458 Urological Cancers During COVID-19: Analyses of Short-Term Outcomes from the COVIDSurg-Cancer Study

Abstract Aim To assess 30-day postoperative outcomes for patients undergoing urological cancer surgery during the COVID-19 pandemic. Method All bladder, kidney, UTUC and prostate cancer patients from the COVIDSurg-Cancer Study who underwent elective potentially curative cancer surgery during the COVID-19 pandemic until July 2020 were included. Univariable and multivariable regression was performed to assess the association of patient factors with mortality, respiratory complications, and operative complications. Results A total of 1,902 patients from 36 countries were included. A total of 42/1902 (0.2%) patients were diagnosed with COVID-19 during their inpatient stay. 21 (0.1%) mortalities were observed; of those, 8 (38.1%) were diagnosed with COVID-19. Mortalities were found to be more likely in patients with concurrent COVID-19 infection (OR 31.7, 95% CI 12.4–81.42, p<0.001), aged over 80, ASA grade 3+ and ECOG grade 1+. 40 (0.2%) respiratory complications (acute respiratory distress syndrome or pneumonia) were observed within 30 days of surgery. Respiratory complications were more likely in patients aged with concurrent COVID-19 infection (OR 40.6, 95%CI 11.41–144.45, p<0.001), over 70, from an area with high community risk or with a revised cardiac risk index of 1+. There were 84 (4.4%) major complications (Clavien-Dindo score ≥3). Patients with a concurrent COVID-19 infection (OR 7.45, 95% CI 2.73–20.3, p<0.001) or aged 80 or above were more likely to experience major complications. Conclusions Our data can inform health services to safely select patients for surgery during the pandemic. Patients with concurrent COVID-19 infection have a higher risk of mortality and respiratory complications and should not undergo surgery if possible.