Head and neck cancer surgery during the COVID-19 pandemic : An international, multicenter, observational cohort study

Shaw, R.; Winter, S.C.; Glasbey, J.; M. W. S., H.; Jackson, R.; Cicconi, S.; Ganly, I.; Batstone, M.; Rey Biel, J.; Nankivell, P.C.; Simon, C.; Omar, O.; Simoes, J.F.F.; Nepogodiev, D.; Bhangu, A.; Schache, A.G.; Jackson, R.; Cicconi, S.; Glasbey, J.; Siaw-Acheampong, K.; Benson, R.A.; Bywater, E.; Chaudhry, D.; Dawson, B.E.; Evans, J.P.; Glasbey, J.C.; Gujjuri, R.R.; Heritage, E.; Jones, C.S.; Kamarajah, S.K.; Khatri, C.; Khaw, R.A.; Keatley, J.M.; Knight, A.; Lawday, S.; Li, E.; Mann, H.S.; Marson, E.J.; Mclean, K.A.; Mckay, S.C.; Mills, E.C.; Nepogodiev, D.; Pellino, G.; Picciochi, M.; Taylor, E.H.; Tiwari, A.; Simoes, J.F.F.; Trout, I.M.; Venn, M.L.; Wilkin, R.J.W.; Bhangu, A.; Glasbey, J.C.; Shaw, R.; Schache, A.G.; Winter, S.C.; M. W. S., H.; Nankivell, P.; Rey Biel, J.; Batstone, M.; Ganly, I.; Simon, C.; Simoes, J.F.F.; Abbott, T.E.F.; Adamina, M.; Ademuyiwa, A.O.; Agarwal, A.; Alameer, E.; Alderson, D.; Alakaloko, F.; Albertsmeiers, M.; Alser, O.; Alshaar, M.; Alshryda, S.; Arnaud, A.P.; Augestad, K.M.; Ayasra, F.; Azevedo, J.; Bankhead-Kendall, B.K.; Barlow, E.; Benson, R.A.; Blanco-Colino, R.; Brar, A.; Minaya-Bravo, A.; Breen, K.A.; Bretherton, C.; Buarque, I.L.; Burke, J.; Caruana, E.J.; Chaar, M.; Chakrabortee, S.; Christensen, P.; Cox, D.; Cukier, M.; Cunha, M.F.; Davidson, G.H.; Desai, A.; Saverio, S.D.; Drake, T.M.; Edwards, J.G.; Elhadi, M.; Emile, S.; Farik, S.; Fiore, M.; Fitzgerald, J.E.; Ford, S.; Garmanova, T.; Gallo, G.; Ghosh, D.; Gomes, G.M.A.; Grecinos, G.; Griffiths, E.A.; Grundl, M.; Halkias, C.; Harrison, E.M.; Hisham, I.; Hutchinson, P.J.; Hwang, S.; Isik, A.; Jenkinson, M.D.; Jonker, P.; Kaafarani, H.M.A.; Kolias, A.; Kruijff, S.; Lawani, I.; Lederhuber, H.; Leventoglu, S.; Litvin, A.; Loehrer, A.; Loffler, M.W.; Aguilera Lorena, M.; Marta Madolo, M.; Major, P.; Martin, J.; Mashbari, H.N.; Mazingi, D.; Metallidis, S.; Minaya-Bravo, A.; Mohan, H.M.; Moore, R.; Moszkowicz, D.; Moug, S.; Ng-Kamstra, J.S.; Maimbo, M.; Niquen, M.; Ntirenganya, F.; Olivos, M.; Oussama, K.; Outani, O.; Parreno-Sacdalanm, M.D.; Pata, F.; Rivera, C.J.P.; Pinkney, T.D.; van der Plas, W.; Pockney, P.; Qureshi, A.; Radenkovic, D.; Ramos-De la Medina, A.; Roberts, K.; Roslani, A.C.; Rutegard, M.; Santos, I.; Satoi, S.; Sayyed, R.; Schache, A.; Schnitzbauer, A.A.; Seyi-Olajide, J.O.; Sharma, N.; Shaw, R.; Shu, S.; Soreide, K.; Spinelli, A.; Stewart, G.D.; Sund, M.; Sundar, S.; Tabiri, S.; Townend, P.; Tsoulfas, G.; van Ramshorst, G.H.; Vidya, R.; Vimalachandran, D.; Warren, O.J.; Wedderburn, D.; Wright, N.; Boccalatte, L.A.; Figari, M.F.; Larranaga, J.J.; Gibson, D.; Moss, J.; Richards, T.; U. G., V.; Cope, D.; Egoroff, N.; Lott, N.; Elliott, M.; Phung, D.; Batstone, M.; Ofner, D.; Gatti, A.; Nardi, C.; Oliva, R.; De Cicco, R.; Luksic, I.; Mamic, M.; Lorencin, M.; Osman, N.; Abdelkarem, M.M.; M. elghazaly S.,; Nageh, M.A.; Saad, M.M.; Salah, M.; Shahine, M.; Bettoni, J.; Dakpe, S.; Devauchelle, B.; Lavagen, N.; Testelin, S.; Boucher, S.; Breheret, R.; Gueutier, A.; Kahn, A.; Kun-Darbois, J.; Barrabe, A.; Louvrier, A.; Ballouhey, Q.; Laloze, J.; Usseglio, J.; Espitalier, F.; Ferron, C.; Malard, O.; Pergolini, I.; Reim, D.; Liokatis, P.; Smolka, W.; Nowak, K.; Reinhard, T.; Holzle, F.; Modabber, A.; Winnand, P.; Knitschke, M.; Kauffmann, P.; Wolfer, S.; Kleeff, J.; Lorenz, K.; Michalski, C.; Ronellenfitsch, U.; Schneider, R.; Betz, C.S.; Bewarder, J.; Bottcher, A.; Burg, S.; Busch, C.J.; Gosau, M.; Koenig, D.; Mockelmann, N.; Smeets, R.; Speth, U.; Thole, S.; Vollkommer, T.; Zeller, N.; Dafnios, N.; Gkrinia, E.; Hajiioannou, J.; Korais, C.; Koukoura, O.; Saratziotis, A.; Skoulakis, C.; Alexoudi, V.; Antoniades, K.; Astreidis, I.; Christidis, P.; Deligiannidis, D.; Grivas, T.; Ioannidis, O.; Kalaitsidou, I.; Loutzidou, L.; Mantevas, A.; Michailidou, D.; Paraskevopoulos, K.; Politis, S.; Stavroglou, A.; Tatsis, D.; Tilaveridis, I.; Vahtsevanos, K.; Venetis, G.; Callanan, D.; Huang, L.; Ionescu, A.; Sheahan, P.; Barry, C.P.; Fitzgerald, C.; Kinsella, J.; Lennon, P.; Timon, C.; Macina, S.; Bissolotti, G.; Fusetti, S.; Lemma, F.; Bellanti, L.; Bergonzani, M.; Bertoli, G.; D'Angelo, G.; Lanfranco, D.; Poli, T.; Santoro, G.P.; Varazzani, A.; Bussu, F.; Perra, T.; Piras, A.; Porcu, A.; Rizzo, D.; Campisi, G.; Cordova, A.; Franza, M.; Rinaldi, G.; Toia, F.; Beltramini, G.A.; Gianni', A.; Pignataro, L.; Torretta, S.; Comini, L.V.; Fiore, M.; Giannini, L.; Piazza, C.; Gasparini, G.; Gordini, L.; Lombardi, C.P.; Moro, A.; Saponaro, G.; De Virgilio, A.; Ferreli, F.; Gaino, F.; Mercante, G.; Rossi, V.; Spriano, G.; Adamoli, L.; Ansarin, M.; Chu, F.; De Berardinis, R.; Mastrilli, F.; Pietrobon, G.; Tagliabue, M.; Baietti, A.M.; Biasini, M.; Maremonti, P.; Neri, F.; Prucher, G.M.; Ricci, S.; Ruggiero, F.; Zarabini, A.G.; Mancini, S.; Marino Cosentino, L.; Sagnotta, A.; Cotoia, A.; Lizzi, V.; Vovola, F.; Cipriani, R.; Pignatti, M.; Pinto, V.; Rottoli, M.; Bertelli, G.; Notte, F.; Balercia, P.; Catarzi, L.; Consorti, G.; Ibrahim, A.; Obeidat, K.; Abou Chaar, M.K.; Al-Masri, M.; Al-Najjar, H.; Alawneh, F.; Alsaraireh, O.; Burgan, D.; Salamah, A.A.; Liew, Y.T.; Roslani, A.C.; Cordera, F.; Alvarez, M.R.; Arrangoiz, R.; Gomez-Pedraza, A.; Becerra Garcia, F.C.; Alfaro-Goldaracena, A.; Buerba, G.A.; Mercado, M.A.; Posadas-Trujillo, O.E.; Sarre, C.; Souadka, A.; Majbar, M.A.; Benkabbou, A.; De Bree, R.; Sholadoye, T.T.; Tolani, M.A.; Abur, P.P.; Ayub, B.; Hassan, N.; Robles, R.; Fernandes, V.; Ferraz, I.; Teixeira, M.; Breda, D.; Colino, M.; Correia, S.; De Barros, J.; De Oliveira Lopez, A.L.; Garrido, S.; Lazaro, A.; Oliveira, J.M.; Rodrigues, M.; Almeida, A.; Cavaleiro, S.; Faria, C.S.; Magalhaes, M.M.; Santos-Sousa, H.; Silveira, H.; Bandovas, J.P.; Borges, N.; Chumbinho, B.; Figueiredo de Barros, I.; Frade, S.; Gomes, J.; Kam da Silva Andrade, A.; Pereira Rodrigues, A.; Pina, S.; Silva, N.; Silveira, N.I.; Sousa, R.; Garrido, R.; Miranda, P.; Rio-Rodrigues, L.; Galvao, D.; Vieira, A.; Faustino, A.; Freitas, A.; Mendes, J.R.; Rosa, J.; Messias, J.; Millan, A.; Salgado, I.; Santos, P.; Alshahrani, M.; Alsharif, F.; Eskander, M.; Majrashi, S.; Mashat, A.; Akeel, N.; Farsi, A.; Malibary, N.; Saleem, A.; Samkari, A.; Trabulsi, N.; Alhefdhi, A.; Alomair, A.; Alotaibi, N.; Alresaini, F.; Alsalamah, R.; Alsobhi, S.; Mahasin, Z.; Othman, E.; Velagapudi, S.; H. H., A.; Alkarak, S.; Alqannas, M.; Alyami, M.; Alzamanan, M.; Elawad, A.; Abdulkareem, A.; Alhassan, B.; Alsaif, A.; Bokhari, A.; Nouh, T.; Paunovic, I.; Slijepcevic, N.; Antic, S.; Dunderovic, D.; Jelovac, D.; Jezdic, Z.; Konstantinovic, V.; Kotlar, B.; Kuzmanovic, C.; Lazic, M.; Pajic, S.; Petrovic, M.; Popovic, F.; Pucar, A.; Romic, M.; Sumrak, S.; Vujanac, V.; Jotic, A.; Milovanovic, J.; Trivic, A.; Buta, M.; Cvetkovic, A.; Djurisic, I.; Gacic, S.; Goran, M.; Inic, Z.; Jeftic, N.; Jevric, M.; Jokic, V.; Markovic, I.; Milanovic, M.; Pejnovic, L.; Savkovic, N.; Spurnic, I.; Stevic, D.; Vucic, N.; Kovacevic, B.; Krdzic, I.; Milutinovic, V.; Galis, B.; Simko, K.; Espino Segura-Illa, M.; Sanchez Aniceto, G.; Santas, M.; Fernandez, R.P.; Cayetano, P.L.; Gomez, F.L.; Gomez Diaz, C.J.; Osorio, A.; Alonso-Lamberti, L.; Carabias, A.; Garcia-Quijada, J.; Jimenez, V.; Salazar, A.; Valle Rubio, A.; Anula, R.; Cano-Valderrama, O.; Del Campo