Prioritization of Surgery in Cancer Patients During the COVID-19 Pandemic: Lessons From a Failed Balancing Act

The prioritization of surgical oncology over other elective interventions during COVID-19 has failed to preserve the quality of care in oncology and will likely lead to an increase of cancer-related mortality in the coming years. We propose five components for systems to improve the organization of surgical oncology during future crises, namely (1) a multidisciplinary governance structure employing predictive models and risk/benefit evaluations, (2) predefined quality objectives based on measurable markers (regularly reviewed and adapted), (3) temporary flexibility in therapeutic algorithms and authorization procedures (with associated safeguards), (4) systems to ensure access to transparent, apolitical information, and (5) explicit, dedicated logistical surgical capacities to optimize coordination and resource allocation.