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.