Martin, M.; Diez-Valladares, L.; Dominguez, I.; Garcia, A.M.; Garcia, R.E.; Gomez, L.L.; Muguerza, J.M.; Pizarro, M.J.; Saez, C.P.; Sanchez del Pueblo, C.; Sanchez-Pernaute, A.; Sanz Ortega, G.; Sanz-Lopez, R.; Torres, A.; Sosa, M.V.; Espinosa, C.A.; Jimenez, T.M.; Martorell, P.; Carrasco, P.M.; Gimenez, F.C.; Marco, G.A.; Martinez Alonso, J.A.; Redondo Calvo, F.J.; Fernandez, M.; Lozano, L.P.; Martin, L.; Tousidonis, M.; Alcaide, M.F.; Garcia Perez, J.M.; Troncoso, P.P.; Mora-Guzman, I.; Abellan, M.; Achalandabaso, B.M.; Barbier, L.; Caja, V.P.; Martin Playa, P.; Di Martino, M.; Munoz de Nova, J.L.; Martin Perez, E.; Colao, G.L.; Hernandez Bartolome, M.A.; Serrano Gonzalez, J.; Chiesa-Estomba, C.M.; Gonzalez Garcia, J.A.; Larruscain, E.; Sistiaga-Suarez, J.A.; Jariod Ferrer, U.M.; Simon Sanz, M.V.; Uson-Bouthelier, T.; Garcia-Sancho Tellez, L.; Heras, A.J.; Mate, P.; Ortega, V.I.; Picardo, A.L.; Sanchez Cabezudo Noguera, F.; Serralta de Colsa, D.; Pingarron-Martin, L.; Ruiz Martin, I.; Enjuto, D.; Martinez, P.P.; Bescos, C.; Brana, I.; Caimari, B.; De Pablo Garcia-Cuenca, A.; Duran-Valles, F.; Giralt Lopez de Sagredo, J.; Pamias, J.; Prat, N.; Pujol, P.R.; Saez barba, M.; Sund, M.; Bayhan, Z.; Capoglu, R.; Firat, N.; Gonullu, E.; Kocer, B.; Mantoglu, B.; Alintoprak, F.; Colak, E.; Kucuk, G.O.; Uyanik, M.S.; Citgez, B.; Tanal, M.; Uludag, M.; Demirli Atici, S.; Kaya, T.; Bekheit, M.; Cymes, W.; Elhusseini, M.; Hannah, A.; Ashcroft, J.; Coughlin, P.; Davies, R.J.; Durrani, A.J.; Habeeb, A.; Irune, E.; Luke, L.; Masterson, L.; Murphy, S.; Singh, A.; Walker, C.; Waseem, S.; Jones, T.; Loh, C.; Pringle, S.; Schache, A.G.; Shaw, R.; Ahad, S.; De La Cruz Monroy, M.F.I.; Oktseloglou, V.; Perera, E.; Raveendran, D.; Ravi-Shankar, K.; Thiruchelvam, J.; Houston, R.; Putnam, G.; Robson, A.; De Gea Rico, A.; Ghazali, N.; Markose, G.; Hardie, J.; Hardie, C.; Mcnaught, C.; Cao, H.; Chai, A.K.W.; Loubani, M.; Ross, E.; Lester, S.; Chidambaram, S.; Fasanmade, K.; Fraser, L.; Fu, H.; Gore, S.; Graystone, J.; Khatkar, H.; Lami, M.; Maher, M.; Mihai, R.; Mykula, R.; Potter, P.; Prabhu, S.; Selbong, U.; Silva, P.; Winter, S.C.; M. W. S., H.; Kanatas, A.; Chan, C.; Shaw, S.; Talwar, R.; Egan, R.J.; Harries, R.; Henry, A.; Kittur, M.; Li, Z.; Parkins, K.; Spencer, N.; Thompson, D.; Burgess, C.; Ojha, S.; Dawe, N.; Mellor, C.; Powell, J.; Williams, T.; Manickavasagam, J.; Mcdonald, C.; Mcgrath, N.; Ameerally, P.; Edmond, M.; King, E.; Breik, O.; Idle, M.; Mak, J.K.C.; Martin, T.; Nankivell, P.; Parmar, S.; Praveen, P.; Sharma, N.; Geddes, A.; Mccaul, J.; Mcmahon, J.; Singh, S.; Kumar, A.; Bowden, J.; Mcdermott, F.D.; Mclennan, A.; Beasley, N.; Chew, D.; Thompson, A.; Varley, I.; Halliday, E.; Zakai, D.; Flavin, M.; Humphries, S.; Walker, D.; Pigadas, N.; Snee, D.; Ethunandan, M.; Sekhon, G.K.; Shields, H.; Singh, R.; Wensley, F.; Abbott, T.; Anwar, S.; Ghufoor, K.; Sohrabi, C.; Kang, C.; Lin, D.J.; Rajgor, A.D.; Scurrah, R.; Steel, B.; Allison, J.; Collard, B.; Lau, K.; Patel, A.; Scott, R.; Thomas, E.; Beech, N.; Green, L.; Kalavrezos, N.; Kiconco, H.; Mcewen, R.; Schilling, C.; Sinha, D.; Dunne, N.; Gill, C.; Howe, D.; Naredla, P.; Walton, G.; Etchill, E.; Gabre-Kidan, A.; Jenny, H.; Kent, A.; Ladd, M.R.; Long, C.; Malapati, H.; Margalit, A.; Rapaport, S.; Rose, J.; Tsai, L.; Vervoort, D.; Yesantharao, P.; Brown, L.; Ganly, I.; Azam, M.; Choudhry, A.; Marx, W.; Fleming, J.; Fuson, A.; Gigliotti, J.; Ovaitt, A.; Ying, Y.; Boeck, M.; El-Sayed, I.H.; P. K., H.; Heaton, C.M.; Kornblith, L.; Lee, R.H.; Nunez-Garcia, B.; Wai, K.C.; M. J., X.; Beswick, D.; Goddard, J.; Manor, J.; Song, J.; Fullmer, T.; Gross, N.; Kiong, K.; Abdallah, M.; Abouassi, A.; Almasri, M.; Kulkarni, G.; Marwan, H.; Mehdi, M.; Aoun, S.G.; Ban, V.S.; Batjer, H.H.; Caruso, J.

doi:10.1002/cncr.33320

Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment.

Head and neck cancer surgery during the COVID-19 pandemic : An international, multicenter, observational cohort study / R. Shaw, S.C. Winter, J. Glasbey, M.W.S. Ho, R. Jackson, S. Cicconi, I. Ganly, M. Batstone, J. Rey Biel, P.C. Nankivell, C. Simon, O. Omar, J.F.F. Simoes, D. Nepogodiev, A. Bhangu, A.G. Schache, R. Jackson, S. Cicconi, J. Glasbey, K. Siaw-Acheampong, R.A. Benson, E. Bywater, D. Chaudhry, B.E. Dawson, J.P. Evans, J.C. Glasbey, R.R. Gujjuri, E. Heritage, C.S. Jones, S.K. Kamarajah, C. Khatri, R.A. Khaw, J.M. Keatley, A. Knight, S. Lawday, E. Li, H.S. Mann, E.J. Marson, K.A. Mclean, S.C. Mckay, E.C. Mills, D. Nepogodiev, G. Pellino, M. Picciochi, E.H. Taylor, A. Tiwari, J.F.F. Simoes, I.M. Trout, M.L. Venn, R.J.W. Wilkin, A. Bhangu, J.C. Glasbey, R. Shaw, A.G. Schache, S.C. Winter, M.W.S. Ho, P. Nankivell, J. Rey Biel, M. Batstone, I. Ganly, C. Simon, J.F.F. Simoes, T.E.F. Abbott, M. Adamina, A.O. Ademuyiwa, A. Agarwal, E. Alameer, D. Alderson, F. Alakaloko, M. Albertsmeiers, O. Alser, M. Alshaar, S. Alshryda, A.P. Arnaud, K.M. Augestad, F. Ayasra, J. Azevedo, B.K. Bankhead-Kendall, E. Barlow, R.A. Benson, R. Blanco-Colino, A. Brar, A. Minaya-Bravo, K.A. Breen, C. Bretherton, I.L. Buarque, J. Burke, E.J. Caruana, M. Chaar, S. Chakrabortee, P. Christensen, D. Cox, M. Cukier, M.F. Cunha, G.H. Davidson, A. Desai, S.D. Saverio, T.M. Drake, J.G. Edwards, M. Elhadi, S. Emile, S. Farik, M. Fiore, J.E. Fitzgerald, S. Ford, T. Garmanova, G. Gallo, D. Ghosh, G.M.A. Gomes, G. Grecinos, E.A. Griffiths, M. Grundl, C. Halkias, E.M. Harrison, I. Hisham, P.J. Hutchinson, S. Hwang, A. Isik, M.D. Jenkinson, P. Jonker, H.M.A. Kaafarani, A. Kolias, S. Kruijff, I. Lawani, H. Lederhuber, S. Leventoglu, A. Litvin, A. Loehrer, M.W. Loffler, M. Aguilera Lorena, M. Marta Madolo, P. Major, J. Martin, H.N. Mashbari, D. Mazingi, S. Metallidis, A. Minaya-Bravo, H.M. Mohan, R. Moore, D. Moszkowicz, S. Moug, J.S. Ng-Kamstra, M. Maimbo, M. Niquen, F. Ntirenganya, M. Olivos, K. Oussama, O. Outani, M.D. Parreno-Sacdalanm, F. Pata, C.J.P. Rivera, T.D. Pinkney, W. van der Plas, P. Pockney, A. Qureshi, D. Radenkovic, A. Ramos-De la Medina, K. Roberts, A.C. Roslani, M. Rutegard, I. Santos, S. Satoi, R. Sayyed, A. Schache, A.A. Schnitzbauer, J.O. Seyi-Olajide, N. Sharma, R. Shaw, S. Shu, K. Soreide, A. Spinelli, G.D. Stewart, M. Sund, S. Sundar, S. Tabiri, P. Townend, G. Tsoulfas, G.H. van Ramshorst, R. Vidya, D. Vimalachandran, O.J. Warren, D. Wedderburn, N. Wright, L.A. Boccalatte, M.F. Figari, J.J. Larranaga, D. Gibson, J. Moss, T. Richards, U.G. Vo, D. Cope, N. Egoroff, N. Lott, M. Elliott, D. Phung, M. Batstone, D. Ofner, A. Gatti, C. Nardi, R. Oliva, R. De Cicco, I. Luksic, M. Mamic, M. Lorencin, N. Osman, M.M. Abdelkarem, S. M. elghazaly, M.A. Nageh, M.M. Saad, M. Salah, M. Shahine, J. Bettoni, S. Dakpe, B. Devauchelle, N. Lavagen, S. Testelin, S. Boucher, R. Breheret, A. Gueutier, A. Kahn, J. Kun-Darbois, A. Barrabe, A. Louvrier, Q. Ballouhey, J. Laloze, J. Usseglio, F. Espitalier, C. Ferron, O. Malard, I. Pergolini, D. Reim, P. Liokatis, W. Smolka, K. Nowak, T. Reinhard, F. Holzle, A. Modabber, P. Winnand, M. Knitschke, P. Kauffmann, S. Wolfer, J. Kleeff, K. Lorenz, C. Michalski, U. Ronellenfitsch, R. Schneider, C.S. Betz, J. Bewarder, A. Bottcher, S. Burg, C.J. Busch, M. Gosau, D. Koenig, N. Mockelmann, R. Smeets, U. Speth, S. Thole, T. Vollkommer, N. Zeller, N. Dafnios, E. Gkrinia, J. Hajiioannou, C. Korais, O. Koukoura, A. Saratziotis, C. Skoulakis, V. Alexoudi, K. Antoniades, I. Astreidis, P. Christidis, D. Deligiannidis, T. Grivas, O. Ioannidis, I. Kalaitsidou, L. Loutzidou, A. Mantevas, D. Michailidou, K. Paraskevopoulos, S. Politis, A. Stavroglou, D. Tatsis, I. Tilaveridis, K. Vahtsevanos, G. Venetis, D. Callanan, L. Huang, A. Ionescu, P. Sheahan, C.P. Barry, C. Fitzgerald, J. Kinsella, P. Lennon, C. Timon, S. Macina, G. Bissolotti, S. Fusetti, F. Lemma, L. Bellanti, M. Bergonzani, G. Bertoli, G. D'Angelo, D. Lanfranco, T. Poli, G.P. Santoro, A. Varazzani, F. Bussu, T. Perra, A. Piras, A. Porcu, D. Rizzo, G. Campisi, A. Cordova, M. Franza, G. Rinaldi, F. Toia, G.A. Beltramini, A. Gianni', L. Pignataro, S. Torretta, L.V. Comini, M. Fiore, L. Giannini, C. Piazza, G. Gasparini, L. Gordini, C.P. Lombardi, A. Moro, G. Saponaro, A. De