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Article

Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan

by
Maria J. Monroy-Iglesias
1,*,†,
Marta Tagliabue
2,3,†,
Harvey Dickinson
4,
Graham Roberts
4,
Rita De Berardinis
2,*,†,
Beth Russell
1,
Charlotte Moss
1,
Sophie Irwin
4,
Jonathon Olsburgh
5,
Ivana Maria Francesca Cocco
6,
Alexis Schizas
6,
Sarah McCrindle
7,
Rahul Nath
8,
Aina Brunet
9,
Ricard Simo
9,
Chrysostomos Tornari
9,
Parthi Srinivasan
10,
Andreas Prachalias
10,
Andrew Davies
4,
Jenny Geh
11,
Stephanie Fraser
12,
Tom Routledge
12,
RuJun Ma
12,
Ella Doerge
13,
Ben Challacombe
13,
Raj Nair
13,
Marios Hadjipavlou
13,
Rosaria Scarpinata
14,
Paolo Sorelli
15,
Saoirse Dolly
7,
Francesco Alessandro Mistretta
16,
Gennaro Musi
16,17,
Monica Casiraghi
18,
Alessia Aloisi
19,
Andrea Dell’Acqua
19,
Donatella Scaglione
20,
Stefania Zanoni
20,
Daniele Rampazio Da Silva
20,
Daniela Brambilla
20,
Raffaella Bertolotti
20,
Giulia Peruzzotti
20,
Angelo Maggioni
19,
Ottavio de Cobelli
16,17,
Lorenzo Spaggiari
17,18,
Mohssen Ansarin
2,
Fabrizio Mastrilli
21,
Sara Gandini
22,
Urvashi Jain
23,
Hisham Hamed
23,
Kate Haire
4 and
Mieke Van Hemelrijck
1add Show full author list remove Hide full author list
1
Faculty of Life Sciences and Medicine, Translational Oncology & Urology Research (TOUR), King’s College London, London WC2R 2LS, UK
2
Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, 20122 Milan, Italy
3
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
4
South East London Cancer Alliance, London SE1 9RT, UK
5
Department of Nephrology and Transplantation, Guy’s & St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
6
Department of Colorectal Surgery, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
7
Department of Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
8
Department of Gynaecological Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
9
Department of Otorhinolaryngology Head and Neck Surgery, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
10
Department of Liver Studies, King’s College Hospital, London SE5 9RS, UK
11
Department of Plastic Surgery, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
12
Department of Thoracic Surgery, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
13
Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
14
Department of Colorectal Surgery, King’s College Hospital, London SE5 9RS, UK
15
Department of Colorectal Surgery, Lewisham and Greenwich NHS Trust, London SE13 6LH, UK
16
Division of Urology, European Institute of Oncology IRCCS, 20122 Milan, Italy
17
Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
18
Division of Thoracic Surgery, European Institute of Oncology IRCCS, 20122 Milan, Italy
19
Division of Gynaecological Surgery, European Institute of Oncology IRCCS, 20122 Milan, Italy
20
Division of Data Management, European Institute of Oncology IRCCS, 20122 Milan, Italy
21
Medical Administration, European Institute of Oncology, IRCCS, 20122 Milan, Italy
22
Department of Experimental Oncology, European Institute of Oncology IRCCS, 20122 Milan, Italy
23
Department of Breast Surgery, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
 
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*
Authors to whom correspondence should be addressed.
†
Maria J. Monroy-Iglesias and Marta Tagliabue contributed equally to this work as co-first authors.
Academic Editors: Brendon Coventry and David Wong
Cancers 2021, 13(7), 1597; https://doi.org/10.3390/cancers13071597
Received: 26 February 2021 / Revised: 19 March 2021 / Accepted: 26 March 2021 / Published: 30 March 2021
(This article belongs to the Section Cancer Epidemiology and Prevention)
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Simple Summary

A better understanding of the reality for cancer patients during the SARS-CoV-2 (COVID-19) pandemic will help us readapt current prediction models. There is a need to dive into rich data sources from apex cancer centres. The aim of our retrospective study was to report on the outcomes of cancer patients receiving radical surgery with curative intent during the first wave of the COVID-19 pandemic. Data from two cancer centres that were at the epicentre of the outbreak from March to September 2020 (as well as a comparator group in 2019) were utilised for this study. We observed that while there was a decline in number of surgeries performed, the implemented COVID-19 minimal pathways were safe for cancer patients requiring surgical treatment.

