Table 2.
Priority surgery recommendations based on different guidelines
| Malignancy | ACS guidelines* [28] | SSO guidelines [29] | IASO guidelines [30] |
|---|---|---|---|
| Breast |
Post NACT IDC, HER2-positive cases, Tumours with discordant biopsy recurrent tumours. |
Progressive disease on NACT Angiosarcoma Malignant phyllodes tumour. |
Poor responders to NACT Malignant phyllodes Sarcomas Patients where systemic therapy cannot be offered. |
| Thoracic |
Oesophageal cancer Lung cancer > 2 cm, post NACT High-grade chest wall tumours Symptomatic mediastinal tumours Staging mediastinoscopy |
– |
Lung cancer Post NACT oesophageal cancer |
| HPB | – | Curative intent stomach pancreas, periampullary and duodenal cancer cases |
Pancreas/periampullary cancer Gall bladder cancer Post NACT stomach cancer |
| Colorectal |
Colonic cancer Nearly obstructing/bleeding tumours Poor responders to NACTRT |
Curative intent colonic cancer cases | Colonic cancer |
| Gynaecological |
Ovarian cancer Endometrial cancer Cervical cancer Gestational trophoblastic tumours |
– | Early cervical cancer |
| Soft tissue | – | Non-metastatic STS | High-grade sarcomas |
| Urological | – | – | Orchiectomy for testicular cancer |
| Head Neck | – | – | T1 and T2 lesions which can be operated with minimal hospitalisation, aggressive thyroid cancers and refractory hyperparathyroidism |
| FHNO guidelines for head neck malignancies | EAU Guidelines for urological malignancies [14] | ||
|
Airway obstruction Day care surgery and surgery for early lesions |
MIBC Testicular cancer (orchiectomy) Post NACT RPLND cT3+ renal cancer High-grade UTUC ACC > 6 cm Penile/urethral cancer |
||
ACS American College of Surgeons, SSO Society of Surgical Oncology, IASO Indian Association of Surgical Oncology, FHNO Federation of Head Neck Oncology, EAU European Association of Urology, HPB hepato-pancreato-biliary, NACT neoadjuvant chemotherapy, IDC infiltrating ductal carcinoma, NACTRT neoadjuvant chemoradiation, STS soft tissue sarcoma, MIBC muscle invasive bladder cancer, RPLND retroperitoneal lymph node dissection, UTUC upper tract urothelial carcinoma, ACC adrenocortical carcinoma
*Phase 1 recommendations where hospital resources are not exhausted, available ICU beds and COVID trajectory not in rapid escalation phase