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

Cancers

Elisabetta Costantini¹  Ester Iliano¹  Michele Marchioni²  Luigi Schips²  Savino M. Di Stasi³  Paolo Gontero⁴  Francesco Soria⁴  Carlo Trombetta⁵  Giovanni Liguori⁵  Rocco Papalia⁶  Roberto M. Scarpa⁶  Rodolfo Hurle⁷  Roberto Contieri⁷  Ottavio de Cobelli⁸  Michele Catellani⁸  Francesco Maria Gerardo Botticelli⁸  Matteo Ferro⁸  Gennaro Musi⁸  Rocco Damiano⁹  Alessandro Antonelli^1,10  Alessandro Tafuri^1,10  Carlo Terrone^1,11  Marco Borghesi^1,11  Alessandro Sciarra^1,12  Martina Maggi^1,12  Francesco Del Giudice^1,12  Pierluigi Bove^1,13  Andrea Conti^1,14  Luca Carmignani^1,14  Matteo Manfredi^1,15  Cristian Fiori^1,15  Francesco Porpiglia^1,15  Riccardo Schiavina^1,16  Eugenio Brunocilla^1,16  Giorgio Ivan Russo^1,17  Alessandro Veccia^1,18  Federico Deho^1,19  Emanuele Zaffuto^1,19  Davide Arcaniolo^2,20  Massimo Madonia^2,21  Alessandro Tedde^2,21  Marco Racioppi^2,22  Mihai Dorin Vartolomei^2,23  Claudio Simeone^2,24  Felice Crocetto^2,25  Nicola Longo^2,25  Biagio Barone^2,25  Lorenzo Spirito^2,25  Francesco Cantiello^2,25  Fabrizio Dal Moro^2,26  Luca Boeri^2,27  Emanuele Montanari^2,27  Paolo Parma^2,28  Vincenzo Pagliarulo^2,29  Giuseppe Carrieri^3,30  Luigi Cormio^3,30  Gian Maria Busetto^3,30  Pasquale Ditonno^3,31  Giuseppe Lucarelli^3,31 

[1] Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, 05100 Terni, Italy;Department of Medical, Oral and Biotechnological Sciences, Urology Unit, “SS. Annunziata” Hospital, G. d’Annunzio University of Chieti, 66100 Chieti, Italy;Department of Surgery and Experimental Medicine, Tor Vergata University, 00133 Rome, Italy;Department of Surgical Sciences, Division of Urology, San Giovanni Battista Hospital, University of Studies of Torino, 10121 Turin, Italy;Department of Urology, ASUITS, University of Trieste, 34149 Trieste, Italy;Department of Urology, Campus Biomedico University Hospital, 00198 Rome, Italy;Department of Urology, Humanitas Research Hospital, IRCCS, 20089 Milan, Italy;Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy;Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;Department of Urology, Ospedale Civile Maggiore, Polo Chirurgico Confortini, University of Verona, 37126 Verona, Italy;Department of Urology, Policlinico San Martino Hospital, University of Genoa, 16132 Genova, Italy;Department of Urology, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy;Department of Urology, San Carlo di Nancy Hospital, Via Aurelia 275, 00165 Rome, Italy;Department of Urology, San Donato Policlinic Hospital, 20094 Milan, Italy;Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, 10043 Turin, Italy;Department of Urology, University of Bologna, S-Orsola-Malpighi Hospital, 40138 Bologna, Italy;Department of Urology, University of Catania, 95124 Catania, Italy;Division of Urology, VCU Health System, Richmond, VA 23298, USA;Unit of Urology, ASST Sette Laghi-Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy;Unit of Urology, Luigi Vanvitelli University of Campania, 80138 Naples, Italy;Urologic Clinic, Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy;Urology Clinic, A. Gemelli Hospital Foundation, Catholic University of the Sacred Heart, IRCCS, 00168 Rome, Italy;Urology Department, Medical University of Vienna, A-1090 Vienna, Austria;Urology Unit, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, 25121 Brescia, Italy;Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy;Urology Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35128 Padua, Italy;Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;Urology Unit, Ospedale San Carlo Poma, 46100 Mantova, Italy;Urology Unit, Ospedale Vito Fazzi, 73100 Lecce, Italy;Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy;Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy;

关键词: bladder cancer;    SARS-CoV-2;    intravesical BCG;    trans-urethral resection of bladder tumor;    Re-TURBT;   

DOI  :  10.3390/cancers13215276

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown