Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID‐19) pandemic: an international accelerated consensus statementCitation formats
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Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID‐19) pandemic: an international accelerated consensus statement. / Tandogdu, Zafer; Collins, Justin; Shaw, Greg; Rohn, Jennifer; Koves, Bela; Sachdeva, Ashwin; Ghazi, Ahmed; Haese, Alexander; Mottrie, Alex; Kumar, Anup; Sivaraman, Ananthakrishnan; Tewari, Ashutosh; Challacombe, Benjamin; Rocco, Bernardo; Giedelman, Camilo; Wagner, Christian; Rogers, Craig G.; Murphy, Declan G.; Pushkar, Dmitry; Ogaya‐Pinies, Gabriel; Porter, James; Seetharam, Kulthe Ramesh; Graefen, Markus; Orvieto, Marcelo A.; Moschovas, Marcio Covas; Schatloff, Oscar; Wiklund, Peter; Coelho, Rafael; Valero, Rair; Reijke, Theo M.; Ahlering, Thomas; Rogers, Travis; Poel, Henk G.; Patel, Vipul; Artibani, Walter; Wagenlehner, Florian; Maes, Kris; Rha, Koon H.; Nathan, Senthil; Johansen, Truls Erik Bjerklund; Hawkey, Peter; Kelly, John.
In: BJU international, Vol. 127, No. 6, 10.06.2021, p. 729-741.Research output: Contribution to journal › Article › peer-review
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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, Jennifer
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, James
AU - Seetharam, Kulthe Ramesh
AU - Graefen, Markus
AU - Orvieto, Marcelo A.
AU - Moschovas, Marcio Covas
AU - Schatloff, Oscar
AU - Wiklund, Peter
AU - Coelho, Rafael
AU - Valero, Rair
AU - Reijke, Theo M.
AU - Ahlering, Thomas
AU - Rogers, Travis
AU - Poel, Henk G.
AU - Patel, Vipul
AU - Artibani, Walter
AU - Wagenlehner, Florian
AU - Maes, Kris
AU - Rha, Koon H.
AU - Nathan, Senthil
AU - Johansen, Truls Erik Bjerklund
AU - Hawkey, Peter
AU - Kelly, John
N1 - Publisher Copyright: © 2020 The Authors BJU International © 2020 BJU International
PY - 2021/6/10
Y1 - 2021/6/10
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.
KW - COVID-19/epidemiology
KW - Critical Pathways
KW - Delphi Technique
KW - Health Care Rationing
KW - Humans
KW - Infection Control
KW - Male
KW - Pandemics
KW - Prostatectomy
KW - Prostatic Neoplasms/surgery
KW - SARS-CoV-2
KW - Time-to-Treatment
U2 - 10.1111/bju.15299
DO - 10.1111/bju.15299
M3 - Article
C2 - 33185026
VL - 127
SP - 729
EP - 741
JO - BJU international
JF - BJU international
SN - 1464-4096
IS - 6
ER -