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The Cancer Hub Approach for Upper Gastrointestinal Surgery During COVID-19 Pandemic: Outcomes from a UK Cancer Centre

Joseph P Doyle1,2, Pranav H Patel1,2, Sophie L F Doran1

  • 1Department of Surgery, The Royal Marsden Hospital, London, UK.

Annals of Surgical Oncology
|October 18, 2022
PubMed

Insights

The RM Partners Cancer Hub safely continued upper gastrointestinal cancer surgeries during the COVID-19 pandemic. This approach ensured continued patient care with good survival outcomes despite healthcare disruptions.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Public Health

Background:

  • The COVID-19 pandemic significantly disrupted global healthcare, leading to widespread cancellations of elective surgeries in England.
  • To maintain cancer care, the Royal Marsden Hospital established the 'RM Partners Cancer Hub' to provide a 'COVID-lite' surgical environment.
  • This initiative aimed to mitigate the impact of the pandemic on essential oncological treatments.

Purpose of the Study:

  • To describe the operational setup of the RM Partners Cancer Hub.
  • To evaluate the outcomes of upper gastrointestinal (UGI) cancer resections performed within this specialized setting.
  • To assess the safety and efficacy of continuing complex cancer surgery during a public health crisis.

Main Methods:

  • The RM Partners Cancer Hub operated from April 2020 to April 2021, coordinating resources across the RM Partners West London Cancer Alliance.
  • A prioritized surgical case strategy was implemented for UGI cancers.
  • Strict infection control protocols and pre-operative screening for COVID-19 were rigorously applied.

Main Results:

  • A total of 231 patients with confirmed or suspected UGI cancer underwent surgery, with 213 successful resections.
  • The combined 90-day mortality rate was 3.5%.
  • Excellent 2-year disease-free survival (DFS) and overall survival (OS) rates were observed for esophageal, gastric, and pancreatic cancer resections, with one patient recovering fully from perioperative COVID-19.

Conclusions:

  • The RM Partners Cancer Hub model proved to be a safe and effective strategy for delivering UGI cancer resectional surgery.
  • This approach facilitated the continuation of vital cancer care during periods of significant healthcare service disruption.
  • The study highlights the feasibility of maintaining specialized oncological surgery amidst global health crises.
Abstract

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