Risks from Deferring Treatment for Genitourinary Cancers: A Collaborative Review to Aid Triage and Management During the COVID-19 Pandemic.
Identifieur interne : 000707 ( Main/Exploration ); précédent : 000706; suivant : 000708Risks from Deferring Treatment for Genitourinary Cancers: A Collaborative Review to Aid Triage and Management During the COVID-19 Pandemic.
Auteurs : Christopher J D. Wallis [États-Unis] ; Giacomo Novara [Italie] ; Laura Marandino [Italie] ; Axel Bex [Royaume-Uni] ; Ashish M. Kamat [États-Unis] ; R Jeffrey Karnes [États-Unis] ; Todd M. Morgan [États-Unis] ; Nicolas Mottet [France] ; Silke Gillessen [Suisse] ; Alberto Bossi [France] ; Morgan Roupret ; Thomas Powles [Royaume-Uni] ; Andrea Necchi [Italie] ; James W F. Catto [Royaume-Uni] ; Zachary Klaassen [États-Unis]Source :
- European urology [ 1873-7560 ] ; 2020.
Descripteurs français
- KwdFr :
- Association thérapeutique (méthodes), Betacoronavirus (MeSH), Délai jusqu'au traitement (organisation et administration), Facteurs de risque (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (épidémiologie), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (épidémiologie), Prise en charge de la maladie (MeSH), Triage (organisation et administration), Tumeurs de l'appareil urogénital (complications), Tumeurs de l'appareil urogénital (diagnostic), Tumeurs de l'appareil urogénital (thérapie).
- MESH :
- diagnostic : Tumeurs de l'appareil urogénital.
- méthodes : Association thérapeutique.
- organisation et administration : Délai jusqu'au traitement, Triage.
- thérapie : Tumeurs de l'appareil urogénital.
- épidémiologie : Infections à coronavirus, Pneumopathie virale.
- complications : Betacoronavirus, Facteurs de risque, Humains, Infections à coronavirus, Pandémies, Pneumopathie virale, Prise en charge de la maladie, Tumeurs de l'appareil urogénital.
English descriptors
- KwdEn :
- Betacoronavirus (MeSH), Combined Modality Therapy (methods), Coronavirus Infections (complications), Coronavirus Infections (epidemiology), Disease Management (MeSH), Humans (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (epidemiology), Risk Factors (MeSH), Time-to-Treatment (organization & administration), Triage (organization & administration), Urogenital Neoplasms (complications), Urogenital Neoplasms (diagnosis), Urogenital Neoplasms (therapy).
- MESH :
- complications : Coronavirus Infections, Pneumonia, Viral, Urogenital Neoplasms.
- diagnosis : Urogenital Neoplasms.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- methods : Combined Modality Therapy.
- organization & administration : Time-to-Treatment, Triage.
- therapy : Urogenital Neoplasms.
- Betacoronavirus, Disease Management, Humans, Pandemics, Risk Factors.
Abstract
CONTEXT
The coronavirus disease 2019 (COVID-19) pandemic is leading to delays in the treatment of many urologic cancers.
OBJECTIVE
To provide a contemporary picture of the risks from delayed treatment for urologic cancers to assist with triage.
EVIDENCE ACQUISITION
A collaborative review using literature published as of April 2, 2020.
