Penn Medicine Head and Neck Cancer Service Line COVID-19 Management Guidelines

Overview

Journal Head Neck

Specialties General Surgery
Oncology

Date 2020 Jun 26

PMID 32584447

Citations 4

Authors

Gregory S Weinstein

Roger Cohen

Alexander Lin

Bert W OMalley Jr

John Lukens

Samuel Swisher-McClure

Rabie M Shanti

Jason G Newman

Harman S Parhar

Kendall Tasche

Robert M Brody

Ara Chalian

Steven Cannady

James N Palmer

Nithin D Adappa

Michael A Kohanski

Joshua Bauml

Charu Aggarwal

Kathleen Montone

Virginia LiVolsi

Zubair W Baloch

Jalal B Jalaly

Kumarasen Cooper

Karthik Rajasekaran

Laurie Loevner

Christopher Rassekh

Affiliations

Soon will be listed here.

Abstract

Introduction: The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has altered the health care environment for the management of head and neck cancers. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management in order to achieve a medically and ethically appropriate balance of risks and benefits.

Methods: Creation of consensus document.

Results: The process yielded a consensus statement among a wide range of practitioners involved in the management of patients with head and neck cancer in a multihospital tertiary care health system.

Conclusions: These guidelines support an ethical approach for the management of head and neck cancers during the COVID-19 epidemic consistent with both the local standard of care as well as the head and neck oncological literature.

Citing Articles

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Lieneck C, Betancourt J, Daemen C, Eich R, Monty E, Petty M Medicina (Kaunas). 2021; 57(10).

PMID: 34684160 PMC: 8540351. DOI: 10.3390/medicina57101123.

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer.

Fagan J, Noronha V, Graboyes E Am Soc Clin Oncol Educ Book. 2021; 41:1-11.

PMID: 33793315 PMC: 8059263. DOI: 10.1200/EDBK_320923.

New Challenges of Treatment for Locally Advanced Head and Neck Cancers in the Covid-19 Pandemic Era.

Mirestean C, Crisan A, Mitrea A, Buzea C, Iancu R, Iancu D J Clin Med. 2021; 10(4).

PMID: 33557273 PMC: 7915471. DOI: 10.3390/jcm10040587.

Penn Medicine Head and Neck Cancer Service Line COVID-19 management guidelines.

Weinstein G, Cohen R, Lin A, OMalley Jr B, Lukens J, Swisher-McClure S Head Neck. 2020; 42(7):1507-1515.

PMID: 32584447 PMC: 7362039. DOI: 10.1002/hed.26318.

References

Parhar H, Tasche K, Brody R, Weinstein G, OMalley Jr B, Shanti R . Topical preparations to reduce SARS-CoV-2 aerosolization in head and neck mucosal surgery. Head Neck. 2020; 42(6):1268-1272. PMC: 7267296. DOI: 10.1002/hed.26200. View

Xiao R, Ward M, Yang K, Adelstein D, Koyfman S, Prendes B . Increased pathologic upstaging with rising time to treatment initiation for head and neck cancer: A mechanism for increased mortality. Cancer. 2018; 124(7):1400-1414. DOI: 10.1002/cncr.31213. View

Civantos A, Carey R, Lichtenstein G, Lukens J, Cohen R, Rassekh C . Care of immunocompromised patients with head and neck cancer during the COVID-19 pandemic: Two challenging and informative clinical cases. Head Neck. 2020; 42(6):1131-1136. PMC: 7262192. DOI: 10.1002/hed.26165. View

Bauml J, Vinnakota R, Anna Park Y, Bates S, Fojo T, Aggarwal C . Cisplatin versus cetuximab with definitive concurrent radiotherapy for head and neck squamous cell carcinoma: An analysis of Veterans Health Affairs data. Cancer. 2018; 125(3):406-415. PMC: 6886128. DOI: 10.1002/cncr.31816. View

Weinstein G, Cohen R, Lin A, OMalley Jr B, Lukens J, Swisher-McClure S . Penn Medicine Head and Neck Cancer Service Line COVID-19 management guidelines. Head Neck. 2020; 42(7):1507-1515. PMC: 7362039. DOI: 10.1002/hed.26318. View

