Tumori Journal Abstract Book - October 2020 - 74

74
Background: COVID-19 pandemic has represented a historic challenge to healthcare systems. The management of
cancer care has become a crucial issue for clinical services
to cancer patients. During the COVID-19 pandemic, raising evidence has been published on lung cancer care but
no data have been presented on the integrated care pathways (ICP) impact.
Materials and methods: We retrospectively reviewed the
ICPs of consecutive lung cancer patients who accessed
two Centres before and after COVID-19 pandemic: the
Veneto Institute of Oncology (IOV)/University Hospital of
Padua and University Hospital of Verona. Sixteen indicators about oncology, radiaton therapy, thoracic surgery,
pathology and pneumology were developed using groupfacilitation techniques taking into account their reproducibility, significance, measurability. We report data extracted
from electronic medical records and linked softwares,
about MDT performance at the two participating Centres,
and preliminary data about pathological and oncological
indicators in Padua. Additional data about both complete
ICPs will be presented at the Conference.
Results: We compared data about ICP performance in two
window periods: 1/3/2019-30/4/2019 and 1/3/2020-
30/4/2020. MDT meetings were reshaped in order to discuss
those cases where more than two specialists were required
and whenever possible on a web-basis; therefore, it determined an average reduction of patients discussed of 57.5%.
Preliminary data from Padua showed that median time
between diagnostic procedure and diagnosis was reduced
from 11 days in 2019 to 7.5 days in 2020, mostly due to a
prioritization of oncological procedures over any other.
Moreover, a 39% reduction of first oncological visits was
observed between the two time frames; this was linked to a
reduction of out of region second opinion and to optimization of outpatient access. Among patients under oncological
treatment, 12(4%) and 8(2%) patients received treatment
within 30 days from death in 2019 and 2020, respectively.
Conclusions: Based on the experience the two Centres
went through, we identified the key steps in ICP impacted
by a pandemic such COVID-19 so to proactively put in
place robust service provision in thoracic oncology.

D18
RESILIENCE IN CANCER CARE AT
THE TIME OF COVID-19: PRACTICAL
APPROACH TO THE MANAGEMENT
OF CANCER PATIENTS DURING THE
COVID-19 EMERGENCY IN A LARGE
ITALIAN COMMUNITY HOSPITAL
Lasagna A.1, Secondino S.1, Agustoni F.1, Monaco T.1, Imarisio I.1,
Pagani A.1, Rizzo G.1, Tancredi R.J.1, Pozzi E.1, Ferraris E.1, Chiellino
S.1, Gandini C.1, Brugnatelli S.G.1, Pedrazzoli P.1
1

Fondazione IRCCS Policlinico San Matteo, Pavia

Tumori Journal 106(2S)
Background: The Fondazione IRCCS Policlinico San
Matteo, the largest academic Hospital in the south-west
part of Lombardy has been involved in the management of
the COVID-19 outbreak since its inception. The Oncology
Unit had to face with the challenge of to keep on active
oncological treatments without compromising the safety
of our pts and healthcare personnel both in the inpatients,
as well as in the outpatients.
Patients and methods: From the very beginning of the
emergency, the inpatient ward and the outpatient clinic
were moved to the main building of the Hospital as their
original locations become COVID-19 wards. From Feb.
24th, we reorganized our Unit, with the introduction of a
double-step triage strategy for cancer pts under treatment
in order to identify pts at risk from COVID-19, and to
avoid their admission to Hospital.
- First step: a phone call the day before active therapy or
admission (virtual swab); - Second step: a clinical evaluation upon entry the outpatient and inpatient wards.
Results: From February 24 to April 7, 2020, 819 phone calls
were performed, leading to the authorization of 788 accesses
to the outpatient clinic for active treatments. 26 pts (8.3%)
with symptoms were kept at home and managed by repeated
telephone calls in collaboration with the family doctor; of
these subjects, 3 were hospitalized for suspected COVID,
while 23 were managed at home with symptomatic treatments and antibiotics. At the second triage level, 5 pts were
hospitalized and proved positive for SARS-CoV-2 by nasal
swab. In the same period, 177 pts were admitted to the inpatient ward: none has been found to be COVID-19-suspected
or swab-positive. Both outpatient and inpatient areas were
still COVID-19 free. No healthcare workers resulted infected
by SARS-CoV-2, including 2 physicians who had fever during this period, but resulted SARS-CoV-2 negative by 2
sequential nasal swabs, performed 14 days apart.
Conclusions: During the emergency phase of the COVID19 outbreak the behavior of health care workers had to be
arranged to appropriately manage it, according to risk
management strategies particularly to that defined as
"resilience". Our screening strategy, which requested neither human nor economic extra resources, put successfully
into practice the capacity to adapt the management to a
global health emergency as we could maintain the preCOVID approach to cancer care, while protecting pts and
healthcare workers from COVID-19 infection.

D19
PREVALENCE AND CLINICAL IMPACT
OF ASYMPTOMATIC OR MILDLY
SYMPTOMATIC SARSCoV-2 INFECTION
AMONG ACTIVELY TREATED CANCER
PATIENTS DURING RECENT COVID-19
PANDEMIC PEAK IN ITALY

Tumori Journal Abstract Book - October 2020

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