Experience of the department of surgical treatment of bone and soft tissue tumors during COVID-19 pandemic period

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Abstract

Since December 2019 the new coronavirus disease (COVID-19) has hit the world, causing the World Health Organization to declare it a pandemic. With the emergence and spread of the new infection, there has been unprecedented pressure on health care systems around the world. The time constraints associated with receiving routine care also affected the risk group – cancer patients, as some hospitals were quarantined. Violation of the terms of both systemic drug, radiation and surgical treatment of cancer patients could lead to the progression of the tumor process and lead to the death of the patient. In connection with the current situation, doctors had to quickly change the tactics of managing cancer patients, due to the lack of accurate data on the basis of which it is possible to determine the optimal approach to the use of therapy, they had to make decisions in conditions of lack of data. The article shows an example of the treatment of 113 patients being treated in the department of surgical treatment of bone and soft tissue tumors in National Medical Research Radiological Center of the Ministry of Health of Russia during the first wave of the pandemic from March 30 to July 1, 2020. Surgical treatment was performed in 103 patients. During the period of stay in the hospital, 11 patients showed signs of coronavirus infection. Of these, 10 patients were diagnosed with coronavirus infection in the postoperative period. According to the study, the nosocomial incidence of COVID-19 is 10%. With timely diagnosis and specialized treatment, the survival rate was 100% in the given example. Consequently, if epidemiological measures are observed at all stages of hospitalization, it is possible to carry out planned surgical treatment for patients with primary and secondary lesions of bones and soft tissues. However, the decision to carry out a planned operation during a pandemic should be individual for each patient.

About the authors

Artem V. Bukharov

Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center

Email: artembuharov@mail.ru
ORCID iD: 0000-0002-2976-8895
SPIN-code: 8349-0930

Cand. Sci. (Med.)

Russian Federation, Moscow

Vitalii A. Derzhavin

Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center

Email: osteosa@yandex.ru
ORCID iD: 0000-0002-4385-9048
SPIN-code: 1811-2737

Cand. Sci. (Med.)

Russian Federation, Moscow

Anna V. Yadrina

Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center

Author for correspondence.
Email: anna_16.06@mail.ru
ORCID iD: 0000-0002-7944-3108
SPIN-code: 9058-3922

Cand. Sci. (Med.)

Russian Federation, Moscow

Dmtrii A. Erin

Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Center

Email: erindmal@yandex.ru
ORCID iD: 0000-0002-3501-036X
SPIN-code: 1769-2667

oncologist

Russian Federation, Moscow

References

  1. National COVID‐19 surveillance reports–GOV.UK; 2020. Available at: https:// www.gov.uk/government/publications/national-covid-19-surveillancereports. Accessed: 05.07.2020.
  2. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS‐CoV‐2 infection: an international cohort study. Lancet. 2020;396:27-38. doi: 10.1016/S0140-6736(20)31182-X
  3. Şahbat Y, Buyuktopcu O, Topkar OM, Erol B. Management of orthopedic oncology patients during coronavirus pandemic. J Surg Oncol. 2020. doi: 10.1002/jso.26092
  4. Royal College of Surgeons. Clinical guide to surgical prioritization during the coronavirus pandemic; 2020. Available at: https://www.rcseng.ac.uk/coronavirus/surgical-prioritisation-guidance/. Accessed: 26.06.2020.
  5. Stevenson JD, Evans S, Morris G, et al. Mortality of high‐risk orthopaedic oncology patients during the COVID‐19 pandemic: A prospective cohort study. J Surg Oncol. 2020;1-4. doi: 10.1002/jso.26127

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Patient D., 75 years old: а – CT-scan, organs of the chest, 01.05.2020. CT-scan – the picture of a single metastasic process with damage to (multiple) lungs. Left-sided pleurisy; b – CT-scan, organs of the chest, 14.05.2020. CT-scan – the picture of bilateral lower lobe pneumonia of moderate-severe (CN 2) severity.

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