key: cord-0996272-4ibqr028
authors: Sterpetti, Antonio V.
title: Surgical oncology in the pandemic. Lessons learned and future perspectives
date: 2020-07-04
journal: Eur J Surg Oncol
DOI: 10.1016/j.ejso.2020.07.007
sha: 2f66d6ba44d695f9e5bc7e845e461296209d710c
doc_id: 996272
cord_uid: 4ibqr028

nan

is forcing elimination of low-value treatments for patients with malignancy and to modify therapeutic schema. Oncologists are reasonably prescribing marginally less effective regimens that have lower risk of precipitating hospitalization, substituting oral for intravenous agents and using other modifications to minimize visits and hospitalizations. (3, 4) . In patients with major, life-threatening cancer complications requiring surgical intervention, a careful assessment of risk and benefits is always required; but in the pandemic period the risk for contamination should be considered . In all hospitals, visits from relatives are not allowed, so that the patient undergoing major surgery should expect a significant isolation time with inevitable negative psychological consequences. Cancer In regions where the pandemic has a low diffusion, the health care workforce is intact and hospital beds and equipment are available, surgeons may propose more conventional surgical indications. In regions with a high diffusion of the pandemic, in the acute phase where the workforce has limited capacity and the health care system is overwhelmed with COVID-19 patients, surgeons must accept compromises and to choose a treatment, which has low short term complication rates, which requires less organizational efforts, with reduced possibilities of contamination and pulmonary complications, rather than a treatment which has been always considered more effective in the medium and long-term.

It may sound unethical, but from this critical condition we may find stimuli to perfect a new vision of surgery. After this crisis, the improvement in telemedicine will remain and may represent the basis for future patient-physician relationship. Follow-up visit and diffuse

Sterpetti AV Lessons learned during the COVID 19 pandemic

Basch E Oncology Practice During the COVID-19 Pandemic

Malik HCancer surgery sustainability in the light of COVID-19 pandemic

COVID-19 and cancer: Looking for evidence