EVIDENCE SYNTHESIS
Patients with low-grade non-muscle-invasive bladder cancer are unlikely to suffer from a 3-6-month delay. Patients with muscle-invasive bladder cancer are at risk of disease progression, with radical cystectomy delays beyond 12 wk from diagnosis or completion of neoadjuvant chemotherapy. Prioritization of these patients for surgery or management with radiochemotherapy is encouraged. Active surveillance should be used for low-risk prostate cancer (PCa). Treatment of most patients with intermediate- and high-risk PCa can be deferred 3-6 mo without change in outcomes. The same may be true for cancers with the highest risk of progression. With radiotherapy, neoadjuvant androgen deprivation therapy (ADT) is the standard of care. For surgery, although the added value of neoadjuvant ADT is questionable, it may be considered if a patient is interested in such an approach. Intervention may be safely deferred for T1/T2 renal masses, while locally advanced renal tumors (≥T3) should be treated expeditiously. Patients with metastatic renal cancer may consider vascular endothelial growth factor targeted therapy over immunotherapy. Risks for delay in the treatment of upper tract urothelial cancer depend on grade and stage. For patients with high-grade disease, delays of 12 wk in nephroureterectomy are not associated with adverse survival outcomes. Expert guidance recommends expedient local treatment of testis cancer. In penile cancer, adverse outcomes have been observed with delays of ≥3 mo before inguinal lymphadenectomy. Limitations include a paucity of data and methodologic variations for many cancers.
CONCLUSIONS
Patients and clinicians should consider the oncologic risk of delayed cancer intervention versus the risks of COVID-19 to the patient, treating health care professionals, and the health care system.
PATIENT SUMMARY
The coronavirus disease 2019 pandemic has led to delays in the treatment of patients with urologic malignancies. Based on a review of the literature, patients with high-grade urothelial carcinoma, advanced kidney cancer, testicular cancer, and penile cancer should be prioritized for treatment during these challenging times.
DOI: 10.1016/j.eururo.2020.04.063
PubMed: 32414626
PubMed Central: PMC7196384
Affiliations:
- France, Italie, Royaume-Uni, Suisse, États-Unis
- Angleterre, Grand Londres, Géorgie (États-Unis), Lombardie, Michigan, Minnesota, Tennessee, Texas
- Londres, Milan, Villejuif
- Université de Londres
Links toward previous steps (curation, corpus...)
Le document en format XML
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Catto</name><affiliation wicri:level="1"><nlm:affiliation>Academic Urology Unit, University of Sheffield, Sheffield, UK. Electronic address: j.catto@sheffield.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Urology Unit, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><affiliation wicri:level="2"><nlm:affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA, USA. Electronic address: zklaassen19@gmail.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32414626</idno><idno type="pmid">32414626</idno><idno type="doi">10.1016/j.eururo.2020.04.063</idno><idno type="pmc">PMC7196384</idno><idno type="wicri:Area/Main/Corpus">001277</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001277</idno><idno type="wicri:Area/Main/Curation">001277</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">001277</idno><idno type="wicri:Area/Main/Exploration">001277</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Risks from Deferring Treatment for Genitourinary Cancers: A Collaborative Review to Aid Triage and Management During the COVID-19 Pandemic.</title><author><name sortKey="Wallis, Christopher J D" sort="Wallis, Christopher J D" uniqKey="Wallis C" first="Christopher J D" last="Wallis">Christopher J D. Wallis</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Novara, Giacomo" sort="Novara, Giacomo" uniqKey="Novara G" first="Giacomo" last="Novara">Giacomo Novara</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua</wicri:regionArea><wicri:noRegion>Padua</wicri:noRegion></affiliation></author><author><name sortKey="Marandino, Laura" sort="Marandino, Laura" uniqKey="Marandino L" first="Laura" last="Marandino">Laura Marandino</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Bex, Axel" sort="Bex, Axel" uniqKey="Bex A" first="Axel" last="Bex">Axel Bex</name><affiliation wicri:level="3"><nlm:affiliation>Royal Free London NHS Foundation Trust, UCL Division of Surgery and Interventional Science, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Royal Free London NHS Foundation Trust, UCL Division of Surgery and Interventional Science, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kamat, Ashish M" sort="Kamat, Ashish