Thread by @Sivesh93

A great pleasure to be sharing the published results of the #OG Cancer #COVID19 international survey of oesophagogastric surgeons!

A tweetorial of the key points ⬇️

academic.oup.com/dote/advance-a…

@ISDE_net @Augishealth @ThoracicsCanada @tentaclestudy

This survey included:

-> 234 oesophagogastric surgeons managing cancer patients
-> 225 centres from 49 countries

This is truly an amazing representation of clinical practice across the globe

academic.oup.com/dote/advance-a…

This online survey was conducted at two time points to assess changes to clinical practice during #COVID-19 pandemic

1) Staging investigations
2) Oncological therapy
3) Surgical management
4) OG Surgeons and COVID-19

academic.oup.com/dote/advance-a…

Let's start with Staging Investigations

There was a massive variation in available staging investigations for #OG Cancers across both rounds of the survey

Most notably only 1 in 5 centres have EUS services available

We will also saw a shift in oncological practices towards Definitive Chemoradiotherapy for both Adenocarcinoma (Figure A) and SCC (Figure B), which is an interesting observation for the former!

academic.oup.com/dote/advance-a…

Whilst no strong evidence exists for dCRT use in adenocarcinoma and SCC, a recent @AnnalsofSurgery paper demonstrated equivalence in survival for dCRT + salvage vs NCRT and salvage!

journals.lww.com/annalsofsurger…

When stratified by country incidence of #COVID19, rates of dCRT were much higher in centres within countries with high (H-CoV) #COVID19 incidence per capita

academic.oup.com/dote/advance-a…

Prioritisation of cancer resections can be tricky - so we assessed what centres used to prioritise them

Again, there was a massive spread

Notably, neoadjuvant timing was prioritised more in round 2 in centres!

academic.oup.com/dote/advance-a…

And then using case vignettes, we also saw a spread in cases that would be deemed priority by centres responding to them!

academic.oup.com/dote/advance-a…

Also, key findings on operative management by centres

-> 46.7% performing resection in the same hospital

-> 40.8% use PPE for all resections

-> 51.6% adopting dual consultant operating

-> 52.2% continuing MI Surgery

academic.oup.com/dote/advance-a…

@SAGES_Updates @ALSGBandI

Finally, we also looked at the impact of #OG surgeons on #COVID19!

-> 44.6% have been symptomatic with COVID-19
-> Only 12.1% had tested positive
-> Majority of #OG surgeon remained in the same department

academic.oup.com/dote/advance-a…

Moving forwards, more patient-driven data will be published soon on cancer surgery to determine impact of current practices on outcomes from @CovidSurg, building on from recent data @TheLancet

thelancet.com/pdfs/journals/…

There is plenty more data in the paper to look at and hope this tweetorial has highlighted some of the key points of the survey!

Hope this tweetorial has been useful and thanks to everyone who contributed! @EwenGriffiths @Pritam__Singh @MarkarSheraz

academic.oup.com/dote/advance-a…