Development and validation of telematic follow-up for cancer patients during the covid-19 outbreak at the medical oncology unit of sant'andrea and san bartolomeo hospitals, la spezia

Background: The reorganization of patient management was essential to maintain an adequate oncologic care and contain patient exposure during SARS-CoV-2 pandemic Follow-up in particular was a major area for remodulation with large volume of patients involved, generally at low oncologic risk Materials and methods: Pts scheduled for follow-up oncologic visits during the lockdown period (March 9th-May 4th 2020) were included in a program of telematic follow-up (TFU) developed at the Medical Oncology Unit of Sant'Andrea and San Bartolomeo Hospital in La Spezia, Italy Eligibility for TFU was determined through a prescreening of medical charts based on tumor type, risk of relapse, geographic accessibility and DFS Pre-calls were made by skilled nurses to assess pts' availability for nextday phone call and to assess availability of laboratory test and imaging results A TFU form was conceived to collect pts' clinical history, symptoms, body weight, ongoing medical therapies, DFS, blood tests and imaging results (from Hospital imaging repository or acquired in the pre-call) Pts without signs/symptoms of relapse were scheduled for the next follow-up visit and the filled-in TFU form was attached to the clinical chart When a suspected disease relapse was found?, an ambulatory visit was performed Results: There were 547 pts previously scheduled for inhospital follow-up visit between March 9th and May 4th, 2020 82 of 547 pts (15%) were considered not eligible for TFU according to the pre-screening assessment 465 pts out of 547 (85%) were included in the TFU program All these pts accepted calls with a compliance rate of 100% The median age was 73 years (34-95);152 male (33%) and 313 female (67%) The distribution by tumor type was: 179 breast cancer (38%), 86 colorectal (18%), 55 urinary tract (12%), 39 melanoma and skin (9%), 31 gynecologic (6%), 26 lung cancer (6%), 16 GEP (3%), 15 head and neck (3%), and 18 other tumors (4%) Ten patients with signs/symptoms of tumor recurrence were detected at TFU: 1 had clinical symptoms, 3 abnormal blood tests and 6 suspicious radiological findings These patients were called for live visit and tumor relapse/progression was confirmed in 10 out of 10 cases Medical or surgical treatment was started, or planned to start, in all 10 patients Conclusions: TFU proved to be feasible with an eligibility rate of 85% and 100% patients' compliance The detection rate for tumor recurrence was 2 1%