Johnson G, ROBINSON W . Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments. J Med Virol. 1991; 33(1):47-50. DOI: 10.1002/jmv.1890330110. View

Montero P, Patel S . Cancer of the oral cavity. Surg Oncol Clin N Am. 2015; 24(3):491-508. PMC: 5018209. DOI: 10.1016/j.soc.2015.03.006. View

Hu S, Fan C, Pecchia B, Rosenberg J . Submental island flap vs free tissue transfer in oral cavity reconstruction: Systematic review and meta-analysis. Head Neck. 2020; 42(8):2155-2164. DOI: 10.1002/hed.26121. View

Li R, Pei S, Chen B, Song Y, Zhang T, Yang W . Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020; 368(6490):489-493. PMC: 7164387. DOI: 10.1126/science.abb3221. View

10.

Liu L, Wei Q, Nishiura K, Peng J, Wang H, Midkiff C . Spatiotemporal interplay of severe acute respiratory syndrome coronavirus and respiratory mucosal cells drives viral dissemination in rhesus macaques. Mucosal Immunol. 2015; 9(4):1089-101. PMC: 4900951. DOI: 10.1038/mi.2015.127. View

11.

Sawchuk W, Weber P, Lowy D, Dzubow L . Infectious papillomavirus in the vapor of warts treated with carbon dioxide laser or electrocoagulation: detection and protection. J Am Acad Dermatol. 1989; 21(1):41-9. DOI: 10.1016/s0190-9622(89)70146-8. View

12.

Chao T, Braslow B, Martin N, Chalian A, Atkins J, Haas A . Tracheotomy in Ventilated Patients With COVID-19. Ann Surg. 2020; 272(1):e30-e32. PMC: 7224612. DOI: 10.1097/SLA.0000000000003956. View

13.

Bauml J, Vinnakota R, Anna Park Y, Bates S, Fojo T, Aggarwal C . Cisplatin Every 3 Weeks Versus Weekly With Definitive Concurrent Radiotherapy for Squamous Cell Carcinoma of the Head and Neck. J Natl Cancer Inst. 2018; 111(5):490-497. PMC: 6510226. DOI: 10.1093/jnci/djy133. View

14.

Inui S, Fujikawa A, Jitsu M, Kunishima N, Watanabe S, Suzuki Y . Chest CT Findings in Cases from the Cruise Ship with Coronavirus Disease (COVID-19). Radiol Cardiothorac Imaging. 2021; 2(2):e200110. PMC: 7233452. DOI: 10.1148/ryct.2020200110. View

15.

Pignon J, Le Maitre A, Maillard E, Bourhis J . Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol. 2009; 92(1):4-14. DOI: 10.1016/j.radonc.2009.04.014. View

16.

Workman A, Welling D, Carter B, Curry W, Holbrook E, Gray S . Endonasal instrumentation and aerosolization risk in the era of COVID-19: simulation, literature review, and proposed mitigation strategies. Int Forum Allergy Rhinol. 2020; 10(7):798-805. DOI: 10.1002/alr.22577. View

17.

Maxwell J, Ferris R, Gooding W, Cunningham D, Mehta V, Kim S . Extracapsular spread in head and neck carcinoma: impact of site and human papillomavirus status. Cancer. 2013; 119(18):3302-8. DOI: 10.1002/cncr.28169. View

18.

Pellino G, Spinelli A . How Coronavirus Disease 2019 Outbreak Is Impacting Colorectal Cancer Patients in Italy: A Long Shadow Beyond Infection. Dis Colon Rectum. 2020; 63(6):720-722. DOI: 10.1097/DCR.0000000000001685. View

19.

Dias F, Walder F, Leonhardt F . The role of transoral robotic surgery in the management of oropharyngeal cancer. Curr Opin Oncol. 2017; 29(3):166-171. DOI: 10.1097/CCO.0000000000000365. View

20.

Chaturvedi A, Engels E, Pfeiffer R, Hernandez B, Xiao W, Kim E . Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011; 29(32):4294-301. PMC: 3221528. DOI: 10.1200/JCO.2011.36.4596. View