Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era

ABSTRACT Purpose: The aim of this work is to review and synthesize the existing evidence and recommendations regarding to the therapeutic and surgical indications as well as monitoring of patients with Penile Cancer in COVID-19 era and to propose an action protocol to facilitate decision-making. M...

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Main Authors: Nelson Canales Casco, María Jiménez Carmona, Álvaro Juárez Soto
Format: Article
Language:English
Published: Sociedade Brasileira de Urologia 2020-07-01
Series:International Brazilian Journal of Urology
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382020000700086&tlng=en
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author Nelson Canales Casco
María Jiménez Carmona
Álvaro Juárez Soto
author_facet Nelson Canales Casco
María Jiménez Carmona
Álvaro Juárez Soto
author_sort Nelson Canales Casco
collection DOAJ
description ABSTRACT Purpose: The aim of this work is to review and synthesize the existing evidence and recommendations regarding to the therapeutic and surgical indications as well as monitoring of patients with Penile Cancer in COVID-19 era and to propose an action protocol to facilitate decision-making. Material and Methods: A non-systematic review of the literature regarding the management of penile cancer during the COVID-19 pandemic was performed until April 30, 2020. We propose our recommendations based on this evidence. Results: Penile cancer is an uncommon but aggressive disease. Prognosis is determined by several characteristics, being the most important the presence of lymph nodes, in which case, treatment should not be delayed. For these reasons, an initial evaluation is mandatory. Priority classifications, based on the oncological outcomes when treatment is delayed, have been made in order to separate deferrable disease from the one that needs high priority treatment. In penile cancer with low risk of progression, surgical treatment can be delayed, but other options must be considered, like topical treatment or laser therapy. In cases with intermediate risk of progression, surgical treatment may be delayed up to three months, but we must consider radiation therapy and brachytherapy as effective options. When feasible, follow-up should by telemonitoring. Conclusions: In the COVID 19 era, initial evaluation of the patient is mandatory. Histological diagnosis with local staging is necessary before offering any therapeutic option. In case of superficial non-invasive disease, topical treatment is effective in absence of lymph node involvement. In selected patients, radiotherapy is an organpreserving approach with good results. Non-deferrable surgical treatment must be performed by an experienced surgeon and as an outpatient procedure when possible. When indicated, iLND should not be delayed since it is decisive for patient survival. Follow-up should be by telemonitoring.
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spelling doaj.art-19614e139304492c9808627eefa559392022-12-22T04:12:25ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192020-07-0146suppl 1869210.1590/s1677-5538.ibju.2020.s110Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 eraNelson Canales Cascohttps://orcid.org/0000-0002-5458-7615María Jiménez CarmonaÁlvaro Juárez SotoABSTRACT Purpose: The aim of this work is to review and synthesize the existing evidence and recommendations regarding to the therapeutic and surgical indications as well as monitoring of patients with Penile Cancer in COVID-19 era and to propose an action protocol to facilitate decision-making. Material and Methods: A non-systematic review of the literature regarding the management of penile cancer during the COVID-19 pandemic was performed until April 30, 2020. We propose our recommendations based on this evidence. Results: Penile cancer is an uncommon but aggressive disease. Prognosis is determined by several characteristics, being the most important the presence of lymph nodes, in which case, treatment should not be delayed. For these reasons, an initial evaluation is mandatory. Priority classifications, based on the oncological outcomes when treatment is delayed, have been made in order to separate deferrable disease from the one that needs high priority treatment. In penile cancer with low risk of progression, surgical treatment can be delayed, but other options must be considered, like topical treatment or laser therapy. In cases with intermediate risk of progression, surgical treatment may be delayed up to three months, but we must consider radiation therapy and brachytherapy as effective options. When feasible, follow-up should by telemonitoring. Conclusions: In the COVID 19 era, initial evaluation of the patient is mandatory. Histological diagnosis with local staging is necessary before offering any therapeutic option. In case of superficial non-invasive disease, topical treatment is effective in absence of lymph node involvement. In selected patients, radiotherapy is an organpreserving approach with good results. Non-deferrable surgical treatment must be performed by an experienced surgeon and as an outpatient procedure when possible. When indicated, iLND should not be delayed since it is decisive for patient survival. Follow-up should be by telemonitoring.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382020000700086&tlng=enPenile NeoplasmsClinical ProtocolsCOVID-19 [Supplementary Concept]Pandemics
spellingShingle Nelson Canales Casco
María Jiménez Carmona
Álvaro Juárez Soto
Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
International Brazilian Journal of Urology
Penile Neoplasms
Clinical Protocols
COVID-19 [Supplementary Concept]
Pandemics
title Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
title_full Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
title_fullStr Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
title_full_unstemmed Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
title_short Therapeutic and Surgical Indications for Patients with Penile Cancer in the COVID-19 era
title_sort therapeutic and surgical indications for patients with penile cancer in the covid 19 era
topic Penile Neoplasms
Clinical Protocols
COVID-19 [Supplementary Concept]
Pandemics
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382020000700086&tlng=en
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AT alvarojuarezsoto therapeuticandsurgicalindicationsforpatientswithpenilecancerinthecovid19era