Mp77-20 trends in definitive therapy for prostate cancer during the covid-19 pandemic: a grade-by-grade- analysis

You have accessJournal of UrologyCME1 Apr 2023MP77-20 TRENDS IN DEFINITIVE THERAPY FOR PROSTATE CANCER DURING THE COVID-19 PANDEMIC: A GRADE-BY-GRADE- ANALYSIS Edoardo Beatrici, Muhieddine Labban, Benjamin V. Stone, Dejan K. Filipas, Sandeep S. Voleti, Nicola Frego, Giovanni Lughezzani, Nicolò Maria Buffi, Firas Abdollah, Adam S. Kibel, Alexander P. Cole, and Quoc-Dien Trinh Edoardo BeatriciEdoardo Beatrici More articles by this author , Muhieddine LabbanMuhieddine Labban More articles by this author , Benjamin V. StoneBenjamin V. Stone More articles by this author , Dejan K. FilipasDejan K. Filipas More articles by this author , Sandeep S. VoletiSandeep S. Voleti More articles by this author , Nicola FregoNicola Frego More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Nicolò Maria BuffiNicolò Maria Buffi More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Adam S. KibelAdam S. Kibel More articles by this author , Alexander P. ColeAlexander P. Cole More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic placed a significant burden on the US healthcare system. Moreover, many healthcare systems triaged cases based on the severity of disease. Therefore, we assessed the impact of the COVID-19 pandemic on prostate cancer management according to the International Society of Urological Pathology (ISUP) grade groups. METHODS: We retrospectively analyzed the National Cancer Database (NCDB) for patients with prostate cancer between 2018-2020. We divided our cohort into “Pre-Pandemic” (2018/2019) and “Pandemic” (2020) periods. Men were classified according to their ISUP grade group at diagnosis. Hospital characteristics and patient-level clinical and sociodemographic variables were extracted. Our primary outcome was the utilization of definitive treatment (surgery or radiation) versus expectant management (active surveillance, watchful waiting, or no treatment). We performed multivariable logistic regressions to predict the type of management for each ISUP grade group across the two periods adjusting for clinical and socioeconomic covariates. RESULTS: A total of 398,719 men with a diagnosis of prostate cancer were reported during the “Pre-Pandemic” (70.6%) and “Pandemic” (29.4%) periods. Overall, 24.5% had an ISUP 1, 30.6% an ISUP 2, 18.2% an ISUP 3, 13% ISUP 4, and 13.8% ISUP 5 disease (Table 1). Treatment was less likely during the “Pandemic” compared to the “Pre-Pandemic” period for ISUP grade group 1 (aOR 0.80; 95% CI 0.77 - 0.83; p-value <0.001), for ISUP grade group 2 (aOR 0.85; 95% CI 0.81 - 0.89; p-value <0.001) and for ISUP grade group 3 (aOR 0.87; 95% CI 0.80 - 0.96; p-value <0.003). However, no differences in treatment trends were found for ISUP grade groups 4 and 5 across the two time periods. CONCLUSIONS: During the COVID-19 pandemic, patients with prostate cancers ISUP grade groups 1, 2, and 3 were more likely to receive expectant management than definitive treatment; however, this was not true for patients with more aggressive diseases. This finding suggests a high capacity of facilities to appropriately risk stratify and prioritize higher-risk cases during a public health emergency. A limitation of our study is the inability to assess the treatment trends of men diagnosed in the last 2020 quarter due to the lack of follow-up. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1110 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Edoardo Beatrici More articles by this author Muhieddine Labban More articles by this author Benjamin V. Stone More articles by this author Dejan K. Filipas More articles by this author Sandeep S. Voleti More articles by this author Nicola Frego More articles by this author Giovanni Lughezzani More articles by this author Nicolò Maria Buffi More articles by this author Firas Abdollah More articles by this author Adam S. Kibel More articles by this author Alexander P. Cole More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement PDF downloadLoading ...