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Recommendations for head and neck surgical oncology practice in a setting of acute severe resource constraint during the COVID-19 pandemic: an international consensus - 03/08/20

Doi : 10.1016/S1470-2045(20)30334-X 
Hisham Mehanna, ProfPhD a, * , John C Hardman, MSc b, *, Jared A Shenson, MD c, *, Ahmad K Abou-Foul, MBBCh d, *, Michael C Topf, MD c, *, Mohammad AlFalasi, MD e, Jason Y K Chan, MBBS f, Pankaj Chaturvedi, ProfMS g, Velda Ling Yu Chow, MS h, Andreas Dietz, ProfPhD i, Johannes J Fagan, ProfMBChB j, Christian Godballe, ProfPhD k, Wojciech Golusiński, ProfPhD l, Akihiro Homma, ProfPhD m, Sefik Hosal, ProfMD n, N Gopalakrishna Iyer, ProfMD o, Cyrus Kerawala, FRCS-OMFS b, Yoon Woo Koh, ProfPhD p, Anna Konney, MD q, Luiz P Kowalski, ProfMD r, s, Dennis Kraus, MD t, Moni A Kuriakose, ProfMD u, Efthymios Kyrodimos, PhD v, Stephen Y Lai, ProfPhD w, C Rene Leemans, ProfPhD x, Paul Lennon, MD y, Lisa Licitra, ProfMD z, Pei-Jen Lou, ProfMD ab, Bernard Lyons, MBBS ac, Haitham Mirghani, ProfPhD ad, Anthonny C Nichols, MD ae, Vinidh Paleri, ProfMS b, Benedict J Panizza, ProfMBBS af, Pablo Parente Arias, PhD ah, Mihir R Patel, MD ai, Cesare Piazza, ProfMD aa, Danny Rischin, ProfMD aj, Alvaro Sanabria, PhD ak, al, Robert P Takes, ProfPhD am, David J Thomson, MD an, ao, Ravindra Uppaluri, MD ap, Yu Wang, ProfPhD aq, Sue S Yom, ProfMD ar, Yi-ming Zhu, ProfMD as, Sandro V Porceddu, ProfMD ag, , John R de Almeida, MD at, au, , Chrisian Simon, ProfMD av, , F Christopher Holsinger, ProfMD c,
a Institute for Head and Neck Studies and Education, University of Birmingham, Birmingham, UK 
b Head and Neck Unit, The Royal Marsden National Health Service Foundation Trust, London, UK 
c Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, CA, USA 
d Department of Otolaryngology and Head and Neck Surgery, Walsall Manor Hospital, Walsall, UK 
e Department of Otolaryngology, United Arab Emirates University, Alain, United Arab Emirates 
f Department of Otorhinolaryngology and Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China 
g Department of Otorhinolaryngology and Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India 
h Department of Surgery, The University of Hong Kong, Hong Kong Special Administrative Region, China 
i Department of Ear, Nose and Throat Surgery, University of Leipzig, Leipzig, Germany 
j Division of Otolaryngology, University of Cape Town, Cape Town, South Africa 
k Department of Otorhinolaryngology–Head and Neck Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark 
l Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, Poland 
m Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan 
n Department of Otolaryngology–Head and Neck Surgery, Atilim University Faculty of Medicine, Ankara, Turkey 
o Department of Head and Neck Surgery, National Cancer Centre and Singapore General Hospital, Singapore 
p Department of Otorhinolaryngology, Yonsei University, Seoul, South Korea 
q Department of Otolaryngology, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, School of Medical Science, Kumasi, Ghana 
r Department of Head and Neck Surgery, University of Sao Paulo Medical School, Sao Paulo, Brazil 
s Department of Head and Neck Surgery and Otorhinolaryngology, A C Camargo Cancer Center, Sao Paulo, Brazil 
t Department of Otolaryngology–Head and Neck Surgery, Zucker School of Medicine, Northwell Health Cancer Institute, New York, NY, USA 
u Department of Otolaryngology–Head and Neck Surgery, Cochin Cancer Research Centre, Cochin, India 
v First Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece 
w Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA 
x Department of Otolaryngology and Head and Neck Surgery, Amsterdam University Medical Centre, Cancer Center Amsterdam, VU University, Amsterdam, Netherlands 
y Department of Otolaryngology and Head and Neck Surgery, St James’s Hospital and The Royal Victoria Eye and Ear Hospital, Dublin, Ireland 
z Foundation IRCCS, Division of Medical Oncology, National Institute of Cancer of Milan, University of Milan, Milan, Italy 
aa Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, National Institute of Cancer of Milan, University of Milan, Milan, Italy 
ab Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan 
ac Department of Otolaryngology Head and Neck Surgery, St Vincent’s Hospital, Melbourne, VIC, Australia 
ad Department of Otolaryngology and Head and Neck Surgery, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France 
ae Department of Otolaryngology–Head and Neck Surgery and Department of Oncology, University of Western Ontario, London, ON, Canada 
af Department of Otolaryngology–Head and Neck Surgery, Princess Alexandra Hospital and Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia 
ag Department of Cancer Services, Princess Alexandra Hospital and Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia 
ah Department of Otolaryngology and Head and Neck Surgery, Hospital Universitario Lucus Augusti, Lugo, Spain 
ai Department of Otolaryngology and Head and Neck Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA 
aj Department of Medical Oncology, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia 
ak Department of Surgery, School of Medicine, Universidad de Antioquia–Hospital Universitario San Vicente Fundación, Medellin, Colombia 
al CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Medellin, Colombia 
am Department of Otolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, Netherlands 
an Department of Clinical Oncology, The Christie National Health Service Foundation Trust, Manchester, UK 
ao Division of Cancer Sciences, University of Manchester, Manchester, UK 
ap Division of Otolaryngology–Head and Neck Surgery, Dana-Farber and Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA, USA 
aq Department of Head and Neck Surgery, Fudan University, Shanghai Cancer Center, Shanghai, China 
ar Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA 
as Department of Head and Neck Surgery, National Cancer Center–Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China 
at Department of Otolaryngology–Head and Neck Surgery and Department of Surgical Oncology, University Health Network, Toronto, ON, Canada 
au Department of Otolaryngology–Head and Neck Surgery, Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada 
av Department of Otolaryngology and Head and Neck Surgery, Lausanne University Hospital, Lausanne, Switzerland 

* Correspondence to: Prof Hisham Mehanna, Institute for Head and Neck Studies and Education, School of Cancer Sciences, University of Birmingham, Birmingham B15 2TT, UK Institute for Head and Neck Studies and Education School of Cancer Sciences University of Birmingham Birmingham B15 2TT UK

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Summary

The speed and scale of the global COVID-19 pandemic has resulted in unprecedented pressures on health services worldwide, requiring new methods of service delivery during the health crisis. In the setting of severe resource constraint and high risk of infection to patients and clinicians, there is an urgent need to identify consensus statements on head and neck surgical oncology practice. We completed a modified Delphi consensus process of three rounds with 40 international experts in head and neck cancer surgical, radiation, and medical oncology, representing 35 international professional societies and national clinical trial groups. Endorsed by 39 societies and professional bodies, these consensus practice recommendations aim to decrease inconsistency of practice, reduce uncertainty in care, and provide reassurance for clinicians worldwide for head and neck surgical oncology in the context of the COVID-19 pandemic and in the setting of acute severe resource constraint and high risk of infection to patients and staff.

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Vol 21 - N° 7

P. e350-e359 - juillet 2020 Retour au numéro
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