COVID-19 screening protocols for preoperative assessment of head and neck cancer patients candidate for elective surgery in the midst of the pandemic: A narrative review with comparison between two Italian institutions

Marco Ferrari; Alberto Paderno; Lorenzo Giannini; Diego Cazzador; Cristina Ciardiello; Giovanni Carretta; Cesare Piazza; Piero Nicolai

doi:10.1016/j.oraloncology.2020.105043

COVID-19 screening protocols for preoperative assessment of head and neck cancer patients candidate for elective surgery in the midst of the pandemic: A narrative review with comparison between two Italian institutions

Oral Oncol. 2021 Jan:112:105043. doi: 10.1016/j.oraloncology.2020.105043. Epub 2020 Oct 14.

Authors

Marco Ferrari¹, Alberto Paderno², Lorenzo Giannini³, Diego Cazzador⁴, Cristina Ciardiello⁵, Giovanni Carretta⁶, Cesare Piazza⁷, Piero Nicolai⁴

Affiliations

¹ Section of Otorhinolaryngology-Head and Neck Surgery, Azienda Ospedaliera di Padova, University of Padua, Padua, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Azienda Spedali Civili di Brescia, University of Brescia, Brescia, Italy. Electronic address: 1990marcoferrari@gmail.com.
² Unit of Otorhinolaryngology-Head and Neck Surgery, Azienda Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
³ Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, Milan, Italy.
⁴ Section of Otorhinolaryngology-Head and Neck Surgery, Azienda Ospedaliera di Padova, University of Padua, Padua, Italy.
⁵ Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, Milan, Italy; Department of Maxillofacial Surgery, San Paolo Hospital, University of Milan, Milan, Italy.
⁶ Medical Direction, Azienda Ospedaliera di Padova, University of Padua, Padua, Italy.
⁷ Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, Milan, Italy; Department of Oncology and Oncohematology, University of Milan, Milan, Italy.

Abstract

Background: Preoperative screening had a key role in planning elective surgical activity for head and neck cancer (HNC) during the COVID-19 pandemic.

Methods: All patients undergoing surgery for HNC at two Italian referral hospitals (University of Padua and National Cancer Institute [NCI]) during the peak of the COVID-19 epidemic in Italy were included. Accuracy of screening protocols was assessed.

Results: In the Padua protocol, 41 patients were screened by pharyngeal swab. The entire sample (100%) was admitted to surgery, diagnostic accuracy was 100%. In the NCI protocol, 23 patients underwent a telephone interview, blood test, and chest CT. Twenty patients (87%) were negative and were directly admitted to surgery. In the remaining 3 (13%), pharyngeal swab was performed. The screening was repeated until a negative chest CT was found. Diagnostic accuracy was 85%.

Conclusions: Dedicated screening protocols for COVID-19 allow to safely perform elective HNC surgery.

Keywords: COVID-19; Chest CT; Diagnostic accuracy; Elective surgery; Head and neck cancer; Pharyngeal swab; Screening protocol.

Publication types

Comparative Study
Review

MeSH terms

Aged
COVID-19 / diagnosis*
COVID-19 / epidemiology
COVID-19 Testing / methods*
Clinical Protocols
Elective Surgical Procedures
Female
Head and Neck Neoplasms / surgery*
Humans
Male
Middle Aged
Preoperative Care*
Retrospective Studies
SARS-CoV-2*
Tomography, X-Ray Computed