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. View Full-Text
Keywords: COVID-19; cancer surgery; postoperative outcomes COVID-19; cancer surgery; postoperative outcomes
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
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MDPI and ACS Style

Monroy-Iglesias, M.J.; Tagliabue, M.; Dickinson, H.; Roberts, G.; De Berardinis, R.; Russell, B.; Moss, C.; Irwin, S.; Olsburgh, J.; Cocco, I.M.F.; Schizas, A.; McCrindle, S.; Nath, R.; Brunet, A.; Simo, R.; Tornari, C.; Srinivasan, P.; Prachalias, A.; Davies, A.; Geh, J.; Fraser, S.; Routledge, T.; Ma, R.; Doerge, E.; Challacombe, B.; Nair, R.; Hadjipavlou, M.; Scarpinata, R.; Sorelli, P.; Dolly, S.; Mistretta, F.A.; Musi, G.; Casiraghi, M.; Aloisi, A.; Dell’Acqua, A.; Scaglione, D.; Zanoni, S.; Rampazio Da Silva, D.; Brambilla, D.; Bertolotti, R.; Peruzzotti, G.; Maggioni, A.; de Cobelli, O.; Spaggiari, L.; Ansarin, M.; Mastrilli, F.; Gandini, S.; Jain, U.; Hamed, H.; Haire, K.; Van Hemelrijck, M. Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan. Cancers 2021, 13, 1597. https://doi.org/10.3390/cancers13071597

AMA Style

Monroy-Iglesias MJ, Tagliabue M, Dickinson H, Roberts G, De Berardinis R, Russell B, Moss C, Irwin S, Olsburgh J, Cocco IMF, Schizas A, McCrindle S, Nath R, Brunet A, Simo R, Tornari C, Srinivasan P, Prachalias A, Davies A, Geh J, Fraser S, Routledge T, Ma R, Doerge E, Challacombe B, Nair R, Hadjipavlou M, Scarpinata R, Sorelli P, Dolly S, Mistretta FA, Musi G, Casiraghi M, Aloisi A, Dell’Acqua A, Scaglione D, Zanoni S, Rampazio Da Silva D, Brambilla D, Bertolotti R, Peruzzotti G, Maggioni A, de Cobelli O, Spaggiari L, Ansarin M, Mastrilli F, Gandini S, Jain U, Hamed H, Haire K, Van Hemelrijck M. Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan. Cancers. 2021; 13(7):1597. https://doi.org/10.3390/cancers13071597

Chicago/Turabian Style

Monroy-Iglesias, Maria J., Marta Tagliabue, Harvey Dickinson, Graham Roberts, Rita De Berardinis, Beth Russell, Charlotte Moss, Sophie Irwin, Jonathon Olsburgh, Ivana M.F. Cocco, Alexis Schizas, Sarah McCrindle, Rahul Nath, Aina Brunet, Ricard Simo, Chrysostomos Tornari, Parthi Srinivasan, Andreas Prachalias, Andrew Davies, Jenny Geh, Stephanie Fraser, Tom Routledge, RuJun Ma, Ella Doerge, Ben Challacombe, Raj Nair, Marios Hadjipavlou, Rosaria Scarpinata, Paolo Sorelli, Saoirse Dolly, Francesco A. Mistretta, Gennaro Musi, Monica Casiraghi, Alessia Aloisi, Andrea Dell’Acqua, Donatella Scaglione, Stefania Zanoni, Daniele Rampazio Da Silva, Daniela Brambilla, Raffaella Bertolotti, Giulia Peruzzotti, Angelo Maggioni, Ottavio de Cobelli, Lorenzo Spaggiari, Mohssen Ansarin, Fabrizio Mastrilli, Sara Gandini, Urvashi Jain, Hisham Hamed, Kate Haire, and Mieke Van Hemelrijck. 2021. "Continuity of Cancer Care: The Surgical Experience of Two Large Cancer Hubs in London and Milan" Cancers 13, no. 7: 1597. https://doi.org/10.3390/cancers13071597

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