COVID-19 Pandemic: Challenges, Impacts and Dilemmas in Surgical Oncology (Descriptive Longitudinal Study)

Background: The oncologic surgery patients constitute a highly susceptible group during COVID-19 pandemic. Aim: To determine how the COVID-19 pandemic affected the cases of surgical oncology, their frequency with reference to the pre-pandemic era and the challenges faced in general and in their management during the pandemic. Methodology: we conducted a descriptive longitudinal study, using consecutive non-probability sampling technique, estimating the number of cancer cases in our center, their management protocols keeping in view the local and international guidelines, resource availability and how the pandemic affected the dynamics of cancer surgery. Results: we received a total of 63 cancer cases from 1st march-31st august 2020, between age groups 29-70 years. 40 patients out of those 63 presented with complications and received early definitive surgery, where surgery could not be deferred due to the course of disease or complications. Rest of the 20 patients received either neoadjuvant chemotherapy, a palliative procedure or chemoradiotherapy, 2 patients tested COVID-19 positive, 1 non-cancer related mortality. We received 63 patients during our 6 months study time, compared with a total of 156 cancer cases received during the pre-pandemic 6 months period, showing significant decrease in frequency of cancer cases. Conclusion: Cancer cases with a chance of upgradation of disease stage due to delay or those complicated with obstruction or bleeding could not be deferred. Mandatory PCR COVID-19 testing of every admitted patient with a repeat test 48-72 hours before surgery. Early referral to corona care center if patient tests positive. Discussion of every case in MDM prior to decision making. Operating every case with complete SOPs.