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Current Oncology
Volume 27
Issue 5
10.3747/co.27.6785
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Review

Strategies for the Delay of Surgery in the Management of Resectable Hepatobiliary Malignancies during the COVID-19 Pandemic

by
S. Bennett
1,
K. Søreide
2,
S. Gholami
3,
P. Pessaux
4,
C. Teh
5,
E. Segelov
6,
H. Kennecke
3,
H. Prenen
7,
S. Myrehaug
1,
D. Callegaro
1,8 and
J. Hallet
1,*
1
Department of Surgery, University of Toronto, Toronto, ON; Department of Radiation Oncology, University of Toronto, Toronto, ON; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
2
Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, and Department of Clinical Medicine, University of Bergen, Bergen, Norway
3
Division of Surgical Oncology, Department of Surgery, University of California, Davis, CA; Virginia Mason Cancer Institute, Seattle, WA, USA
4
Department of Surgery, Institut Hospitalo-Universitaire de Strasbourg, Strasbourg, France
5
Institute of Surgery, St. Luke’s Medical Center, Quezon City; Department of Surgery, Makati Medical Center, Makati; and Department of General Surgery, National Kidney and Transplant Institute, Quezon City, Philippines
6
Monash University and Monash Health, Melbourne, Australia
7
Department of Oncology, University Hospital Antwerp, Antwerp, Belgium
8
Department of Surgery, Fondazione irccs Istituto Nazionale Tumori, Milan, Italy
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(5), 501-511; https://doi.org/10.3747/co.27.6785
Submission received: 11 July 2020 / Revised: 10 August 2020 / Accepted: 8 September 2020 / Published: 1 October 2020

Abstract

Objective: We aimed to review data about delaying strategies for the management of hepatobiliary cancers requiring surgery during the covid-19 pandemic. Background: Given the covid-19 pandemic, many jurisdictions, to spare resources, have limited access to operating rooms for elective surgical activity, including cancer, thus forcing deferral or cancellation of cancer surgeries. Surgery for hepatobiliary cancer is high-risk and particularly resource-intensive. Surgeons must critically appraise which patients will benefit most from surgery and which ones have other therapeutic options to delay surgery. Little guidance is currently available about potential delaying strategies for hepatobiliary cancers when surgery is not possible. Methods: An international multidisciplinary panel reviewed the available literature to summarize data relating to standard-of-care surgical management and possible mitigating strategies to be used as a bridge to surgery for colorectal liver metastases, hepatocellular carcinoma, gallbladder cancer, intrahepatic cholangiocarcinoma, and hilar cholangiocarcinoma. Results: Outcomes of surgery during the covid-19 pandemic are reviewed. Resource requirements are summarized, including logistics and adverse effects profiles for hepatectomy and delaying strategies using systemic, percutaneous and radiation ablative, and liver embolic therapies. For each cancer type, the long-term oncologic outcomes of hepatectomy and the clinical tools that can be used to prognosticate for individual patients are detailed. Conclusions: There are a variety of delaying strategies to consider if availability of operating rooms decreases. This review summarizes available data to provide guidance about possible delaying strategies depending on patient, resource, institution, and systems factors. Multidisciplinary team discussions should be leveraged to consider patient- and tumour-specific information for each individual case.
Keywords: covid-19; coronavirus; hepatobiliary cancer; hcc; metastases; cholangiocarcinoma; gallbladder carcinoma covid-19; coronavirus; hepatobiliary cancer; hcc; metastases; cholangiocarcinoma; gallbladder carcinoma

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MDPI and ACS Style

Bennett, S.; Søreide, K.; Gholami, S.; Pessaux, P.; Teh, C.; Segelov, E.; Kennecke, H.; Prenen, H.; Myrehaug, S.; Callegaro, D.; et al. Strategies for the Delay of Surgery in the Management of Resectable Hepatobiliary Malignancies during the COVID-19 Pandemic. Curr. Oncol. 2020, 27, 501-511. https://doi.org/10.3747/co.27.6785

AMA Style

Bennett S, Søreide K, Gholami S, Pessaux P, Teh C, Segelov E, Kennecke H, Prenen H, Myrehaug S, Callegaro D, et al. Strategies for the Delay of Surgery in the Management of Resectable Hepatobiliary Malignancies during the COVID-19 Pandemic. Current Oncology. 2020; 27(5):501-511. https://doi.org/10.3747/co.27.6785

Chicago/Turabian Style

Bennett, S., K. Søreide, S. Gholami, P. Pessaux, C. Teh, E. Segelov, H. Kennecke, H. Prenen, S. Myrehaug, D. Callegaro, and et al. 2020. "Strategies for the Delay of Surgery in the Management of Resectable Hepatobiliary Malignancies during the COVID-19 Pandemic" Current Oncology 27, no. 5: 501-511. https://doi.org/10.3747/co.27.6785

APA Style

Bennett, S., Søreide, K., Gholami, S., Pessaux, P., Teh, C., Segelov, E., Kennecke, H., Prenen, H., Myrehaug, S., Callegaro, D., & Hallet, J. (2020). Strategies for the Delay of Surgery in the Management of Resectable Hepatobiliary Malignancies during the COVID-19 Pandemic. Current Oncology, 27(5), 501-511. https://doi.org/10.3747/co.27.6785

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