@article{ffa6e501d29a4ec1a41408b5c0960b89,
title = "Management of Germ Cell Tumors During the Outbreak of the Novel Coronavirus Disease-19 Pandemic: A Survey of International Expertise Centers",
abstract = "Background: The coronavirus disease 2019 (COVID-19) pandemic has become a public health emergency affecting frail populations, including patients with cancer. This poses the question of whether cancer treatments can be postponed or modified without compromising their efficacy, especially for highly curable cancers such as germ cell tumors (GCTs). Materials and Methods: To depict the state-of-the-art management of GCTs during the COVID-19 pandemic, a survey including 26 questions was circulated by e-mail among the physicians belonging to three cooperative groups: (a) Italian Germ Cell Cancer Group; (b) European Reference Network–Rare Adult Solid Cancers, Domain G3 (rare male genitourinary cancers); and (c) Genitourinary Medical Oncologists of Canada. Percentages of agreement between Italian respondents (I) versus Canadian respondents (C), I versus European respondents (E), and E versus C were compared by using Fisher's exact tests for dichotomous answers and chi square test for trends for the questions with three or more options. Results: Fifty-three GCT experts responded to the survey: 20 Italian, 6 in other European countries, and 27 from Canada. Telemedicine was broadly used; there was high consensus to interrupt chemotherapy in COVID-19–positive patients (I = 75%, C = 55%, and E = 83.3%) and for use of granulocyte colony-stimulating factor primary prophylaxis for neutropenia (I = 65%, C = 62.9%, and E = 50%). The main differences emerged regarding the management of stage I and stage IIA disease, likely because of cultural and geographical differences. Conclusion: Our study highlights the common efforts of GCT experts in Europe and Canada to maintain high standards of treatment for patients with GCT with few changes in their management during the COVID-19 pandemic. Implications for Practice: 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 and sharing best practices to minimize frequency and intensity of patient contacts with thinly stretched health care capacity. {\textcopyright} 2020 AlphaMed Press",
keywords = "COVID-19, Curable tumors, Expert centers, Germ cell tumors, Pandemic, Testicular cancer, bleomycin, carboplatin, cisplatin, etoposide, granulocyte colony stimulating factor, adjuvant chemotherapy, Article, Canada, cancer chemotherapy, cancer staging, coronavirus disease 2019, e-mail, Europe, germ cell tumor, health care personnel, health survey, human, low risk patient, lung toxicity, neutropenia, pandemic, physician, priority journal, questionnaire, telemedicine, therapy delay, throat culture, cancer center, clinical practice, epidemiology, neoplasm, oncologist, prevention and control, Cancer Care Facilities, Granulocyte Colony-Stimulating Factor, Humans, Neoplasms, Germ Cell and Embryonal, Oncologists, Practice Patterns, Physicians', SARS-CoV-2, Surveys and Questionnaires, Telemedicine",
author = "L. Nappi and M. Ottaviano and P. Rescigno and M. Tortora and G.L. Banna and G. Baciarello and U. Basso and C. Canil and A. Cavo and {Cossu Rocca}, M. and P. Czaykowski and {De Giorgi}, U. and {Garcia del Muro}, X. and {Di Napoli}, M. and G. Fornarini and J.A. Gietema and D.Y.C. Heng and S.J. Hotte and C. Kollmannsberger and M. Maruzzo and C. Messina and F. Morelli and S. Mulder and C. Nichols and F. Nol{\`e} and C. Oing and T. Sava and S. Secondino and G. Simone and D. Soulieres and B. Vincenzi and P.A. Zucali and {De Placido}, S. and G. Palmieri and (IGG), {Italian Germ Cell Cancer Group} and G3, {ERN-EURACAN Domain} and (GUMOC), {Genitourinary Medical Oncologists of Canada}",
