Impact of COVID-19 on Systemic Treatment in Metastatic Uro-Oncology Patients in German University Hospitals

Overview

This multicenter analysis evaluated 162 metastatic uro-oncologic patients receiving systemic cancer therapy during the first COVID-19 wave in Germany. The study found that 24.1% experienced delays in systemic treatment or follow-up, with variations by tumor entity and treatment modality, highlighting the pandemic's impact on uro-oncologic care.

Background

The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, including oncologic care. Patients with metastatic uro-oncologic diseases are particularly vulnerable due to their immunosuppressed status and the necessity for continuous systemic therapies. German university hospitals maintained care during the crisis, but the extent of treatment delays and their impact on outcomes remained unclear. This study aimed to assess how the pandemic influenced systemic treatment delivery and follow-up in this high-risk population.

Data Highlights

Key Findings

• 24.1% of metastatic uro-oncologic patients experienced delays in systemic treatment or follow-up during the first COVID-19 wave.
• Delays were significantly associated with tumor entity (p = 0.002) and treatment modality (p = 0.001), with medium effect sizes (Cramér’s V = 0.31 and 0.33, respectively).
• Patients receiving immuno-oncologic therapies or androgen deprivation therapies had fewer delays compared to those on chemotherapy.
• The majority of patients (81.9%) maintained favorable performance status (ECOG 0–1) despite the pandemic.
• No SARS-CoV-2 infections were reported among the cohort during the study period.

Clinical Implications

Clinicians should be aware that the COVID-19 pandemic can lead to significant delays in systemic treatment and follow-up for metastatic uro-oncologic patients, potentially impacting disease control. Prioritizing uninterrupted care, especially for patients on chemotherapy, and utilizing telemedicine where appropriate may mitigate these delays. Close monitoring of treatment schedules and patient status remains essential during ongoing or future healthcare disruptions.

Conclusion

The COVID-19 pandemic caused measurable delays in systemic cancer treatment and follow-up for metastatic uro-oncologic patients in German university hospitals, with variations by tumor type and therapy. Maintaining timely oncologic care during such crises is critical to avoid adverse outcomes in this vulnerable population.

References

1. Robert Koch Institute 2021 -- COVID-19 Situation Reports Germany
2. European Centre for Disease Prevention and Control 2021 -- COVID-19 Surveillance Data
3. German Society of Urology 2020 -- Impact of COVID-19 on Urooncologic Care
4. IBM Corp. 2013 -- SPSS Statistics for Windows, Version 22.0