The coronavirus disease 2019 (COVID-19) pandemic has become a public health emergency, affecting frail populations including cancer patients. This poses the question as to whether cancer treatments can be postponed or modified without compromising their efficacy, especially for highly curable cancers such as germ cell tumors (GCTs).
To depict the state of art management of GCTs during the COVID-19 pandemic a survey including 26 questions was circulated by e-mail among the physicians belonging to 3 cooperative groups: 1. Italian Germ cell cancer Group (IGG); 2. European G3 Domain (Rare male genito-urinary cancers); 3. Genitourinary Medical Oncologists of Canada (GUMOC). Percentages of agreement between I vs C, I vs E and E vs C were compared by using Fisher's exact tests for dichotomous answers and Chi square-test for trends for the questions with 3 or more options.
Fifty-three GCT experts responded to the survey: 20 Italian (I), 6 in other European (E) countries and 27 from Canada (C). Telemedicine was broadly utilized; there was high consensus to interrupt chemotherapy in COVID-positive patients (I=75%, C=55% and E=83.3%) and for G-CSF primary prophylaxis use for neutropenia (I=65%, C=62.9% and E=50%). Main differences emerged regarding the management of stage I and stage IIA disease, likely due to cultural and geographical differences.
Our study highlights the common efforts of GCT experts in Europe and Canada to maintain high standards of treatment for GCT patients with few changes in their management during the COVID-19 pandemic.
Despite the chaos, disruptions and fears fomented by the Covid-19 illness, oncology care teams in Italy, other European countries and Canada are delivering the enormous promise of curative management strategies for patients with testicular cancer and other germ cell tumors. At the same time, these teams are applying safe and innovative solutions to minimize frequency and intensity on patient contacts with thinly stretched health care capacity and sharing best practices.
The oncologist. 2020 Jul 31 [Epub ahead of print]
Lucia Nappi, Margaret Ottaviano, Pasquale Rescigno, Marianna Tortora, Giuseppe L Banna, Giulia Baciarello, Umberto Basso, Christina Canil, Alessia Cavo, Maria Cossu Rocca, Piotr Czaykowski, Ugo De Giorgi, Xavier Garcia Del Muro, Marilena Di Napoli, Giuseppe Fornarini, Jourik A Gietema, Daniel Y C Heng, Sebastien J Hotte, Christian Kollmannsberger, Marco Maruzzo, Carlo Messina, Franco Morelli, Sasja Mulder, Craig Nichols, Franco Nolè, Christoph Oing, Teodoro Sava, Simona Secondino, Giuseppe Simone, Denis Soulieres, Bruno Vincenzi, Paolo A Zucali, Sabino De Placido, Giovannella Palmieri, Italian Germ cell cancer Group (IGG), the ERN-EURACAN G3 Domain and the Genitourinary Medical Oncologists of Canada (GUMOC) group
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