M" uniqKey="Kamat A" first="Ashish M" last="Kamat">Ashish M. Kamat</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, MD Anderson Cancer Center, Houston, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, MD Anderson Cancer Center, Houston, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Karnes, R Jeffrey" sort="Karnes, R Jeffrey" uniqKey="Karnes R" first="R Jeffrey" last="Karnes">R Jeffrey Karnes</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, Mayo Clinic, Rochester, MN, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, Mayo Clinic, Rochester, MN</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Morgan, Todd M" sort="Morgan, Todd M" uniqKey="Morgan T" first="Todd M" last="Morgan">Todd M. Morgan</name><affiliation wicri:level="2"><nlm:affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Urology, University of Michigan, Ann Arbor, MI</wicri:regionArea><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Mottet, Nicolas" sort="Mottet, Nicolas" uniqKey="Mottet N" first="Nicolas" last="Mottet">Nicolas Mottet</name><affiliation wicri:level="1"><nlm:affiliation>Department of Urology, University hospital Nord, St Etienne, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Urology, University hospital Nord, St Etienne</wicri:regionArea><wicri:noRegion>St Etienne</wicri:noRegion><wicri:noRegion>St Etienne</wicri:noRegion></affiliation></author><author><name sortKey="Gillessen, Silke" sort="Gillessen, Silke" uniqKey="Gillessen S" first="Silke" last="Gillessen">Silke Gillessen</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Oncology, Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Medical Oncology, Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano</wicri:regionArea><wicri:noRegion>Lugano</wicri:noRegion></affiliation></author><author><name sortKey="Bossi, Alberto" sort="Bossi, Alberto" uniqKey="Bossi A" first="Alberto" last="Bossi">Alberto Bossi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Radiation Oncology, Institut Gustave Roussy, Villejuif</wicri:regionArea><placeName><settlement type="city">Villejuif</settlement></placeName></affiliation></author><author><name sortKey="Roupret, Morgan" sort="Roupret, Morgan" uniqKey="Roupret M" first="Morgan" last="Roupret">Morgan Roupret</name><affiliation><nlm:affiliation>Urology, GRC n°5, PREDICTIVE ONCO-URO, AP-HP, Pitié Salpetriere Hospital, Sorbonne University, Paris, France; European Section of Onco Urology, EAU.</nlm:affiliation><wicri:noCountry code="subField">EAU</wicri:noCountry></affiliation></author><author><name sortKey="Powles, Thomas" sort="Powles, Thomas" uniqKey="Powles T" first="Thomas" last="Powles">Thomas Powles</name><affiliation wicri:level="4"><nlm:affiliation>Barts Cancer Center, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Barts Cancer Center, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Necchi, Andrea" sort="Necchi, Andrea" uniqKey="Necchi A" first="Andrea" last="Necchi">Andrea Necchi</name><affiliation wicri:level="3"><nlm:affiliation>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Catto, James W F" sort="Catto, James W F" uniqKey="Catto J" first="James W F" last="Catto">James W F. Catto</name><affiliation wicri:level="1"><nlm:affiliation>Academic Urology Unit, University of Sheffield, Sheffield, UK. Electronic address: j.catto@sheffield.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Academic Urology Unit, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation></author><author><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><affiliation wicri:level="2"><nlm:affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA, USA. Electronic address: zklaassen19@gmail.com.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author></analytic><series><title level="j">European urology</title><idno type="eISSN">1873-7560</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Betacoronavirus (MeSH)</term><term>Combined Modality Therapy (methods)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (epidemiology)</term><term>Disease Management (MeSH)</term><term>Humans (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (epidemiology)</term><term>Risk Factors (MeSH)</term><term>Time-to-Treatment (organization & administration)</term><term>Triage (organization & administration)</term><term>Urogenital Neoplasms (complications)</term><term>Urogenital Neoplasms (diagnosis)</term><term>Urogenital Neoplasms (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Association thérapeutique (méthodes)</term><term>Betacoronavirus (MeSH)</term><term>Délai jusqu'au traitement (organisation et administration)</term><term>Facteurs de risque (MeSH)</term><term>Humains (MeSH)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (épidémiologie)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (épidémiologie)</term><term>Prise