Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID‐19) pandemic: an international accelerated consensus statement

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Zafer Tandogdu
  • Justin Collins
  • Greg Shaw
  • Jennifer Rohn
  • Bela Koves
  • Ahmed Ghazi
  • Alexander Haese
  • Alex Mottrie
  • Anup Kumar
  • Ananthakrishnan Sivaraman
  • Ashutosh Tewari
  • Benjamin Challacombe
  • Bernardo Rocco
  • Camilo Giedelman
  • Christian Wagner
  • Craig G. Rogers
  • Declan G. Murphy
  • Dmitry Pushkar
  • Gabriel Ogaya‐Pinies
  • James Porter
  • Kulthe Ramesh Seetharam
  • Markus Graefen
  • Marcelo A. Orvieto
  • Marcio Covas Moschovas
  • Oscar Schatloff
  • Peter Wiklund
  • Rafael Coelho
  • Rair Valero
  • Theo M. Reijke
  • Thomas Ahlering
  • Travis Rogers
  • Henk G. Poel
  • Vipul Patel
  • Walter Artibani
  • Florian Wagenlehner
  • Kris Maes
  • Koon H. Rha
  • Senthil Nathan
  • Truls Erik Bjerklund Johansen
  • Peter Hawkey
  • John Kelly

Abstract

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.

Bibliographical metadata

Original languageEnglish
Pages (from-to)729-741
Number of pages13
JournalBJU international
Volume127
Issue number6
DOIs
Publication statusPublished - 10 Jun 2021