Kuusk, T;
Cullen, D;
Neves, JB;
Campain, N;
Barod, R;
Boleti, E;
El-Sheihk, S;
... Bex, A; + view all
(2021)
Impact of the first surge of the COVID-19 pandemic on a tertiary referral centre for kidney cancer.
BJU International
, 128
(6)
pp. 752-758.
10.1111/bju.15441.
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Abstract
OBJECTIVES: To analyse the impact of the COVID-19 pandemic on a centralised specialist kidney cancer care pathway. MATERIALS & METHODS: Retrospective analysis of patient and pathway characteristics including prioritisation strategies at the Specialist Centre for Kidney Cancer (SCKC) located at the Royal Free London NHS Foundation Trust (RFH) before and during the surge of COVID-19. RESULTS: On March 18, 2020 all elective surgery was halted at RFH to redeploy resources and staff for the COVID-19 surge. Prioritising of patients according to European Association of Urology guidance was introduced. Clinics and the specialist multidisciplinary team meetings (SMDT) were maintained with physical distancing, kidney surgery moved to a COVID-protected site and infection prevention measurements were enforced. During the 7 weeks of lockdown (March 23 to May 10, 2020), 234 cases were discussed at the SMDT, 53% compared to 446 in the 7 weeks pre-lockdown. The reduction in referral was more pronounced for small and asymptomatic renal masses. Of 62 low priority cancer patients, 27 (43.5%) were deferred. Only 1 (4%) COVID-19 infection occurred postoperatively followed by full recovery. No increase in clinical or pathological upstaging could be detected in patients who underwent deferred surgery compared to pre-COVID practice. CONCLUSION: The first surge of the COVID-19 pandemic severely impacted diagnosis, referral and treatment of kidney cancer at a tertiary referral centre. With a policy of prioritisation and COVID-protected pathways, capacity for time-sensitive oncological interventions was maintained and no immediate clinical harm was observed.
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