Table 1 Our MDT identifications of elective undeferrable PC management in this COVID-19 time.
From: Elective procedures for prostate cancer in the time of Covid-19: a multidisciplinary team experience
Elective procedure | Undeferrable/deferrable | Risk to delay | Risk to treat | Alternative management |
|---|---|---|---|---|
PSA determination | Deferrable | Tumor progression in high risk | – | – |
Biopsy | -Undeferrable: mMRI capsular bulging or suspect for cT3 or N+ or M+ -Deferrable: mMRI cT2N0M0 | -High risk tumor progression -Lower risk tumor progression | Â | mMRI whether not performed Mainly base to mMRI results |
Radical prostatectomy | -Undeferrable: GS ≥ 7(4 + 3) or cT3 or N+ -Deferrable: GS ≤ 7(3 + 4) and cT2N0 | -High risk tumor progression -Low risk tumor progression | On the basis of patient age and comorbidities Surgeries with lower priority than other urological neoplasms (≥T2 RCC and TCC) | Radiotherapy plus HT Active surveillance |
Radiotherapy | -Undeferrable: GS ≥ 7(4 + 3) or cT3 or N+ -Deferrable: GS  ≤ 7(3 + 4) and cT2N0 | -High risk tumor progression -Low risk tumor progression | On the basis of patient age and comorbidities | Extended HT as neoadiuvant Active surveillance |
Hormonal therapy for metastatic HSPC | Undeferrable: all cases Deferrable: no cases | High risk tumor progression | Low risk to increase COVID infection susceptibility | No alternative treatments |
Treatments for metastatic CRPC | Undeferrable: all cases Deferrable: no cases | High risk tumor progression | Low risk to increase COVID infection susceptibility | Don’t shift ongoing treatments New treatment: prefer ARTA on chemotherapy |