Virgilio, F. Ferreli, F. Gaino, G. Mercante, V. Rossi, G. Spriano, L. Adamoli, M. Ansarin, F. Chu, R. De Berardinis, F. Mastrilli, G. Pietrobon, M. Tagliabue, A.M. Baietti, M. Biasini, P. Maremonti, F. Neri, G.M. Prucher, S. Ricci, F. Ruggiero, A.G. Zarabini, S. Mancini, L. Marino Cosentino, A. Sagnotta, A. Cotoia, V. Lizzi, F. Vovola, R. Cipriani, M. Pignatti, V. Pinto, M. Rottoli, G. Bertelli, F. Notte, P. Balercia, L. Catarzi, G. Consorti, A. Ibrahim, K. Obeidat, M.K. Abou Chaar, M. Al-Masri, H. Al-Najjar, F. Alawneh, O. Alsaraireh, D. Burgan, A.A. Salamah, Y.T. Liew, A.C. Roslani, F. Cordera, M.R. Alvarez, R. Arrangoiz, A. Gomez-Pedraza, F.C. Becerra Garcia, A. Alfaro-Goldaracena, G.A. Buerba, M.A. Mercado, O.E. Posadas-Trujillo, C. Sarre, A. Souadka, M.A. Majbar, A. Benkabbou, R. De Bree, T.T. Sholadoye, M.A. Tolani, P.P. Abur, B. Ayub, N. Hassan, R. Robles, V. Fernandes, I. Ferraz, M. Teixeira, D. Breda, M. Colino, S. Correia, J. De Barros, A.L. De Oliveira Lopez, S. Garrido, A. Lazaro, J.M. Oliveira, M. Rodrigues, A. Almeida, S. Cavaleiro, C.S. Faria, M.M. Magalhaes, H. Santos-Sousa, H. Silveira, J.P. Bandovas, N. Borges, B. Chumbinho, I. Figueiredo de Barros, S. Frade, J. Gomes, A. Kam da Silva Andrade, A. Pereira Rodrigues, S. Pina, N. Silva, N.I. Silveira, R. Sousa, R. Garrido, P. Miranda, L. Rio-Rodrigues, D. Galvao, A. Vieira, A. Faustino, A. Freitas, J.R. Mendes, J. Rosa, J. Messias, A. Millan, I. Salgado, P. Santos, M. Alshahrani, F. Alsharif, M. Eskander, S. Majrashi, A. Mashat, N. Akeel, A. Farsi, N. Malibary, A. Saleem, A. Samkari, N. Trabulsi, A. Alhefdhi, A. Alomair, N. Alotaibi, F. Alresaini, R. Alsalamah, S. Alsobhi, Z. Mahasin, E. Othman, S. Velagapudi, H.H. Al, S. Alkarak, M. Alqannas, M. Alyami, M. Alzamanan, A. Elawad, A. Abdulkareem, B. Alhassan, A. Alsaif, A. Bokhari, T. Nouh, I. Paunovic, N. Slijepcevic, S. Antic, D. Dunderovic, D. Jelovac, Z. Jezdic, V. Konstantinovic, B. Kotlar, C. Kuzmanovic, M. Lazic, S. Pajic, M. Petrovic, F. Popovic, A. Pucar, M. Romic, S. Sumrak, V. Vujanac, A. Jotic, J. Milovanovic, A. Trivic, M. Buta, A. Cvetkovic, I. Djurisic, S. Gacic, M. Goran, Z. Inic, N. Jeftic, M. Jevric, V. Jokic, I. Markovic, M. Milanovic, L. Pejnovic, N. Savkovic, I. Spurnic, D. Stevic, N. Vucic, B. Kovacevic, I. Krdzic, V. Milutinovic, B. Galis, K. Simko, M. Espino Segura-Illa, G. Sanchez Aniceto, M. Santas, R.P. Fernandez, P.L. Cayetano, F.L. Gomez, C.J. Gomez Diaz, A. Osorio, L. Alonso-Lamberti, A. Carabias, J. Garcia-Quijada, V. Jimenez, A. Salazar, A. Valle Rubio, R. Anula, O. Cano-Valderrama, M. Del Campo Martin, L. Diez-Valladares, I. Dominguez, A.M. Garcia, R.E. Garcia, L.L. Gomez, J.M. Muguerza, M.J. Pizarro, C.P. Saez, C. Sanchez del Pueblo, A. Sanchez-Pernaute, G. Sanz Ortega, R. Sanz-Lopez, A. Torres, M.V. Sosa, C.A. Espinosa, T.M. Jimenez, P. Martorell, P.M. Carrasco, F.C. Gimenez, G.A. Marco, J.A. Martinez Alonso, F.J. Redondo Calvo, M. Fernandez, L.P. Lozano, L. Martin, M. Tousidonis, M.F. Alcaide, J.M. Garcia Perez, P.P. Troncoso, I. Mora-Guzman, M. Abellan, B.M. Achalandabaso, L. Barbier, V.P. Caja, P. Martin Playa, M. Di Martino, J.L. Munoz de Nova, E. Martin Perez, G.L. Colao, M.A. Hernandez Bartolome, J. Serrano Gonzalez, C.M. Chiesa-Estomba, J.A. Gonzalez Garcia, E. Larruscain, J.A. Sistiaga-Suarez, U.M. Jariod Ferrer, M.V. Simon Sanz, T. Uson-Bouthelier, L. Garcia-Sancho Tellez, A.J. Heras, P. Mate, V.I. Ortega, A.L. Picardo, F. Sanchez Cabezudo Noguera, D. Serralta de Colsa, L. Pingarron-Martin, I. Ruiz Martin, D. Enjuto, P.P. Martinez, C. Bescos, I. Brana, B. Caimari, A. De Pablo Garcia-Cuenca, F. Duran-Valles, J. 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Head and neck cancer surgery during the COVID-19 pandemic : An international, multicenter, observational cohort study

