The Impact of SARS-CoV-2 Pandemic on Time to Primary, Secondary Resection and Adjuvant Intravesical Therapy in Patients with High-Risk Non-Muscle Invasive Bladder Cancer: A Retrospective Multi-Institutional Cohort Analysis

Matteo Ferro, Francesco Del Giudice, Giuseppe Carrieri, Gian Maria Busetto, Luigi Cormio, Rodolfo Hurle, Roberto Contieri, Davide Arcaniolo, Alessandro Sciarra, Martina Maggi, Francesco Porpiglia, Matteo Manfredi, Cristian Fiori, Alessandro Antonelli, Alessandro Tafuri, Pierluigi Bove, Carlo Terrone, Marco Borghesi, Elisabetta Costantini, Ester IlianoEmanuele Montanari, Luca Boeri, Giorgio Ivan Russo, Massimo Madonia, Alessandro Tedde, Alessandro Veccia, Claudio Simeone, Giovanni Liguori, Carlo Trombetta, Eugenio Brunocilla, Riccardo Schiavina, Fabrizio Dal Moro, Marco Racioppi, Mihai Dorin Vartolomei, Nicola Longo, Lorenzo Spirito, Felice Crocetto, Francesco Cantiello, Rocco Damiano, Savino M. Di Stasi, Michele Marchioni, Luigi Schips, Paolo Parma, Luca Carmignani, Andrea Conti, Francesco Soria, Paolo Gontero, Biagio Barone, Federico Deho, Emanuele Zaffuto, Rocco Papalia, Roberto M. Scarpa, Vincenzo Pagliarulo, Giuseppe Lucarelli, Pasquale Ditonno, Francesco Maria Gerardo Botticelli, Gennaro Musi, Michele Catellani, Ottavio De Cobelli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Simple Summary: The worldwide COVID-19 emergency has had an important impact on healthcare systems with the need to assist infected patients and also treat non-deferrable oncological conditions. In urology, the main concern has been for patients with bladder cancer, the tenth most common malignancy, where the quality and the alacrity of treatment has a clear well-demonstrated impact on the survivor. The aim of our Italian multi-institutional retrospective study was to assess the impact of the COVID-19 outbreak on diagnosis and treatment of non-muscle invasive bladder cancer. We observed a significant delay between diagnosis and surgical treatment, with a lower adherence to the standard therapeutic scheme such as BCG intravesical instillation and urological guidelines. We also recorded a different attitude in treatment depending on the patients' location in Italy. Further investigation could show the impact of the pandemic on the survival of these patients.Background: To investigate the impact of COVID-19 outbreak on the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC). Methods: A retrospective analysis was performed using an Italian multi-institutional database of TURBT patients with high-risk urothelial NMIBC between January 2019 and February 2021, followed by Re-TURBT and/or adjuvant intravesical BCG. Results: A total of 2591 patients from 27 institutions with primary TURBT were included. Of these, 1534 (59.2%) and 1056 (40.8%) underwent TURBT before and during the COVID-19 outbreak, respectively. Time between diagnosis and TURBT was significantly longer during the COVID-19 period (65 vs. 52 days, p = 0.002). One thousand and sixty-six patients (41.1%) received Re-TURBT, 604 (56.7%) during the pre-COVID-19. The median time to secondary resection was significantly longer during the COVID-19 period (55 vs. 48 days, p < 0.0001). A total of 977 patients underwent adjuvant intravesical therapy after primary or secondary resection, with a similar distribution across the two groups (n = 453, 86% vs. n = 388, 86.2%). However, the proportion of the patients who underwent maintenance significantly differed (79.5% vs. 60.4%, p < 0.0001). Conclusions: The COVID-19 pandemic represented an unprecedented challenge to our health system. Our study did not show significant differences in TURBT quality. However, a delay in treatment schedule and disease management was observed. Investigation of the oncological impacts of those differences should be advocated.
Lingua originaleEnglish
pagine (da-a)5276-N/A
RivistaCancers
Volume13
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Re-TURBT
  • SARS-CoV-2
  • trans-urethral resection of bladder tumor
  • intravesical BCG
  • bladder cancer

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