Background: In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines defined priority groups to guide the prioritization of surgery for urological malignancies. The objective of this study was to evaluate the impact of the COVID-19 prioritization recommendations on tumor pathological characteristics in a real-world setting at our academic referral Institution.
Methods: We compared baseline and pathological tumor features of all patients with urological malignancies treated during the pandemic period (2020-2021) versus in the post-pandemic period (2022-2023). Our institution adhered to the International recommendations and prioritized those cases defined as “high-risk”.
Results: Data of 9196 patients treated for urological malignancies were reviewed and grouped according to period of surgery (4401 in the pandemic vs 4785 in non-pandemic period). The overall number of surgical procedures was comparable for all diseases except for the number of radical prostatectomy (1117 vs 1405; p=0.03) and partial nephrectomy (609 vs 759; p=0.02) which were significantly lower in the pandemic period. Regarding tumors’ pathological features, none of the recorded variable was found to differ according to period of surgery, including disease stage, tumor grading, presence of necrosis, lymphovascular invasion, histological variants.
Conclusion: A correct policy of prioritization of oncological pathologies during emergency periods and a centralization of oncological cases in reference centers reduces the possible risk of worsening cancer disease features related to the reorganization of healthcare resources.