en charge de la maladie (MeSH)</term><term>Triage (organisation et administration)</term><term>Tumeurs de l'appareil urogénital (complications)</term><term>Tumeurs de l'appareil urogénital (diagnostic)</term><term>Tumeurs de l'appareil urogénital (thérapie)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Urogenital Neoplasms</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Urogenital Neoplasms</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Tumeurs de l'appareil urogénital</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Combined Modality Therapy</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Association thérapeutique</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Délai jusqu'au traitement</term><term>Triage</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Time-to-Treatment</term><term>Triage</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Urogenital Neoplasms</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Tumeurs de l'appareil urogénital</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>Disease Management</term><term>Humans</term><term>Pandemics</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Betacoronavirus</term><term>Facteurs de risque</term><term>Humains</term><term>Infections à coronavirus</term><term>Pandémies</term><term>Pneumopathie virale</term><term>Prise en charge de la maladie</term><term>Tumeurs de l'appareil urogénital</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>CONTEXT</b></p><p>The coronavirus disease 2019 (COVID-19) pandemic is leading to delays in the treatment of many urologic cancers.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To provide a contemporary picture of the risks from delayed treatment for urologic cancers to assist with triage.</p></div><div type="abstract" xml:lang="en"><p><b>EVIDENCE ACQUISITION</b></p><p>A collaborative review using literature published as of April 2, 2020.</p></div><div type="abstract" xml:lang="en"><p><b>EVIDENCE SYNTHESIS</b></p><p>Patients with low-grade non-muscle-invasive bladder cancer are unlikely to suffer from a 3-6-month delay. Patients with muscle-invasive bladder cancer are at risk of disease progression, with radical cystectomy delays beyond 12 wk from diagnosis or completion of neoadjuvant chemotherapy. Prioritization of these patients for surgery or management with radiochemotherapy is encouraged. Active surveillance should be used for low-risk prostate cancer (PCa). Treatment of most patients with intermediate- and high-risk PCa can be deferred 3-6 mo without change in outcomes. The same may be true for cancers with the highest risk of progression. With radiotherapy, neoadjuvant androgen deprivation therapy (ADT) is the standard of care. For surgery, although the added value of neoadjuvant ADT is questionable, it may be considered if a patient is interested in such an approach. Intervention may be safely deferred for T1/T2 renal masses, while locally advanced renal tumors (≥T3) should be treated expeditiously. Patients with metastatic renal cancer may consider vascular endothelial growth factor targeted therapy over immunotherapy. Risks for delay in the treatment of upper tract urothelial cancer depend on grade and stage. For patients with high-grade disease, delays of 12 wk in nephroureterectomy are not associated with adverse survival outcomes. Expert guidance recommends expedient local treatment of testis cancer. In penile cancer, adverse outcomes have been observed with delays of ≥3 mo before inguinal lymphadenectomy. Limitations include a paucity of data and methodologic variations for many cancers.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Patients and clinicians should consider the oncologic risk of delayed cancer intervention versus the risks of COVID-19 to the patient, treating health care professionals, and the health care system.</p></div><div type="abstract" xml:lang="en"><p><b>PATIENT SUMMARY</b></p><p>The coronavirus disease 2019 pandemic has led to delays in the treatment of patients with urologic malignancies. Based on a review of the literature, patients with high-grade urothelial carcinoma, advanced kidney cancer, testicular cancer, and penile cancer should be prioritized for treatment during these challenging times.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32414626</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>13</Day></DateCompleted><DateRevised><Year>2020</Year><Month>07</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1873-7560</ISSN><JournalIssue CitedMedium="Internet"><Volume>78</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Jul</Month></PubDate></JournalIssue><Title>European urology</Title><ISOAbbreviation>Eur. Urol.