Urologic oncology practice during COVID-19 pandemic: A systematic review on what can be deferrable vs. nondeferrable

Andrew B. Katims, Shirin Razdan, Benjamin M. Eilender, Peter Wiklund, Ashutosh K. Tewari, Natasha Kyprianou, Ketan K. Badani, Reza Mehrazin

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Purpose: To provide a review of high-risk urologic cancers and the feasibility of delaying surgery without impacting oncologic or mortality outcomes. Materials and methods: A thorough literature review was performed using PubMed and Google Scholar to identify articles pertaining to surgical delay and genitourinary oncology. We reviewed all relevant articles pertaining to kidney, upper tract urothelial cell, bladder, prostate, penile, and testicular cancer in regard to diagnostic, surgical, or treatment delay. Results: The majority of urologic cancers rely on surgery as primary treatment. Treatment of unfavorable intermediate or high-risk prostate cancer, can likely be delayed for 3 to 6 months without affecting oncologic outcomes. Muscle-invasive bladder cancer and testicular cancer can be treated initially with chemotherapy. Surgical management of T3 renal masses, high-grade upper tract urothelial carcinoma, and penile cancer should not be delayed. Conclusion: The majority of urologic oncologic surgeries can be safely deferred without impacting long-term cancer specific or overall survival. Notable exceptions are muscle-invasive bladder cancer, high-grade upper tract urothelial cell, large renal masses, testicular and penile cancer. Joint decision making among providers and patients should be encouraged. Clinicians must manage emotional anxiety and stress when decisions around treatment delays are necessary as a result of a pandemic.

Original languageEnglish
Pages (from-to)783-792
Number of pages10
JournalUrologic Oncology: Seminars and Original Investigations
Issue number10
StatePublished - Oct 2020


  • COVID-19
  • Cancer
  • Delayed treatment
  • Urologic oncology
  • Urology


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