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Trends in urologic oncology clinical practice and medical education under COVID-19 pandemic: An international survey of senior clinical and academic urologists.
Rosenzweig, Barak; Bex, Axel; Dotan, Zohar A; Frydenberg, Mark; Klotz, Laurence; Lotan, Yair; Schulman, Claude C; Tsaur, Igor; Ramon, Jacob.
  • Rosenzweig B; Department of Urology, Chaim Sheba Medical Center, Ramat Gan, Israel, The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2013, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Electronic address: Barak.ros
  • Bex A; UCL Division of Surgery and Interventional Science, Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK.
  • Dotan ZA; Department of Urology, Chaim Sheba Medical Center, Ramat Gan, Israel, The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
  • Frydenberg M; Department of Surgery, Department of Anatomy and Developmental Biology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
  • Klotz L; Division of Urology, University of Toronto, Toronto, Ontario, Canada.
  • Lotan Y; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
  • Schulman CC; Clinic E Cavell and University of Brussels, Brussels, Belgium.
  • Tsaur I; Department of Urology, University Hospital of Mainz, Mainz, Germany.
  • Ramon J; Department of Urology, Chaim Sheba Medical Center, Ramat Gan, Israel, The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Urol Oncol ; 38(12): 929.e1-929.e10, 2020 12.
Article in English | MEDLINE | ID: covidwho-838829
ABSTRACT

OBJECTIVE:

Ad-hoc guidelines for managing the COVID-19 pandemic are published worldwide. We investigated international applications of such policies in the urologic-oncology community.

METHODS:

A 20-item survey was e-mailed via SurveyMonkey to 100 international senior urologic-oncology surgeons. Leaders' policies regarding clinical/surgical management and medical education were surveyed probing demographics, affiliations, urologic-oncologic areas of interest, and current transportation restrictions. Data on COVID-19 burden were retrieved from the ECDC. Statistical analyses employed non-parametric tests (SPSS v.25.0, IBM).

RESULTS:

Of 100 leaders from 17 countries, 63 responded to our survey, with 58 (92%) reporting university and/or cancer-center affiliations. Policies on new-patient visits remained mostly unchanged, while follow-up visits for low-risk diseases were mostly postponed, for example, 83.3% for small renal mass (SRM). Radical prostatectomy was delayed in 76.2% of cases, while maintaining scheduled timing for radical cystectomy (71.7%). Delays were longer in Europe than in the Americas for kidney cancer (SRM follow-up, P = 0.014), prostate cancer (new visits, P = 0.003), and intravesical therapy for intermediate-risk bladder cancer (P = 0.043). In Europe, COVID-19 burden correlated with policy adaptation, for example, nephrectomy delays for T2 disease (r = 0.5, P =0.005). Regarding education policies, trainees' medical education was mainly unchanged, whereas senior urologists' planned attendance at professional meetings dropped from 6 (IQR 1-11) to 2 (IQR 0-5) (P < 0.0001).

CONCLUSION:

Under COVID-19, senior urologic-oncology surgeons worldwide apply risk-stratified approaches to timing of clinical and surgical schedules. Policies regarding trainee education were not significantly affected. We suggest establishment of an international consortium to create a directive for coping with such future challenges to global healthcare.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urology / Urologists / COVID-19 / Medical Oncology Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Urol Oncol Journal subject: Neoplasms / Urology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urology / Urologists / COVID-19 / Medical Oncology Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Topics: Long Covid Limits: Humans Language: English Journal: Urol Oncol Journal subject: Neoplasms / Urology Year: 2020 Document Type: Article