Lessons learned after one year of COVID-19 from a urologist and radiotherapist view: A German survey on prostate cancer diagnosis and treatment

• Published in: PloS one Vol. 17; no. 6; p. e0269827
• Main Authors: Nina N Harke, Christian Wagner, Robert M Hermann, Boris A Hadaschik, Jan Philipp Radtke, Alev Altay-Langguth, Stefan Aufderklamm, Christian Bach, Martina Becker-Schiebe, Andreas Blana, Frank Bruns, Stephan Buse, Stephanie E Combs, Christina L Engels, Emad Ezzibdeh, Marcel Fiedler, Laura-Anna Fischer, Mahmoud Farzat, Alexander Frismann, Matthias M Heck, Christoph Henkenberens, Marie C Roesch, Christoph Käding, Gunther Klautke, Philipp Krausewitz, Markus A Kuczyk, Conrad Leitsmann, Sebastian Lettmaier, Samy Mahjoub, Andreas Manseck, Daniel Medenwald, Andreas Meyer, Oliver Micke, Rudolf Moritz, Marcel Ott, Inga Peters, Sasa Pokupic, Daniel Porres, Felix Preisser, Kathrin Reichel, Andreas Schneider, Christian Schwentner, Sergiu Scobioala, Michael Truss, Daniel Wegener, Felix Wezel, Kay Willborn, Jörn H Witt, Andrea Wittig, Michael Wittlinger, Hendrik A Wolff, Volker Zimmermanns, Hans Christiansen
• Format: Journal Article
• Language: English
• Published: Public Library of Science (PLoS) 01-01-2022
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0269827

IntroductionSince the beginning of the pandemic in 2020, COVID-19 has changed the medical landscape. International recommendations for localized prostate cancer (PCa) include deferred treatment and adjusted therapeutic routines.Materials and methodsTo longitudinally evaluate changes in PCa treatment strategies in urological and radiotherapy departments in Germany, a link to a survey was sent to 134 institutions covering two representative baseline weeks prior to the pandemic and 13 weeks from March 2020 to February 2021. The questionnaire captured the numbers of radical prostatectomies, prostate biopsies and case numbers for conventional and hypofractionation radiotherapy. The results were evaluated using descriptive analyses.ResultsA total of 35% of the questionnaires were completed. PCa therapy increased by 6% in 2020 compared to 2019. At baseline, a total of 69 radiotherapy series and 164 radical prostatectomies (RPs) were documented. The decrease to 60% during the first wave of COVID-19 particularly affected low-risk PCa. The recovery throughout the summer months was followed by a renewed reduction to 58% at the end of 2020. After a gradual decline to 61% until July 2020, the number of prostate biopsies remained stable (89% to 98%) during the second wave. The use of RP fluctuated after an initial decrease without apparent prioritization of risk groups. Conventional fractionation was used in 66% of patients, followed by moderate hypofractionation (30%) and ultrahypofractionation (4%). One limitation was a potential selection bias of the selected weeks and the low response rate.ConclusionWhile the diagnosis and therapy of PCa were affected in both waves of the pandemic, the interim increase between the peaks led to a higher total number of patients in 2020 than in 2019. Recommendations regarding prioritization and fractionation routines were implemented heterogeneously, leaving unexplored potential for future pandemic challenges.