TY - JOUR
T1 - Trends in urologic oncology clinical practice and medical education under COVID-19 pandemic
T2 - An international survey of senior clinical and academic urologists
AU - Rosenzweig, Barak
AU - Bex, Axel
AU - Dotan, Zohar A.
AU - Frydenberg, Mark
AU - Klotz, Laurence
AU - Lotan, Yair
AU - Schulman, Claude C.
AU - Tsaur, Igor
AU - Ramon, Jacob
N1 - Funding Information:
We wish to deeply thank our collaborators worldwide for their great effort and contribution to this work:, Peter Albers1, Edgardo F. Becher2, Charles Karim Bensalah3, Mitchell Benson4, Anders Bjartell5, Peter Black6, Bernard Bochner7, Gennady Bratslavsky8, Maurizio Brausi9, Fiona Burkhard10, Michael L. Cher11, Zachary Dovey12, Christopher Evans13, Adam Feldman14, Hanan Goldberg8, Markus Graefen15, Rennen Haramaty16, Markus Hohenfellner17, Adam Kibel18, Badrinath Konety19, Alon Lazarovich16, Seth Lerner20, Carlos Llorente21, Vitaly Margulis22, Surena F. Matin23, Vsevolod Matveev24, Francesco Montorsi25, Nicolas Mottet26, Peter Mulders27, Declan Murphy28, Joan Palou29, David Penson30, Jehonathan Pinthus31, Dmitry Pushkar32, Piotr Radziszewski32, Maria Jose Ribal Caparros34, Bernardo Maria Cesare Rocco35, Alejandro Rodriguez36, Morgan Rouprêt37, Rafael Sanchez-Salas38, Arieh Shalhav39, Joel Sheinfeld7, Neal Shore40, Mark Soloway41, Prasanna Sooriakumaran42, Robert Stein43, Arnulf Stenzl44, Christian Stief45, Mark Stovsky43, Ashutosh Tewari12, George Thalmann10, Levent Turkeri46, Celi Varol47, Arnauld Villers48, Wagaskar Vinayak12, Fred Witjes27, Marc Zerbib49, Alex Zlotta50, 1 Department of Urology, Heinrich-Heine University, Medical Faculty, Düsseldorf, Germany, 2 Devision of Urology, University of Buenos Aires, Buenos Aires, Argentina, 3 Department of Urology, University of Rennes, Rennes, France, 4 Department of Urology, Columbia University Irving Medical Center, New York, NY, USA, 5 Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden, 6 Department of Urologic Science, University of British Columbia, Vancouver, BC, Canada, 7 Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, 8 Department of Urology, Upstate Medical University, Syracuse, New York, NY, USA, 9 Department of Urology, B. Ramazzini Hospital, Modena, Italy, 10 Department of Urology, University Hospital Bern, Bern, Switzerland, 11 Department of Urology, Wayne State University, School of Medicine, Detroit, MI, USA, 12 Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA, 13 Department of Urology, School of Medicine, University of California, Davis, Sacramento, CA, USA, 14 Department of Urology, Massachusetts General Hospital, Boston, MA, USA, 15 Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 16Department of Urology, Chaim Sheba Medical Center, Ramat Gan, Israel, The Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel, 17 Department of Urology, University Hospital Heidelberg, Heidelberg, Germany, 18 Division of Urology, Brigham and Women's Hospital, Boston, MA, USA, 19 Department of Urology, University of Minnesota, Minneapolis, MN, USA, 20 Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA, 21 Department of Urology, Hospital Universitario Fundacion Alcorcon, Universidad Rey Juan Carlos, Madrid, Spain, 22 Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA, 23 Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 24 N.N. Blokhin Cancer Research Center, Moscow, Russia, 25 Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy, 26 Department of Urology, University Hospital Nord St. Etienne, St. Etienne, France, 27 Radboud University Medical Center, Nijmegen, Netherlands, 28 Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia, 29 Department of Urology, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain, 30 Department of Urology and the Center for Surgical Quality and Outcomes Research, Vanderbilt University, and the VA Tennessee Valley Geriatric Research, Education, and Clinical Center, Nashville, TN, USA, 31 Division of Urology, McMaster University, Hamilton, ON, Canada, 32 Department of Urology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia, 33 Department of Urology, Warsaw Medical University, Warsaw, Poland, 34 Uro-Oncology Unit, Hospital clinic. University of Barcelona, Barcelona, Spain, 35 Department of Urology, University of Modena and Reggio Emilia, Modena, Italy, 36 Urology Associates of Rochester, Rochester, NY, USA, 37 Sorbonne University, GRC 5 Predictive ONCO-URO, AP-HP, Urology, Pitie-Salpetriere Hospital, F-75013 PARIS, France, 38 Department of Urology, Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France, 39 Section of Urology, University of Chicago, Chicago, IL, USA, 40 Carolina Urologic Research Center and Atlantic Urology Clinics, Myrtle Beach, SC, USA, 41 Division of Urologic Oncology, Memorial Hospital, Hollywood, FL, USA, 42 Department of Uro-oncology, University College London Hospital, London, UK, 43 Department of Urology, Cleveland Clinic, Cleveland, OH, USA, 44 Department of Urology, Eberhard-Karls-University, Tübingen, Germany, 45 Department of Urology, Campus Großhadern, Ludwig-Maximilians-Universität München, Munich, Germany, 46 Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey, 47 Nepean Urology Research Group, Nepean Hospital, Kingswood, Australia, 48 Department of Urology, CHU Lille, University Lille Nord de France, Lille, France, 49 Department of Urology, Cochin Hospital, Paris Descartes University, Paris, France, 50 Department of Urology, Mount Sinai Hospital, Toronto, Ontario, Canada, The first author would like to thank Ido Didi Fabian, MD, leader of the Global Retinoblastoma Study Group, for his assistance in planning and setting in motion this international study.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/12
Y1 - 2020/12
N2 - 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.
AB - 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.
KW - Bladder cancer
KW - COVID-19 pandemic
KW - Kidney cancer
KW - Medical education
KW - Policy
KW - Prostate cancer
KW - Testicular cancer
KW - Urologic oncology
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U2 - 10.1016/j.urolonc.2020.09.015
DO - 10.1016/j.urolonc.2020.09.015
M3 - Article
C2 - 33036903
AN - SCOPUS:85092088754
SN - 1078-1439
VL - 38
SP - 929.e1-929.e10
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
IS - 12
ER -