Background: COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel.
Methods: The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus. HNC subsites considered included aerodigestive tract mucosa, sinonasal, salivary, endocrine, cutaneous, and ocular.
Recommendations: Each subsite is presented separately with disease-specific recommendations. Options for alternative treatment modalities are provided if surgical treatment needs to be deferred.
Conclusion: These guidelines are intended to help clinicians caring for patients with HNC appropriately allocate resources during a health care crisis, such as the COVID-19 pandemic. We continue to advocate for individual consideration of cases in a multidisciplinary fashion based on individual patient circumstances and resource availability.
Keywords: SARS-CoV-2; oncology; otolaryngology.
© 2020 Wiley Periodicals, Inc.
Head and neck oncology during the COVID-19 pandemic: Reconsidering traditional treatment paradigms in light of new surgical and other multilevel risks.Oral Oncol. 2020 Jun;105:104684. doi: 10.1016/j.oraloncology.2020.104684. Epub 2020 Apr 6. Oral Oncol. 2020. PMID: 32330858 Free PMC article. Review.
Endocrine surgery in the Coronavirus disease 2019 pandemic: Surgical Triage Guidelines.Head Neck. 2020 Jun;42(6):1325-1328. doi: 10.1002/hed.26169. Epub 2020 Apr 30. Head Neck. 2020. PMID: 32437031 Free PMC article.
Changing practice patterns in head and neck oncologic surgery in the early COVID-19 era.Head Neck. 2020 Jun;42(6):1179-1186. doi: 10.1002/hed.26202. Epub 2020 May 7. Head Neck. 2020. PMID: 32459061
Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiation Therapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement.Int J Radiat Oncol Biol Phys. 2020 Apr 14:S0360-3016(20)31034-8. doi: 10.1016/j.ijrobp.2020.04.016. Online ahead of print. Int J Radiat Oncol Biol Phys. 2020. PMID: 32302681 Free PMC article.
International Guidelines And Recommendations For Surgery During Covid-19 Pandemic: A Systematic Review.Int J Surg. 2020 May 23:S1743-9191(20)30444-1. doi: 10.1016/j.ijsu.2020.05.061. Online ahead of print. Int J Surg. 2020. PMID: 32454253 Free PMC article. Review.
- Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020.
- Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020.
- World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19: 11 March 2020. 2020; https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%E2%80%9411-march-2020. Accessed April 5, 2020.
- CDC. Cumulative total number of COVID-19 cases in the United States by report date. 2020; https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-in-us.html. Accessed April 8, 2020.
- FACS. COVID-19: guidance for triage of non-emergent surgical procedures. 2020; https://www.facs.org/covid-19/clinical-guidance/triage. Accessed April 5, 2020.