Sarcoma Care Practice in India During COVID Pandemic: A Nationwide Survey
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ORIGINAL ARTICLE
Sarcoma Care Practice in India During COVID Pandemic: A Nationwide Survey Ashish Gulia1 · Akshay Tiwari2 · Ramandeep Singh Arora3 · Srinath Gupta1 · Anand Raja4 Received: 3 June 2020 / Accepted: 17 July 2020 © Indian Orthopaedics Association 2020
Abstract Background Amidst the COVID-19 pandemic, management of cancer has been one of the most intensely debated topics across the globe. We conducted an online survey to determine the consistency/or the lack of it, in the management of sarcoma patients between centres and the changes in policies. Methods A twenty-five question online survey was conducted among practicing physicians over a period of 10 days using online portal (surveymonkey.com). It was followed by a critical analysis based on responses to each question. Results Of 194 medical professionals who participated, 80% were surgeons and 53% were working in government institutes. Most respondents (81%) continued their practice with some modifications. In OP majority (67%) relied only on symptom, contact enquiry and temperature recording for screening. COVID-19 testing was done more (43%) in IP patients. Most of institutes (83%) followed rotational policy to reduce the number of staff at risk while 57% offered an alternate accommodation. 52.3% continued chemotherapy for all patients while radiotherapy for all was offered by 45%. In metastatic cases, majority preferred either no treatment or non-surgical intervention (71%).84.5% believed in adapting changes (42%—avoid supra major surgeries, 27%—Operating only emergency cases and 15.5%—High grade sarcomas with curative intent) in surgical management of sarcomas. For benign bone tumors, majority (71%) agreed on adapting changes while 25% agreed on deferring all cases. 69% preferred teleconsultations for follow-up. Complete PPE were being used for all aerosol generating procedures by 44%. Only two thirds agreed with their institutes policy of PPE usage and COVID-19 testing. Conclusion This survey has highlighted disparity on COVID-19 screening and management in various institutes across the country. This will act as a reference point for tracking future trends in bone and soft tissue tumor management guidelines, as the COVID-19 scenario unfolds globally and particularly in India. Keywords COVID19 · Sarcoma · Survey · PPE · India
Introduction Amidst the COVID-19 pandemic, management of cancer has been one of the most intensely debated topics across the globe [1, 2]. Most of the attention, resources and priorities of
the healthcare systems have been directed towards containing the pandemic. This, coupled with delayed presentation of patients (both from fear of going out and from a lack of means of travel during the lockdown) is likely to lead to a delayed diagnosis and stage migration of a large number
* Ashish Gulia [email protected]
1
Dept of Surgical Oncology, Tata Memorial Hospital, and Homi Bhabha National Institure (HBNI), Mumbai, India
Akshay Tiwari [email protected]
2
Musculoskeletal Oncology, Max Institut
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