Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: An International Accelerated Consensus Statement

TY - JOUR

T1 - Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: An International Accelerated Consensus Statement

AU - Tandogdu, Zafer

AU - Collins, Justin

AU - Shaw, Greg

AU - Rohn, Jenifer

AU - Koves, Bela

AU - Sachdeva, Ashwin

AU - Ghazi, Ahmed

AU - Haese, Alexander

AU - Mottrie, Alex

AU - Kumar, Anup

AU - Sivaraman, Ananthakrishnan

AU - Tewari, Ashutosh

AU - Challacombe, Benjamin

AU - Rocco, Bernardo

AU - Giedelman, Camilo

AU - Wagner, Christian

AU - Rogers, Craig G

AU - Murphy, Declan G

AU - Pushkar, Dmitry

AU - Ogaya-Pinies, Gabriel

AU - Porter, Jim

AU - Ramesh Seetharam, Kulthe

AU - Graefen, Markus

AU - Orvieto, Marcelo A

AU - Covas Moschovas, Marcio

AU - Schatloff, Oscar

AU - Wiklund, Peter

AU - Coelho, Rafael

AU - Valero, Rair

AU - de Reijke, Theo M

AU - Ahlering, Thomas

AU - Rogers, Travis

AU - van der Poel, Henk G

AU - Patel, Vipul

AU - Artibani, Walter

AU - Wagenlehner, Florian

AU - Nathan, Senthil

AU - Erik Bjerklund Johansens, Truls

AU - Hawkey, Peter

AU - Kelly, John

N1 - This article is protected by copyright. All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - OBJECTIVE: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic.METHODS: We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways.RESULTS: Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as 'COVID-19 cold' sites.CONCLUSION: Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3-6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.

AB - OBJECTIVE: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment. A second aim was to identify the infection prevention and control (IPC) measures to achieve a low likelihood of coronavirus disease 2019 (COVID-19) hazard if radical prostatectomy (RP) was to be carried out during the outbreak and whilst the disease is endemic.METHODS: We conducted an accelerated consensus process and systematic review of the evidence on COVID-19 and reviewed international guidance on prostate cancer. These were presented to an international prostate cancer expert panel (n = 34) through an online meeting. The consensus process underwent three rounds of survey in total. Additions to the second- and third-round surveys were formulated based on the answers and comments from the previous rounds. The Consensus opinion was defined as ≥80% agreement and this was used to reconfigure the prostate cancer pathways.RESULTS: Evidence on the delayed management of patients with prostate cancer is scarce. There was 100% agreement that prostate cancer pathways should be reconfigured and measures developed to prevent nosocomial COVID-19 for patients treated surgically. Consensus was reached on prioritisation criteria of patients for surgery and management pathways for those who have delayed treatment. IPC measures to achieve a low likelihood of nosocomial COVID-19 were coined as 'COVID-19 cold' sites.CONCLUSION: Reconfiguring management pathways for patients with prostate cancer is recommended if significant delay (>3-6 months) in surgical management is unavoidable. The mapped pathways provide guidance for such patients. The IPC processes proposed provide a framework for providing RP within an environment with low COVID-19 risk during the outbreak or when the disease remains endemic. The broader concepts could be adapted to other indications beyond prostate cancer surgery.

U2 - 10.1111/bju.15299

DO - 10.1111/bju.15299

M3 - SCORING: Journal article

C2 - 33185026

VL - 127

SP - 729

EP - 741

JO - BJU INT

JF - BJU INT

SN - 1464-4096

IS - 6

ER -