Jakarta Head and Neck Oncology Surgery Priority Score (Ja-HOP)

COVID-19 Pandemic has made a major change in the health care system including oncologic services. Elective surgery was mostly delayed to preserve resources and decreased COVID-19 transmission. Head and neck oncologic surgery will often be classified as “urgent” surgery and need special management in the current policy restrictions. We provide a score-based system for prioritizing head and neck surgery during the pandemic in the Indonesia setting. Several categories of considerations are made as a priority including tumors type and staging, outcomes following the delay in head and neck cancer therapy, airway, the population affected, patient location, and risk of transmission during otolaryngologic surgery. All categories were translated into a 3-point based specific subcategory score system with a maximum score is 27 and applied to each surgery candidate. The system also included a timeframe in which the physician should reconsider medical treatment if surgery were still not feasible. We applied the Ja-HOP score in our institution and compare patient treatment characteristics before and after implementation. 14 patients (10 curatives, 4 diagnostics) have elective surgery in June 2020 versus 18 patients (15 curatives, 2 diagnostics, 1 follow-up) in May 2021 after implementation. 11 patients have identified high Ja-HOP score (>20), 2 patients were converted to medical and palliative treatment after being assessed with Ja-HOP because of an advanced case. Ja-HOP Score is useful as an objective tool for managing surgical head and neck oncologic patients in our setting. This system will most beneficial for patients and decrease surgeon subjectivity that is prone to the conventional method.