Shaw R.;Winter S. C.;Glasbey J.;Ho M. W. S.;Jackson R.;Cicconi S.;Ganly I.;Batstone M.;Rey Biel J.;Nankivell P. C.;Simon C.;Omar O.;Simoes J. F. F.;Nepogodiev D.;Bhangu A.;Schache A. G.;Jackson R.;Cicconi S.;Glasbey J.;Siaw-Acheampong K.;Benson R. A.;Bywater E.;Chaudhry D.;Dawson B. E.;Evans J. P.;Glasbey J. C.;Gujjuri R. R.;Heritage E.;Jones C. S.;Kamarajah S. K.;Khatri C.;Khaw R. A.;Keatley J. M.;Knight A.;Lawday S.;Li E.;Mann H. S.;Marson E. J.;McLean K. A.;Mckay S. C.;Mills E. C.;Nepogodiev D.;Pellino G.;Picciochi M.;Taylor E. H.;Tiwari A.;Simoes J. F. F.;Trout I. M.;Venn M. L.;Wilkin R. J. W.;Bhangu A.;Glasbey J. C.;Shaw R.;Schache A. G.;Winter S. C.;Ho M. W. S.;Nankivell P.;Rey Biel J.;Batstone M.;Ganly I.;Simon C.;Simoes J. F. F.;Abbott T. E. F.;Adamina M.;Ademuyiwa A. O.;Agarwal A.;Alameer E.;Alderson D.;Alakaloko F.;Albertsmeiers M.;Alser O.;Alshaar M.;Alshryda S.;Arnaud A. P.;Augestad K. M.;Ayasra F.;Azevedo J.;Bankhead-Kendall B. K.;Barlow E.;Benson R. A.;Blanco-Colino R.;Brar A.;Minaya-Bravo A.;Breen K. A.;Bretherton C.;Buarque I. L.;Burke J.;Caruana E. J.;Chaar M.;Chakrabortee S.;Christensen P.;Cox D.;Cukier M.;Cunha M. F.;Davidson G. H.;Desai A.;Saverio S. D.;Drake T. M.;Edwards J. G.;Elhadi M.;Emile S.;Farik S.;Fiore M.;Fitzgerald J. E.;Ford S.;Garmanova T.;Gallo G.;Ghosh D.;Gomes G. M. A.;Grecinos G.;Griffiths E. A.;Grundl M.;Halkias C.;Harrison E. M.;Hisham I.;Hutchinson P. J.;Hwang S.;Isik A.;Jenkinson M. D.;Jonker P.;Kaafarani H. M. A.;Kolias A.;Kruijff S.;Lawani I.;Lederhuber H.;Leventoglu S.;Litvin A.;Loehrer A.;Loffler M. W.;Aguilera Lorena M.;Marta Madolo M.;Major P.;Martin J.;Mashbari H. N.;Mazingi D.;Metallidis S.;Minaya-Bravo A.;Mohan H. M.;Moore R.;Moszkowicz D.;Moug S.;Ng-Kamstra J. S.;Maimbo M.;Niquen M.;Ntirenganya F.;Olivos M.;Oussama K.;Outani O.;Parreno-Sacdalanm M. D.;Pata F.;Rivera C. J. P.;Pinkney T. D.;van der Plas W.;Pockney P.;Qureshi A.;Radenkovic D.;Ramos-De la Medina A.;Roberts K.;Roslani A. C.;Rutegard M.;Santos I.;Satoi S.;Sayyed R.;Schache A.;Schnitzbauer A. A.;Seyi-Olajide J. O.;Sharma N.;Shaw R.;Shu S.;Soreide K.;Spinelli A.;Stewart G. D.;Sund M.;Sundar S.;Tabiri S.;Townend P.;Tsoulfas G.;van Ramshorst G. H.;Vidya R.;Vimalachandran D.;Warren O. J.;Wedderburn D.;Wright N.;Boccalatte L. A.;Figari M. F.;Larranaga J. J.;Gibson D.;Moss J.;Richards T.;Vo U. G.;Cope D.;Egoroff N.;Lott N.;Elliott M.;Phung D.;Batstone M.;Ofner D.;Gatti A.;Nardi C.;Oliva R.;De Cicco R.;Luksic I.;Mamic M.;Lorencin M.;Osman N.;Abdelkarem M. M.;M. elghazaly S.;Nageh M. A.;Saad M. M.;Salah M.;Shahine M.;Bettoni J.;Dakpe S.;Devauchelle B.;Lavagen N.;Testelin S.;Boucher S.;Breheret R.;Gueutier A.;Kahn A.;Kun-Darbois J.;Barrabe A.;Louvrier A.;Ballouhey Q.;Laloze J.;Usseglio J.;Espitalier F.;Ferron C.;Malard O.;Pergolini I.;Reim D.;Liokatis P.;Smolka W.;Nowak K.;Reinhard T.;Holzle F.;Modabber A.;Winnand P.;Knitschke M.;Kauffmann P.;Wolfer S.;Kleeff J.;Lorenz K.;Michalski C.;Ronellenfitsch U.;Schneider R.;Betz C. S.;Bewarder J.;Bottcher A.;Burg S.;Busch C. J.;Gosau M.;Koenig D.;Mockelmann N.;Smeets R.;Speth U.;Thole S.;Vollkommer T.;Zeller N.;Dafnios N.;Gkrinia E.;Hajiioannou J.;Korais C.;Koukoura O.;Saratziotis A.;Skoulakis C.;Alexoudi V.;Antoniades K.;Astreidis I.;Christidis P.;Deligiannidis D.;Grivas T.;Ioannidis O.;Kalaitsidou I.;Loutzidou L.;Mantevas A.;Michailidou D.;Paraskevopoulos K.;Politis S.;Stavroglou A.;Tatsis D.;Tilaveridis I.;Vahtsevanos K.;Venetis G.;Callanan D.;Huang L.;Ionescu A.;Sheahan P.;Barry C. P.;Fitzgerald C.;Kinsella J.;Lennon P.;Timon C.;Macina S.;Bissolotti G.;Fusetti S.;Lemma F.;Bellanti L.;Bergonzani M.;Bertoli G.;D'Angelo G.;Lanfranco D.;Poli T.;Santoro G. P.;Varazzani A.;Bussu F.;Perra T.;Piras A.;Porcu A.;Rizzo D.;Campisi G.;Cordova A.;Franza M.;Rinaldi G.;Toia F.;G.A. Beltramini;A. Gianni';L. Pignataro;S. Torretta;Comini L. V.;Fiore M.;Giannini L.;Piazza C.;Gasparini G.;Gordini L.;Lombardi C. P.;Moro A.;Saponaro G.;De Virgilio A.;Ferreli F.;Gaino F.;Mercante G.;Rossi V.;Spriano G.;Adamoli L.;Ansarin M.;Chu F.;De Berardinis R.;Mastrilli F.;Pietrobon G.;Tagliabue M.;Baietti A. M.;Biasini M.;Maremonti P.;Neri F.;Prucher G. M.;Ricci S.;Ruggiero F.;Zarabini A. G.;Mancini S.;Marino Cosentino L.;Sagnotta A.;Cotoia A.;Lizzi V.;Vovola F.;Cipriani R.;Pignatti M.;Pinto V.;Rottoli M.;Bertelli G.;Notte F.;Balercia P.;Catarzi L.;Consorti G.;Ibrahim A.;Obeidat K.;Abou Chaar M. K.;Al-Masri M.;Al-Najjar H.;Alawneh F.;Alsaraireh O.;Burgan D.;Salamah A. A.;Liew Y. T.;Roslani A. C.;Cordera F.;Alvarez M. R.;Arrangoiz R.;Gomez-Pedraza A.;Becerra Garcia F. C.;Alfaro-Goldaracena A.;Buerba G. A.;Mercado M. A.;Posadas-Trujillo O. E.;Sarre C.;Souadka A.;Majbar M. A.;Benkabbou A.;De Bree R.;Sholadoye T. T.;Tolani M. A.;Abur P. P.;Ayub B.;Hassan N.;Robles R.;Fernandes V.;Ferraz I.;Teixeira M.;Breda D.;Colino M.;Correia