</ISOAbbreviation></Journal><ArticleTitle>Risks from Deferring Treatment for Genitourinary Cancers: A Collaborative Review to Aid Triage and Management During the COVID-19 Pandemic.</ArticleTitle><Pagination><MedlinePgn>29-42</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0302-2838(20)30331-6</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.eururo.2020.04.063</ELocationID><Abstract><AbstractText Label="CONTEXT" NlmCategory="BACKGROUND">The coronavirus disease 2019 (COVID-19) pandemic is leading to delays in the treatment of many urologic cancers.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To provide a contemporary picture of the risks from delayed treatment for urologic cancers to assist with triage.</AbstractText><AbstractText Label="EVIDENCE ACQUISITION" NlmCategory="METHODS">A collaborative review using literature published as of April 2, 2020.</AbstractText><AbstractText Label="EVIDENCE SYNTHESIS" NlmCategory="RESULTS">Patients with low-grade non-muscle-invasive bladder cancer are unlikely to suffer from a 3-6-month delay. Patients with muscle-invasive bladder cancer are at risk of disease progression, with radical cystectomy delays beyond 12 wk from diagnosis or completion of neoadjuvant chemotherapy. Prioritization of these patients for surgery or management with radiochemotherapy is encouraged. Active surveillance should be used for low-risk prostate cancer (PCa). Treatment of most patients with intermediate- and high-risk PCa can be deferred 3-6 mo without change in outcomes. The same may be true for cancers with the highest risk of progression. With radiotherapy, neoadjuvant androgen deprivation therapy (ADT) is the standard of care. For surgery, although the added value of neoadjuvant ADT is questionable, it may be considered if a patient is interested in such an approach. Intervention may be safely deferred for T1/T2 renal masses, while locally advanced renal tumors (≥T3) should be treated expeditiously. Patients with metastatic renal cancer may consider vascular endothelial growth factor targeted therapy over immunotherapy. Risks for delay in the treatment of upper tract urothelial cancer depend on grade and stage. For patients with high-grade disease, delays of 12 wk in nephroureterectomy are not associated with adverse survival outcomes. Expert guidance recommends expedient local treatment of testis cancer. In penile cancer, adverse outcomes have been observed with delays of ≥3 mo before inguinal lymphadenectomy. Limitations include a paucity of data and methodologic variations for many cancers.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Patients and clinicians should consider the oncologic risk of delayed cancer intervention versus the risks of COVID-19 to the patient, treating health care professionals, and the health care system.</AbstractText><AbstractText Label="PATIENT SUMMARY" NlmCategory="UNASSIGNED">The coronavirus disease 2019 pandemic has led to delays in the treatment of patients with urologic malignancies. Based on a review of the literature, patients with high-grade urothelial carcinoma, advanced kidney cancer, testicular cancer, and penile cancer should be prioritized for treatment during these challenging times.</AbstractText><CopyrightInformation>Copyright © 2020. Published by Elsevier B.V.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wallis</LastName><ForeName>Christopher J D</ForeName><Initials>CJD</Initials><AffiliationInfo><Affiliation>Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Novara</LastName><ForeName>Giacomo</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Surgery, Oncology, and Gastroenterology-Urology Clinic, University of Padua, Padua, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marandino</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bex</LastName><ForeName>Axel</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Royal Free London NHS Foundation Trust, UCL Division of Surgery and Interventional Science, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kamat</LastName><ForeName>Ashish M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Urology, MD Anderson Cancer Center, Houston, TX, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Karnes</LastName><ForeName>R Jeffrey</ForeName><Initials>RJ</Initials><AffiliationInfo><Affiliation>Department of Urology, Mayo Clinic, Rochester, MN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morgan</LastName><ForeName>Todd M</ForeName><Initials>TM</Initials><AffiliationInfo><Affiliation>Department of Urology, University of Michigan, Ann Arbor, MI, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mottet</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Urology, University hospital Nord, St Etienne, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gillessen</LastName><ForeName>Silke</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bossi</LastName><ForeName>Alberto</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roupret</LastName><ForeName>Morgan</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Urology, GRC n°5, PREDICTIVE ONCO-URO, AP-HP, Pitié Salpetriere Hospital, Sorbonne University, Paris, France; European Section of Onco Urology, EAU.