Ediz VURUŞKAN, Kadir KARKİN, Hakan ERÇİL

Mesane kanserli hastaların progresyonuna Covid-19 pandemisinin etkisi

Amaç: Çalışmamızda COVID-19 pandemisi sırasında kontaminasyon korkusuyla hastane ziyaretlerini zamanında yapmayarak, tedavilerini geciktiren kasa invaze mesane kanserli (MIBC) hastaların progresyon sonuçlarını tartışılması amaçlanmıştır. Gereç ve Yöntem: Mart 2020 ile Haziran 2020 tarihleri arasında MIBC tanısı alan ve radikal sistektomi (RC) önerdiğimiz hastaların kayıtları incelendi. Hastaların planlanan zamanda opere edilip edilmediği, edilmediyse ilk tanı anı veya neoadjuvan kemoterapi (NAC) bitiminden sonra geçen süre kaydedildi. Kliniğimize geç başvuran hastalara yeniden evreleme yapılarak pandemi sürecinde progresyon gelişip gelişmediği incelendi. Bulgular: Yirmidört hastanın dokuzuna RC öncesi NAC önerilirken, kalan 15 hastaya direkt olarak RC önerildi. NAC sonrasında, dört hastaya planlanan sürede RC uygulandı, 4 hasta ise gecikmiş olarak başvuru yaptı. Geç başvuru yapan hastaların NAC sonrası ortalama başvuru süresi 197.8±68.5 gündü. İkisinde (%50) akciğer metastazı ve pelvik lenfadenopatiler bulundu. NAC almayan onbeş hastanın sekizine planlanan sürede RC uygulandı. Bu hastalardan beşi RC yapılmak üzere geç dönemde başvuru yaptı ve tanı konulduktan sonraki ortalama başvuru süresi 202.8±31.9 gündü. Bu beş hastanın ikisinde (%40) progresyon (cT2, N0, M1b) olduğu tespit edildi. Sonuç: COVID-19 salgının yaygın olduğu dönemlerde hekimler tanı ve tedavideki gecikmelerden kaynaklanan potansiyel evre progresyonu ve daha kötü sağkalım sonuçları açısından dikkatli olmalıdır.

Effect of Covid-19 pandemic on the progression of bladder cancer patients

Purpose: The aim of this study was to discuss the progression results of patients with muscle invasive bladder cancer (MIBC) who delayed their treatment by not making hospital visits on time for fear of contamination during the COVID-19 pandemic. Materials and Methods: Records of patients diagnosed with MIBC and recommended radical cystectomy (RC) between March 2020 and June 2020 were reviewed. Whether patients were operated on the scheduled time, and if not, the time elapsed after the first diagnosis or the end of neoadjuvant chemotherapy (NAC) were recorded. The patients who applied to our clinic late were restaged and examined whether there was any progression during the pandemic period. Results: NAC was recommended before RC in 9 of 24 patients, RC was recommended directly to the remaining 15 patients. After NAC, RC was applied to four patients in the planned period, and 4 patients applied delayed. The mean admission period of the patients who applied late after NAC was 197.8±68.5 days. Lung metastases and pelvic lymphadenopathies were found in two (50%). RC was applied to eight of fifteen patients who did not receive NAC in the planned period. Five of these patients applied for RC in the late period and the average application time after diagnosis was 202.8±31.9 days. In the staging of these five patients who presented late, two (40%) had progression (cT2, N0,M1b). Conclusion: In times of widespread COVID-19 outbreak, physicians should be alert to potential stage progression and worse survival outcomes resulting from delays in diagnosis and treatment.

Keywords:

COVID-19, Coronavirus Bladder cancer, Delayed treatment, Progression,

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