Protocol for dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Surgery Centers
-
Athena Farahzadi
,
Habibollah Mahmoodzadeh
,
Farimah Hadjilooei
,
Seyed Rouhollah Miri
,
Parham Khoshdani Farahani
Abstract
Background: In March 2020, the World Health Organization declared the novel COVID-19 infection a pandemic. Among high-risk patients infected by the virus, upper gastrointestinal cancer patients similar to other immunosuppressed patients are vulnerable to develop more severe infections. Most of the routine activities of medical centers, especially cancer surgery centers around the world, are affected by this epidemic. Thus, some modifications are needed to adjust international protocols to deal with upper gastrointestinal cancers in all the world. Methods: The headings of upper gastrointestinal cancer management protocols have been discussed among the university-affiliated professors in different disciplines involved in upper gastrointestinal cancer management. The discussions were done through an interactive application (WhatsApp & Telegram) in which participants considered the headlines and the latest news about COVID-19. Under each heading, we provide the consensus of all members in the related disciplines. Recommendations and Conclusion: In each specialty, all members agreed to choose minimal intervention. The members know that some recommendations may interfere with the routine best-practice recommendations and decrease the quality measures in the patient's outcome. Therefore, these recommendations are valid just in epidemic COVID-19 situation. According to the consensus of cancer surgery professors in several cancer surgery centers, gastric cancer with T1, T2 and T3 but N0 should be upfront operated but in T3 or N1 or more, the surgery after six courses of chemotherapy should be postponed until the end of the COVID-19 Epidemic and in this phase no diagnostic laparoscopy will be performed , but in the esophageal cancer, T1,T2 and N0 should be upfront operated but T3, T4 and N1 or more, a PET-CT scan will be performed. In the status of high uptake and severe dysphagia, the stent placement is reasonable but in low uptake without any dysphagia, only conservation is our suggestion. Keywords: Upper Gastrointestinal Cancers; COVID-19; Outbreak; Cancer Surgery Centers; Consensus
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7. Kamboj M, Sepkowitz KA. Nosocomial infections inpatients with cancer. Lancet Oncol. 2009;10(6):589-97.
8. Lindesy H. Preventing infection in immunocompromisedcancer patients: Latest recommendations. OncologyTimes. 2008;30(18): 25-6.
9. Doran S.L.F., Patel P.H., Chaudry A., et al. COVID-19 infection in patients following hepato-pancreatico-biliary intervention: an early experience.Eur J Surg Oncol. 2020 Apr 28 doi: 10.1016/j.ejso.2020.04.045. pii: S0748-7983(20)30443-1. [Epubahead of print] [CrossRef] [Google Scholar]
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14. Fligor SC, Wang S, Allar BG, et al. Gastrointestinal malignancies and the COVID-19 pandemic: evi¬dence-based triage to surgery. J Gastrointest Surg. 2020;24: 2357–73. https://doi.org/10.1007/s11605- 020-04712-5.
15. Wojciech Piotr Polkowsk ,Katarzyna Sędłak ,Karol Rawicz-Pruszyński. Treatment of Gastric Cancer Patients DuringCOVID-19 Pandemic: The West is More Vulnerable. Cancer Management and Research 2020:12 6467–6476 .
16. National Center for Immunization and Respiratory Diseases (NCIRD) DoVD. About Coronavirus Dis¬ease 2019 (COVID-19), March 2020. https://www. cdc.gov/coronavirus/2019ncov/about/index.html.
17. National Center for Immunization and Respiratory Diseases (NCIRD) DoVD. Coronavirus Disease 2019 (COVID-19), Interim Clinical Guidance for Manage¬ment of Patients with Confirmed Coronavirus Dis¬ease (COVID-19). March 020.https://www.cdc.gov/coronavirus/2019ncov/prepare/prevention.html? CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov-%2Fcoronavirus%2F2019-ncov%2Fabout%2Fpreven¬tion. Html
18. WHO Regional Office for the Eastern Mediterranean, Daily report on COVID-19 in the Eastern Mediterra-nean Region, March 26 2020. http://www.emro.who. int/index.html
19. Onder G., Rezza G., Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. J Am Med Assoc. 2020 Mar 23 doi: 10.1001/jama.2020.4683. [Epub ahead of print] [CrossRef] [Google Scholar]
20. Liang W., Guan W., Chen R., et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335–337. doi: 10.1016/S1470-2045(20)30096-6. Epub 2020 Feb¬ruary 14. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
21. Zeng MH, Boni L, Fingerhut A .Minimally In¬vasive Surgery and the Novel Coronavirus Out¬Out¬break: Lessons Learned in China and Italy. Ann Surg2020 Jul;272(1):e5-e6. doi: 10.1097/ SLA.0000000000003924
22. Caricato, M., Baiocchi, G.L., Crafa, F. et al. Colorectal surgery in Italy during the Covid19 outbreak: a survey from the iCral study group. Updates Surg 72, 249–257 (2020). https://doi.org/10.1007/s13304-020-00760-3
23. Mao R, Liang J, Shen J, et al. Implication of COV¬ID-19 for patients with pre-existing digestive disease. Lancet Gastroenterol Hepatol. 2020;5:426–428. doi: 10.1016/S2468-1253(20)30076-5. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
| Files | ||
| Issue | Vol 13 No 3 (2021) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v13i3.11399 | |
| Keywords | ||
| Upper Gastrointestinal Cancers COVID-19 Outbreak Cancer Surgery Centers | ||
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How to Cite
1.
Farahzadi A, Mahmoodzadeh H, Hadjilooei F, Miri SR, Farahani P. Protocol for dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Surgery Centers. Basic Clin Cancer Res. 2022;13(3):187-192.
