Management Recommendations for Prostate Cancer during the COVID-19 pandemic: A Systematic Review
Bibliographic record
Abstract
Introduction: The COVID-19 pandemic has delayed screening, diagnostic workup, and treatment in prostate cancer (PCa) patients. Our purpose was to review PCa screening, diagnostic workup, active surveillance (AS), radical prostatectomy (RP), radiotherapy (RT), androgen deprivation therapy (ADT) and systemic therapy during the COVID-19 pandemic. Materials and Methods: We performed a systematic literature search of MEDLINE, EMBASE, Scopus, LILACS, and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) statement for relevant material published from December 2019 to February 2021. Results: Prostate biopsy can be delayed, except when high-risk PCa is suspected or the patient is symptomatic. Active surveillance is appropriate for patients with very low risk, low risk (LR) and favorable intermediate risk (FIR). RP and RT for high risk and very high risk can be safely postponed up to 3 months. Hypofractionated external beam RT (EBRT) is recommended when RT is employed. ADT should be used according to standard PCa-based indications. Chemotherapy should be postponed until the pandemic is contained. Conclusions: The international urological community was not prepared for such an acute and severe pandemic. PCa patients can be adequately managed according to risk stratification. During the COVID-19 pandemic, LR and FIR patients can be followed with active surveillance. Delaying RP and RT in high risk and locally advanced disease is justified.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.008 |
| Bibliometrics | 0.010 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".