note = "Cited By :4 Export Date: 4 March 2021 CODEN: OCOLF Correspondence Address: Palmieri, G.; Department of Clinical Medicine and Surgery, Italy; email: giovpalm@unina.it Correspondence Address: Palmieri, G.; Centro di riferimento Campania per i tumori rar (CRCTR) Regional Rare Tumors Reference CenterItaly; email: giovpalm@unina.it Chemicals/CAS: bleomycin, 11056-06-7, 9041-93-4; carboplatin, 41575-94-4; cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; etoposide, 33419-42-0, 433304-61-1; Granulocyte Colony-Stimulating Factor References: (2020) Coronavirus Disease (COVID-19) Pandemic. World Health Organization Web Site, , https://www.who.int/emergencies/diseases/novel-coronavirus-2019.Accessed, Available at, March 22; Lazzerini, M., Putoto, G., COVID-19 in Italy: Momentous decisions and many uncertainties (2020) Lancet Glob Health, 8, pp. e641-e642; Zhou, F., Yu, T., Du, R., Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: A retrospective cohort study (2020) Lancet, 395, pp. 1054-1062; Liang, W., Guan, W., Chen, R., Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China (2020) Lancet Oncol, 21, pp. 335-337; Albers, P., Albrecht, W., Algaba, F., Guidelines on testicular cancer: 2015 update (2015) Eur Urol, 68, pp. 1054-1068; Verhoeven, R.H., Coebergh, J.W., Kiemeney, L.A., Testicular cancer: Trends in mortality are well explained by changes in treatment and survival in the southern Netherlands since 1970 (2007) Eur J Cancer, 43, pp. 2553-2558; Richiardi, L., Scelo, G., Boffetta, P., Second malignancies among survivors of germ-cell testicular cancer: A pooled analysis between 13 cancer registries (2007) Int J Cancer, 120, pp. 623-631; Condello, C., Rescigno, P., Ottaviano, M., Clinical features and psychological aspects of the decision-making process in stage I testicular germ cell tumors (2018) Future Oncol, 14, pp. 1591-1599; Kollmannsberger, C., Tandstad, T., Bedard, P.L., Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance (2015) J Clin Oncol, 33, pp. 51-57; Kutikov, A., Weinberg, D.S., Edelman, M.J., A war on two fronts: Cancer care in the time of COVID-19 (2020) Ann Intern Med, 172, pp. 756-758; Standard-Dose Combination Chemotherapy or High-Dose Combination Chemotherapy and Stem Cell Transplant in Treating Patients with Relapsed or Refractory Germ Cell Tumors (2015) TIGER Trial. Clinicaltrials.Gov Identifier: NCT0237504. Bethesda, , March 2; Grasselli, G., Zangrillo, A., Zanella, A., Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region (2020) Italy. JAMA, 323, pp. 1574-1581; Nichols, C., Kollmannsberger, C., Alternatives to standard BEP x 3 in good-prognosis germ cell tumors–you bet your life (2010) J Natl Cancer Inst, 102, pp. 1214-1215; Culine, S., Kerbrat, P., Kramar, A., Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: A randomized trial of the Genito- Urinary Group of the French Federation of Cancer Centers (GETUG T93BP) (2007) Ann Oncol, 18, pp. 917-924; Stephenson, A.J., Bosl, G.J., Bajorin, D.F., Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion (2005) J Urol, 174, pp. 557-560; Kollmannsberger, C.K., Nappi, L., Nichols, C., Management of stage II germ cell tumors: Be sure, be patient, be safe (2019) J Clin Oncol, 37, pp. 1856-1862; Hamilton, R.J., Nayan, M., Anson-Cartwright, L., Treatment of relapse of clinical stage I nonseminomatous germ cell tumors on surveillance (2019) J Clin Oncol, 37, pp. 1919-1926",
year = "2020",
doi = "10.1634/theoncologist.2020-0420",
language = "English",
volume = "25",
pages = "e1509--e1515",
journal = "Oncologist",
issn = "1083-7159",
publisher = "Wiley-Blackwell",
number = "10",
}