European Urology Open Science (Mar 2021)
Major Urological Cancer Surgery for Patients is Safe and Surgical Training Should Be Encouraged During the COVID-19 Pandemic: A Multicentre Analysis of 30-day Outcomes
- Wei Shen Tan,
- Rajan Arianayagam,
- Pramit Khetrapal,
- Edward Rowe,
- Samantha Kearley,
- Ahmed Mahrous,
- Raj Pal,
- William Fowler,
- Rakesh Heer,
- Mohamed Elajnaf,
- Jayne Douglas-Moore,
- T.R. Leyshon Griffiths,
- James Voss,
- Daniel Wilby,
- Omar Al Kadhi,
- Jonathan Noel,
- Nikhil Vasdev,
- Alastair McKay,
- Imran Ahmad,
- Islam Abu-Nayla,
- Benjamin Lamb,
- George T. Hill,
- Krishna Narahari,
- Howard Kynaston,
- Arzu Yousuf,
- Venkata R.M. Kusuma,
- Jo Cresswell,
- Pete Cooke,
- Aniruddha Chakravarti,
- Ravi Barod,
- Axel Bex,
- John D. Kelly
Affiliations
- Wei Shen Tan
- Division of Surgery and Interventional Science, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK; Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK; Corresponding author. Division of Surgery and Interventional Science, University College London, 43–45 Foley Street, London W1W 7TY, UK.
- Rajan Arianayagam
- Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK
- Pramit Khetrapal
- Division of Surgery and Interventional Science, University College London, London, UK; Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK
- Edward Rowe
- Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Samantha Kearley
- Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Ahmed Mahrous
- Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Raj Pal
- Department of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- William Fowler
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
- Rakesh Heer
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK; Department of Urology, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Mohamed Elajnaf
- Department of Urology, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Jayne Douglas-Moore
- Department of Urology, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- T.R. Leyshon Griffiths
- Department of Urology, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- James Voss
- Department of Urology, Queen Alexandra Hospital, Portsmouth Hospital NHS Trust, Portsmouth, UK
- Daniel Wilby
- Department of Urology, Queen Alexandra Hospital, Portsmouth Hospital NHS Trust, Portsmouth, UK
- Omar Al Kadhi
- Department of Urology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Jonathan Noel
- Department of Urology, Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK
- Nikhil Vasdev
- Department of Urology, Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Alastair McKay
- Department of Urology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
- Imran Ahmad
- Department of Urology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK; Beatson Institute for Cancer Research, Glasgow, UK
- Islam Abu-Nayla
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Benjamin Lamb
- Department of Urology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- George T. Hill
- Department of Urology, University Hospital of Wales, Cardiff & Vale University Health Board, Cardiff, UK
- Krishna Narahari
- Department of Urology, University Hospital of Wales, Cardiff & Vale University Health Board, Cardiff, UK
- Howard Kynaston
- Department of Urology, University Hospital of Wales, Cardiff & Vale University Health Board, Cardiff, UK
- Arzu Yousuf
- Department of Urology, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
- Venkata R.M. Kusuma
- Department of Urology, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
- Jo Cresswell
- Department of Urology, The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
- Pete Cooke
- Department of Urology, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Aniruddha Chakravarti
- Department of Urology, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Ravi Barod
- Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK
- Axel Bex
- Division of Surgery and Interventional Science, University College London, London, UK; Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK
- John D. Kelly
- Division of Surgery and Interventional Science, University College London, London, UK; Department of Uro-Oncology, University College London Hospitals NHS Foundation Trust, London, UK
- Journal volume & issue
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Vol. 25
pp. 39 – 43
Abstract
COVID-19 has resulted in the deferral of major surgery for genitourinary (GU) cancers with the exception of cancers with a high risk of progression. We report outcomes for major GU cancer operations, namely radical prostatectomy (RP), radical cystectomy (RC), radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy performed at 13 major GU cancer centres across the UK between March 1 and May 5, 2020. A total of 598 such operations were performed. Four patients (0.7%) developed COVID-19 postoperatively. There was no COVID-19–related mortality at 30 d. A minimally invasive approach was used in 499 cases (83.4%). A total of 228 cases (38.1%) were described as training procedures. Training case status was not associated with a higher American Society of Anesthesiologists (ASA) score (p = 0.194) or hospital length of stay (LOS; p > 0.05 for all operation types). The risk of contracting COVID-19 was not associated with longer hospital LOS (p = 0.146), training case status (p = 0.588), higher ASA score (p = 0.295), or type of hospital site (p = 0.303). Our results suggest that major surgery for urological cancers remains safe and training should be encouraged during the ongoing COVID-19 pandemic provided appropriate countermeasures are taken. These real-life data are important for policy-makers and clinicians when counselling patients during the current pandemic. Patient summary: We collected outcome data for major operations for prostate, bladder, and kidney cancers during the COVID-19 pandemic. These surgeries remain safe and training should be encouraged during the ongoing pandemic provided appropriate countermeasures are taken. Our real-life results are important for policy-makers and clinicians when counselling patients during the COVID-19 pandemic.
