Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan
Maria J. Monroy‐Iglesias, Marta Tagliabue, Harvey Dickinson, Graham Roberts, Rita De Berardinis, Beth Russell, Charlotte Moss, Sophie Irwin, Jonathon Olsburgh, Ivana Maria Francesca Cocco, Alexis Schizas, S McCrindle, Rahul Nath, Aina Brunet, Ricard Simó, Chrysostomos Tornari, Parthi Srinivasan, Andreas Prachalias, Andrew Davies, Jenny L. C. Geh, Stephanie Fraser, Tom Routledge, Rujun Ma, Ella Doerge, Ben Challacombe, Raj Nair, Marios Hadjipavlou, Rosaria Scarpinata, Paolo Sorelli, Saoirse Dolly, Francesco Alessandro Mistretta, Gennaro Musi, Monica Casiraghi, Alessia Aloisi, A. Dell’Acqua, Donatella Scaglione, Stefania Zanoni, Daniele Rampazio Da Silva, Daniela Brambilla, Raffaella Bertolotti, G. Peruzzotti, Angelo Maggioni, Ottavio De Cobelli, Lorenzo Spaggiari, Mohssen Ansarin, Fabrizio Mastrilli, Sara Gandini, Urvashi Jain, Hisham Hamed, Kate Haire, Mieke Van Hemelrijck
Abstract
The SARS-CoV-2 (COVID-19) pandemic is having a large effect on the management of cancer patients. This study reports on the approach and outcomes of cancer patients receiving radical surgery with curative intent between March and September 2020 (in comparison to 2019) in the European Institute of Oncology, IRCCS (IEO) in Milan and the South East London Cancer Alliance (SELCA). Both institutions implemented a COVID-19 minimal pathway where patients were required to self-isolate prior to admission and were swabbed for COVID-19 within 72 h of surgery. Positive patients had surgery deferred until a negative swab. At IEO, radical surgeries declined by 6% as compared to the same period in 2019 (n = 1477 vs. 1560, respectively). Readmissions were required for 3% (n = 41), and <1% (n = 9) developed COVID-19, of which only one had severe disease and died. At SELCA, radical surgeries declined by 34% (n = 1553 vs. 2336). Readmissions were required for 11% (n = 36), <1% (n = 7) developed COVID-19, and none died from it. Whilst a decline in number of surgeries was observed in both centres, the implemented COVID-19 minimal pathways have shown to be safe for cancer patients requiring radical treatment, with limited complications and almost no COVID-19 infections.