Urological Cancer Treatment by a Multidisciplinary Teamthroughout the Covid-19 Pandemic: What Have We Learned? / Tratamiento del cáncer urológico por un equipo multidisciplinario durante la pandemia de Covid-19: ¿QueÌ hemos aprendido?
urol. colomb. (Bogotá. En línea)
; 30(3): 210-216, 15/09/2021. tab
Article
em En
| LILACS, COLNAL
| ID: biblio-1369434
Biblioteca responsável:
CO364.9
ABSTRACT
Introduction It is known that cancer care is best approached by a multidisciplinary team (MDT). This became specifically true in the Covid-19 pandemic in which choices for urological cancer treatment are influenced by many factors. In some cases, delayed treatment may have consequences regarding the patient's oncological outcomes. The aim of the present article is to report our experience throughout the Covid-19 pandemic treating patients with urological neoplasms at a high-volume center. Methods We used a convenience sampling method. Cases were evaluated and discussed on an individual basis at the MDT meetings, and, after a consensus regarding delaying or scheduling treatment, patients were scheduled according to the risk of postponing the procedures. The Medically Necessary, Time-Sensitive (MeNTS) scoring system was measured in each patient; all patients answered the Centers for Disease Control and Prevention (CDC) Covid-19 self-screening questionnaire prior to surgery. The Covid-19-free survival rate was estimated. Results A total of 194 patients were assessed by themultidisciplinary team and finally treated, with median follow-up of 4 (interquartile range [IQR] 2.75 to 6) months. Only two patients had Covid-19 confirmed by real-time polymerase chain reaction (RT-PCR). In total, 54 patients underwent oncological surgery, 129 were treated with radiotherapy, and 11 were treated with intravenous chemotherapy. Themedian age was 66 years (IQR 59 to 94 years), and the median MeNTS score in the surgically-treated cohort was 35 points (IQR 31 to 47 points). Conclusions The evaluation and treatment of urological cancer should be conducted by an MDT; this is of utmost importance, especially during the Covid-19 pandemic. The data collected in our institution showed that most patients could be safely treated by taking all necessary precautions and discussing each case individually in the MDT meetings and performing a close follow-up.
RESUMEN
Introduccion La atencioÌn del caÌncer se aborda mejor con un equipo multidisciplinario (EMD), aspecto que se tornoÌ maÌs importante en la pandemia por Covid-19, en que las opciones para tratar el caÌncer uroloÌgico estaÌn influenciadas por muchos factores. En algunos casos, el tratamiento retrasado puede tener consecuencias en los resultados oncoloÌgicos del paciente. El objetivo de este estudio es describir nuestra experiencia en un centro de referencia y de alto volumen para el tratamiento de neoplasias urológicas durante la pandemia por Covid-19. MeÌtodos Realizamos un muestreo por conveniencia. Posteriormente, los casos fueron evaluados y discutidos de forma individual en las reuniones del EMD. Posterior a la obtencioÌn de un consenso sobre el tratamiento del paciente, los pacientes fueron programados seguÌn el riesgo individual de posponer el manejo. Se midioÌ la puntuacioÌn de cada paciente en el sistema Medically Necessary Time-Sensitive (MeNTS, "Médicamente necesario, sensibles al tiempo"). Todos los pacientes respondieron el cuestionario de autoevaluacioÌn del Centers for Disease Control and Prevention (CDC) COVID-19 antes de la cirugiÌa. Se estimó la tasa de supervivencia libre de Covid-19. Resultados Un total de 194 pacientes fueron evaluados por el EMD y finalmente tratados, con una mediana de seguimiento de 4 (rango intercuartil [RIC] 2,75 a 6) meses. Solo dos teniÌan Covid-19 confirmado por reacción en cadena de la polimerasa en tiempo real (RCP-TR). Un total de 54 pacientes fueron sometidos a cirugiÌa oncoloÌgica, 129 fueron tratados con radioterapia, y 11 fueron tratados con quimioterapia intravenosa. La mediana de edad fue de 66 anÌos (RIC 59 a 94 años), la puntuacioÌn mediana en el MeNTS de la cohorte tratada quiruÌrgicamente fue de 35 puntos (RIC 31 a 47 puntos). Conclusiones La evaluacioÌn y el tratamiento del caÌncer uroloÌgico debe ser realizado por un EMD durante la pandemia de Covid-19. Los datos recopilados en nuestra institucioÌn mostraron que la mayoriÌa de los pacientes podriÌan ser tratados de manera segura, discutiendo cada caso individualmente y haciendo un seguimiento cercano.
Assuntos
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
COLNAL
/
LILACS
Assunto principal:
Terapêutica
/
Neoplasias Urológicas
/
COVID-19
Tipo de estudo:
Screening_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Urol. colomb. (Bogotá. En línea)
Assunto da revista:
Urologia
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Colômbia
País de publicação:
Colômbia