CovidSurg-Cancer UROLOGY Follow-Up Study
Veeru Kasivisvanathan and Chuanyu Gao were awarded a grant for their project investigating the long term outcomes of elective cancer surgery for kidney, bladder and prostate cancer during the COVID-19 pandemic crisis. Find out more about this international, multicentre, observational cohort study below.
Long term outcomes of elective cancer surgery for kidney, bladder, and prostate cancer during the COVID-19 pandemic crisis: an international, multicentre, observational cohort study. (CovidSurg-Cancer UROLOGY Follow-Up Study).
Veeru Kasivisvanathan and Chuanyu Gao
Grant awarded: £10,000.
Dates: Dec 2020 – Aug 2024
Aims: This study set out to understand the impact of the COVID-19 pandemic upon patients diagnosed with urological (kidney, bladder and prostate) cancer in 2020. It aimed to assess important outcomes including overall and disease-free survival as well as other key disease-specific patient-level outcomes. This study allowed a unique opportunity to ethically evaluate the potential negative consequences of delaying cancer surgery.
Key findings:
Prostate – the study showed at one-year follow-up there was no adverse oncological outcome for delaying radical prostatectomy by 90 days.
Bladder – a significant proportion of patients had a deviation in typical care as a direct consequence of the COVID-19 pandemic. The one-year outcomes for patients with non-muscle invasive bladder cancer in this cohort are poorer than for previously reported cohorts, suggesting that compromised cancer care during the pandemic may have unfortunately contributed to higher levels of cancer recurrence and disease progression.
Kidney – Unfortunately no data was available owing to operational problems incurred by the study’s overall data management partner, Birmingham Centre for Observational and Prospective Studies (BiCOPS) who conducted the original COVIDSurg study and hosted the database.
Significance: Men with prostate cancer were more likely to have a delay in their care however it does not seem they suffered any adverse impact. This will reassure the scientific community that radical prostatectomy can be delayed if absolutely needed without consequently harming patients. This has implications for management of prostate cancer patients globally when balancing resource limitations with the need to perform prompt surgery. Whilst a smaller proportion of bladder cancer patients had a change in standard cancer care compared to prostate cancer patients, the disease related outcomes in this study are poorer than for historical cohorts in the pre-pandemic era. The urological community was correct to prioritise bladder cancer over prostate cancer and going forward our data suggests we need to maintain our strict timeline in managing bladder cancer whereas we have somewhat more room for manoeuvre when managing prostate cancer. This study has shown that changes to de-escalate bladder cancer care and surveillance should proceed cautiously and would not typically be appropriate in high-risk patients.
