Table 1.

Simplified summary of the triage protocol to be followed in the management of Urological cancers during COVID-19

Site of Cancer	Cancer stage	Management
Kidney	cT1a	Postpone Sx for 6 months
	≥cT1b	Postpone Sx for 3 months
	Any T, Hematuria/ symptomatic/Renal vein/IVC involvement	Immediate Sx
	Metastatic RCC IMDC Good and Intermediate risk	TTX, CN after 3-6 month
	Metastatic RCC IMDC poor risk	TTX
NMIBC	Low risk	Postpone Sx for 3 months
	Intermediate risk	Prefer Sx
	High risk	Sx
	Any tumor with hematuria	Sx
MIBC	cT2N0	Trimodal therapy/Sx
	≥cT/ any N+	Sx within 3 months
	pT3/T4, p N1-N3	Defer adjuvant CT after Sx, Immuno preferred
	Metastatic bladder cancer	Defer CT, Immuno preferred
	Metastatic bladder cancer with hematuria	Hemostatic RT/Endoscopic fulguration
Prostate	Low risk	AS/Defer treatment for 6 months
	Intermediate risk	Defer treatment for 3-6 months
	High risk	Neoadjuvant ADT for 3-6 months followed by Sx/RT
	Metastatic	LHRH agonist preferred
	CRPC	Abiraterone/Enzalutamide preferred. Avoid Docetaxel CT.
Penis	cTis, cTa, cT1	Postpone Sx for 3 months
	cT2/cT3	Sx
	cT4	Sx + adjuvant CT
	B/l negative groin
	Low risk	Surveillance
	Intermediate risk	Surveillance
	High risk	Sx postponed for 3 months
	Positive mobile nodes	Sx
	Positive fixed nodes/>4cm	Neoadjuvant CT followed by Sx
	Metastatic disease	Palliative CT
Testis	Seminoma
	CS I Low risk	Surveillance
	CS I High risk	Surveillance/CT
	CS II A, IIB	CT/RT
	CS IIC, III	CT
	Non Seminoma
	CS I A	Surveillance
	CS IB	Surveillance
	CS IS	CT
	CS IIA, IIB	CT
	CS II C, III
	Good risk	CT
	Intermediate risk	CT
	High risk	CT

Sx: Surgery, TTx: Targeted therapy, CN: Cytoreductive nephrectomy, NMIBC: Non muscle invasive bladder cancer, MIBC: Muscle invasive balader cancer, CT: Chemotherapy, RT: Radiotherapy, AS: Active surveillance,