INTRODUCTİON
The incidence of renal cell cancer (RCC) is increasing worldwide. With the increasing use of imaging methods such as ultrasonography (USG) and computed tomography (CT), more than 60% of RCC can often be detected in the early stages when patients are asymptomatic. Nowadays, the incidence of RCC varies more than 10 times worldwide, and is higher in Western countries than in Asian countries.1 The fact that more than 60% of the cases are seen in developed countries supports this notion.2 RCC is the third most common urological cancer. Most of the cases are detected between the ages of 60-70.3 RCC is more common in men than women (3:2). Only 10% of RCC patients present with characteristic clinical symptoms consisting of hematuria, palpable abdominal mass, and back or flank pain. Despite the increase in early diagnosis, metastatic RCC is detected in imaging methods in 20-30% of patients.2Smoking, obesity, hypertension and/or medications have been implicated as risk factors, but the etiology of RCC is still unclear.4 RCC is divided into different histological types. The most common types are clear cell (70-90%), papillary (10-15%), and chromophobe (3-5%) RCCs. Tumor type is known to have prognostic significance.5 The tumor-node-metastasis (TNM) system is used in RCC staging and only curative treatment for localized RCC is surgery. Partial nephrectomy is the first choice for T1 tumors, while radical nephrectomy is the first choice for T2-4 tumors.6
A viral SARS-CoV-2 (COVID-19) strain emerged in the Wuhan region of China in late 2019, initiating a global pandemic that affected millions of people worldwide and caused a high number of deaths.7 Healthcare professionals were deployed to combat the pandemic, and intensive care units and other units were used to treat COVID-19 patients. Rapid working group has been formed by the European Association of Urology (EAU) to develop adaptive guidelines for dealing with various situations and priorities following the COVID-19 outbreak. Within the scope of the COVID-19 pandemic, urological diseases were divided into 4 priority levels: low priority (can be delayed for 6 months), medium priority (can be delayed for 3-4 months), high priority (can’t be delayed for more than 6 weeks), and emergency (can’t be delayed for more than 24 hours).8
In terms of RCC treatment, for Bosnian type III and IV cysts as well as T1 tumors it was recommended to postpone under monitoring and for T2 tumors to postpone and keep under close observation. It was suggested that surgery should be performed primarily for T3-T4 tumors. For metastatic RCC, it was recommended to evaluate for surgery, follow-up, or chemotherapy, depending on the patient’s condition.9
In this study, we aimed to investigate whether there was a difference in the number of RCC operations, pathologies, and surgical preferences in 9 different centers in Turkey between 1-year periods before and during the COVID-19 pandemic. We also aimed to examine how the COVID-19 pandemic affected the diagnosis and treatment of RCC.