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Powles</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Barts Cancer Center, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Necchi</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Catto</LastName><ForeName>James W F</ForeName><Initials>JWF</Initials><AffiliationInfo><Affiliation>Academic Urology Unit, University of Sheffield, Sheffield, UK. Electronic address: j.catto@sheffield.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klaassen</LastName><ForeName>Zachary</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Department of Surgery, Division of Urology, Augusta University-Medical College of Georgia, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA, USA. Electronic address: zklaassen19@gmail.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>03</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Eur Urol</MedlineTA><NlmUniqueID>7512719</NlmUniqueID><ISSNLinking>0302-2838</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Eur Urol. 2020 Sep;78(3):478-481</RefSource><PMID Version="1">32416977</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019468" MajorTopicYN="Y">Disease Management</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061665" MajorTopicYN="N">Time-to-Treatment</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014218" MajorTopicYN="N">Triage</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="Y">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014565" MajorTopicYN="N">Urogenital Neoplasms</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Bladder cancer</Keyword><Keyword MajorTopicYN="N">Coronavirus</Keyword><Keyword MajorTopicYN="N">Coronavirus disease 2019</Keyword><Keyword MajorTopicYN="N">Delayed treatment</Keyword><Keyword MajorTopicYN="N">Kidney cancer</Keyword><Keyword MajorTopicYN="N">Penile cancer</Keyword><Keyword MajorTopicYN="N">Prostate cancer</Keyword><Keyword MajorTopicYN="N">Sstemic therapy</Keyword><Keyword MajorTopicYN="N">Surgery</Keyword><Keyword MajorTopicYN="N">Testicular cancer</Keyword><Keyword MajorTopicYN="N">Upper tract urothelial carcinoma</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>04</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32414626</ArticleId><ArticleId IdType="pii">S0302-2838(20)30331-6</ArticleId><ArticleId IdType="doi">10.1016/j.eururo.2020.04.063</ArticleId><ArticleId IdType="pmc">PMC7196384</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li><li>Italie</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Géorgie (États-Unis)</li><li>Lombardie</li><li>Michigan</li><li>Minnesota</li><li>Tennessee</li><li>Texas</li></region><settlement><li>Londres</li><li>Milan</li><li>Villejuif</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><noCountry><name sortKey="Roupret, Morgan" sort="Roupret, Morgan" uniqKey="Roupret M" first="Morgan" last="Roupret">Morgan Roupret</name></noCountry><country name="États-Unis"><region name="Tennessee"><name sortKey="Wallis, Christopher J D" sort="Wallis, Christopher J D" uniqKey="Wallis C" first="Christopher J D" last="Wallis">Christopher J D. Wallis</name></region><name sortKey="Kamat, Ashish M" sort="Kamat, Ashish M" uniqKey="Kamat A" first="Ashish M" last="Kamat">Ashish M. Kamat</name><name sortKey="Karnes, R Jeffrey" sort="Karnes, R Jeffrey" uniqKey="Karnes R" first="R Jeffrey" last="Karnes">R Jeffrey Karnes</name><name sortKey="Klaassen, Zachary" sort="Klaassen, Zachary" uniqKey="Klaassen Z" first="Zachary" last="Klaassen">Zachary Klaassen</name><name sortKey="Morgan, Todd M" sort="Morgan, Todd M" uniqKey="Morgan T" first="Todd M" last="Morgan">Todd M. Morgan</name></country><country name="Italie"><noRegion><name sortKey="Novara, Giacomo" sort="Novara, Giacomo" uniqKey="Novara G" first="Giacomo" last="Novara">Giacomo Novara</name></noRegion><name sortKey="Marandino, Laura" sort="Marandino, Laura" uniqKey="Marandino L" first="Laura" last="Marandino">Laura Marandino</name><name sortKey="Necchi, Andrea" sort="Necchi, Andrea" uniqKey="Necchi A" first="Andrea" last="Necchi">Andrea Necchi</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Bex, Axel" sort="Bex, Axel" uniqKey="Bex A" first="Axel" last="Bex">Axel Bex</name></region><name sortKey="Catto, James W F" sort="Catto, James W F" uniqKey="Catto J" first="James W F" last="Catto">James W F. 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