S.;De Barros J.;De Oliveira Lopez A. L.;Garrido S.;Lazaro A.;Oliveira J. M.;Rodrigues M.;Almeida A.;Cavaleiro S.;Faria C. S.;Magalhaes M. M.;Santos-Sousa H.;Silveira H.;Bandovas J. P.;Borges N.;Chumbinho B.;Figueiredo de Barros I.;Frade S.;Gomes J.;Kam da Silva Andrade A.;Pereira Rodrigues A.;Pina S.;Silva N.;Silveira N. I.;Sousa R.;Garrido R.;Miranda P.;Rio-Rodrigues L.;Galvao D.;Vieira A.;Faustino A.;Freitas A.;Mendes J. R.;Rosa J.;Messias J.;Millan A.;Salgado I.;Santos P.;Alshahrani M.;Alsharif F.;Eskander M.;Majrashi S.;Mashat A.;Akeel N.;Farsi A.;Malibary N.;Saleem A.;Samkari A.;Trabulsi N.;Alhefdhi A.;Alomair A.;Alotaibi N.;Alresaini F.;Alsalamah R.;Alsobhi S.;Mahasin Z.;Othman E.;Velagapudi S.;Al H. H.;Alkarak S.;Alqannas M.;Alyami M.;Alzamanan M.;Elawad A.;Abdulkareem A.;Alhassan B.;Alsaif A.;Bokhari A.;Nouh T.;Paunovic I.;Slijepcevic N.;Antic S.;Dunderovic D.;Jelovac D.;Jezdic Z.;Konstantinovic V.;Kotlar B.;Kuzmanovic C.;Lazic M.;Pajic S.;Petrovic M.;Popovic F.;Pucar A.;Romic M.;Sumrak S.;Vujanac V.;Jotic A.;Milovanovic J.;Trivic A.;Buta M.;Cvetkovic A.;Djurisic I.;Gacic S.;Goran M.;Inic Z.;Jeftic N.;Jevric M.;Jokic V.;Markovic I.;Milanovic M.;Pejnovic L.;Savkovic N.;Spurnic I.;Stevic D.;Vucic N.;Kovacevic B.;Krdzic I.;Milutinovic V.;Galis B.;Simko K.;Espino Segura-Illa M.;Sanchez Aniceto G.;Santas M.;Fernandez R. P.;Cayetano P. L.;Gomez F. L.;Gomez Diaz C. J.;Osorio A.;Alonso-Lamberti L.;Carabias A.;Garcia-Quijada J.;Jimenez V.;Salazar A.;Valle Rubio A.;Anula R.;Cano-Valderrama O.;Del Campo Martin M.;Diez-Valladares L.;Dominguez I.;Garcia A. M.;Garcia R. E.;Gomez L. L.;Muguerza J. M.;Pizarro M. J.;Saez C. P.;Sanchez del Pueblo C.;Sanchez-Pernaute A.;Sanz Ortega G.;Sanz-Lopez R.;Torres A.;Sosa M. V.;Espinosa C. A.;Jimenez T. M.;Martorell P.;Carrasco P. M.;Gimenez F. C.;Marco G. A.;Martinez Alonso J. A.;Redondo Calvo F. J.;Fernandez M.;Lozano L. P.;Martin L.;Tousidonis M.;Alcaide M. F.;Garcia Perez J. M.;Troncoso P. P.;Mora-Guzman I.;Abellan M.;Achalandabaso B. M.;Barbier L.;Caja V. P.;Martin Playa P.;Di Martino M.;Munoz de Nova J. L.;Martin Perez E.;Colao G. L.;Hernandez Bartolome M. A.;Serrano Gonzalez J.;Chiesa-Estomba C. M.;Gonzalez Garcia J. A.;Larruscain E.;Sistiaga-Suarez J. A.;Jariod Ferrer U. M.;Simon Sanz M. V.;Uson-Bouthelier T.;Garcia-Sancho Tellez L.;Heras A. J.;Mate P.;Ortega V. I.;Picardo A. L.;Sanchez Cabezudo Noguera F.;Serralta de Colsa D.;Pingarron-Martin L.;Ruiz Martin I.;Enjuto D.;Martinez P. P.;Bescos C.;Brana I.;Caimari B.;De Pablo Garcia-Cuenca A.;Duran-Valles F.;Giralt Lopez de Sagredo J.;Pamias J.;Prat N.;Pujol P. R.;Saez barba M.;Sund M.;Bayhan Z.;Capoglu R.;Firat N.;Gonullu E.;Kocer B.;Mantoglu B.;Alintoprak F.;Colak E.;Kucuk G. O.;Uyanik M. S.;Citgez B.;Tanal M.;Uludag M.;Demirli Atici S.;Kaya T.;Bekheit M.;Cymes W.;Elhusseini M.;Hannah A.;Ashcroft J.;Coughlin P.;Davies R. J.;Durrani A. J.;Habeeb A.;Irune E.;Luke L.;Masterson L.;Murphy S.;Singh A.;Walker C.;Waseem S.;Jones T.;Loh C.;Pringle S.;Schache A. G.;Shaw R.;Ahad S.;De La Cruz Monroy M. F. I.;Oktseloglou V.;Perera E.;Raveendran D.;Ravi-Shankar K.;Thiruchelvam J.;Houston R.;Putnam G.;Robson A.;De Gea Rico A.;Ghazali N.;Markose G.;Hardie J.;Hardie C.;McNaught C.;Cao H.;Chai A. K. W.;Loubani M.;Ross E.;Lester S.;Chidambaram S.;Fasanmade K.;Fraser L.;Fu H.;Gore S.;Graystone J.;Khatkar H.;Lami M.;Maher M.;Mihai R.;Mykula R.;Potter P.;Prabhu S.;Selbong U.;Silva P.;Winter S. C.;Ho M. W. S.;Kanatas A.;Chan C.;Shaw S.;Talwar R.;Egan R. J.;Harries R.;Henry A.;Kittur M.;Li Z.;Parkins K.;Spencer N.;Thompson D.;Burgess C.;Ojha S.;Dawe N.;Mellor C.;Powell J.;Williams T.;Manickavasagam J.;McDonald C.;McGrath N.;Ameerally P.;Edmond M.;King E.;Breik O.;Idle M.;Mak J. K. C.;Martin T.;Nankivell P.;Parmar S.;Praveen P.;Sharma N.;Geddes A.;McCaul J.;McMahon J.;Singh S.;Kumar A.;Bowden J.;McDermott F. D.;McLennan A.;Beasley N.;Chew D.;Thompson A.;Varley I.;Halliday E.;Zakai D.;Flavin M.;Humphries S.;Walker D.;Pigadas N.;Snee D.;Ethunandan M.;Sekhon G. K.;Shields H.;Singh R.;Wensley F.;Abbott T.;Anwar S.;Ghufoor K.;Sohrabi C.;Kang C.;Lin D. J.;Rajgor A. D.;Scurrah R.;Steel B.;Allison J.;Collard B.;Lau K.;Patel A.;Scott R.;Thomas E.;Beech N.;Green L.;Kalavrezos N.;Kiconco H.;McEwen R.;Schilling C.;Sinha D.;Dunne N.;Gill C.;Howe D.;Naredla P.;Walton G.;Etchill E.;Gabre-Kidan A.;Jenny H.;Kent A.;Ladd M. R.;Long C.;Malapati H.;Margalit A.;Rapaport S.;Rose J.;Tsai L.;Vervoort D.;Yesantharao P.;Brown L.;Ganly I.;Azam M.;Choudhry A.;Marx W.;Fleming J.;Fuson A.;Gigliotti J.;Ovaitt A.;Ying Y.;Boeck M.;El-Sayed I. H.;Ha P. K.;Heaton C. M.;Kornblith L.;Lee R. H.;Nunez-Garcia B.;Wai K. C.;Xu M. J.;Beswick D.;Goddard J.;Manor J.;Song J.;Fullmer T.;Gross N.;Kiong K.;Abdallah M.;Abouassi A.;Almasri M.;Kulkarni G.;Marwan H.;Mehdi M.;Aoun S. G.;Ban V. S.;Batjer H. H.;Caruso J.

