoplasm of prostate
Predicate
COEXISTS_WITH
Object
COVID-19
3. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
4. Neoplasms PROCESS_OF Patients
Subject
Neoplasms
Predicate
PROCESS_OF
Object
Patients
5. Antiandrogen therapy TREATS American College of Cardiology/American Heart Association Lesion Complexity Score C
Subject
Antiandrogen therapy
Predicate
TREATS
Object
American College of Cardiology/American Heart Association Lesion Complexity Score C
6. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Patients
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Patients
7. Antiandrogen therapy TREATS Patients
Subject
Antiandrogen therapy
Predicate
TREATS
Object
Patients
8. FLVCR1 PART_OF Patients
Subject
FLVCR1
Predicate
PART_OF
Object
Patients
9. Patient observation TREATS Patients
Subject
Patient observation
Predicate
TREATS
Object
Patients
10. Surgical assistance TREATS Malignant neoplasm of prostate
Subject
Surgical assistance
Predicate
TREATS
Object
Malignant neoplasm of prostate
11. Malignant neoplasm of prostate COEXISTS_WITH COVID-19
Subject
Malignant neoplasm of prostate
Predicate
COEXISTS_WITH
Object
COVID-19
12. Malignant Neoplasms PROCESS_OF Patients
Subject
Malignant Neoplasms
Predicate
PROCESS_OF
Object
Patients
13. Neoplasms PROCESS_OF Patients
Subject
Neoplasms
Predicate
PROCESS_OF
Object
Patients
14. Antiandrogen therapy TREATS American College of Cardiology/American Heart Association Lesion Complexity Score C
Subject
Antiandrogen therapy
Predicate
TREATS
Object
American College of Cardiology/American Heart Association Lesion Complexity Score C
15. American College of Cardiology/American Heart Association Lesion Complexity Score C PROCESS_OF Patients
Subject
American College of Cardiology/American Heart Association Lesion Complexity Score C
Predicate
PROCESS_OF
Object
Patients
16. Antiandrogen therapy TREATS Patients
Subject
Antiandrogen therapy
Predicate
TREATS
Object
Patients
17. FLVCR1 PART_OF Patients
Subject
FLVCR1
Predicate
PART_OF
Object
Patients
18. Patient observation TREATS Patients
Subject
Patient observation
Predicate
TREATS
Object
Patients
ABSTRACT

PURPOSE:

Propose an approach of prostate cancer (PCa) patients during COVID-19 pandemic. MATERIAL AND

METHODS:

We conducted a review of current literature related to surgical and clinical management of patients during COVID-19 crisis paying special attention to oncological ones and especially those suffering from PCa. Based on these publications and current urological guidelines, a manual to manage PCa patients is suggested.

RESULTS:

Patients suffering from cancer are likely to develop serious complications from COVID-19 disease together with an increased risk of postoperative morbidity and mortality. Therefore, the management of oncological patients should be taken into special consideration and most of the treatments postponed. In case the procedure is not deferrable, it should be adapted to the current situation. While the shortest radiotherapy (RT) regimens should be applied, surgical procedures must undergo the following recommendations proposed by main surgical associations. PCa prognosis is generally favourable and therefore one can safely delay most of the biopsies up to 6 months without interfering with survival outcomes in the vast majority of cases. In the same way, most of the localised PCa patients are suitable for active surveillance (AS) or hormonal therapy until local definitive treatment could be reconsidered. In metastatic as well as castration resistant PCa stages, adding androgen receptor targeted agents (abiraterone, apalutamide, darolutamide or enzalutamide) to androgen-deprivation therapy (ADT) could be considered in high risk patients. On the contrary, chemotherapy, immunotherapy and Radium-223 must be avoided with regard to the consequence of hematologic toxicity and risk of COVID-19 infection because of immunodepression.

CONCLUSIONS:

Most of the biopsies should be delayed while AS is advised in those patients with low risk PCa. ADT allows us to defer definitive local treatment in many cases of intermediate and high risk PCa. In regard to metastatic and castration resistant PCa, combination therapies with abiraterone, apalutamide, darolutamide or enzalutamide could be considered. Chemotherapy, Radium-223 and immunotherapy are discouraged.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Prostatic Neoplasms / Urology / Coronavirus Infections Type of study: Clinical Practice Guide Limits: Humans / Male Language: English Journal: Int Braz J Urol Journal subject: Urology Year: 2020 Document Type: Article Affiliation country: S1677-5538.IBJU.2020.S106

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Prostatic Neoplasms / Urology / Coronavirus Infections Type of study: Clinical Practice Guide Limits: Humans / Male Language: English Journal: Int Braz J Urol Journal subject: Urology Year: 2020 Document Type: Article Affiliation country: S1677-5538.IBJU.2020.S106