2021

Abstract

Background: The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19–positive patients and infections in the surgical team were determined by univariate analysis. Results: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. Conclusions: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Lay Summary: Head and neck surgery is safe for patients during the coronavirus disease 2019 pandemic even when it is lengthy and complex. This is significant because concerns over patient safety raised in many guidelines appear not to be reflected by outcomes, even for those who have other serious illnesses or require complex reconstructions. Patients subjected to suboptimal or nonstandard treatments should be carefully followed up to optimize their cancer outcomes. The overlap between patients and surgeons testing positive for severe acute respiratory syndrome coronavirus 2 is notable and emphasizes the need for fastidious cross-infection controls and effective personal protective equipment.

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	Parole chiave
	
			coronavirus; coronavirus disease 2019 (COVID-19); head and neck cancer; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); surgery; Adult; Aged; Aged, 80 and over; COVID-19; Critical Care; Head and Neck Neoplasms; Humans; Infectious Disease Transmission, Patient-to-Professional; International Cooperation; Middle Aged; Neoplasm Staging; Pandemics; Personal Protective Equipment; Reconstructive Surgical Procedures; Young Adult; Surgeons
		
	Settori scientifico-disciplinari dell'articolo
	
			Settore MED/31 - Otorinolaringoiatria
		
	Data di pubblicazione
	
			lug-2021
		
	Rivista in ANCE
	
			CANCER
		
	DOI
	
			https://dx.doi.org/10.1002/cncr.33320
		
	Tipologia
	
			Article (author)
		
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			01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/860294

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