Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic - FRANCOGYN group for the CNGOF - 08/06/20
, Lise Lecointre a, Matthieu Mezzadri p, Camille Mimoun p, Lobna Ouldamer q, Emilie Raimond l, Cyril Touboul d
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Abstract |
Introduction |
In the context of the COVID-19 pandemic, specific recommendations are required for the management of patients with gynecologic cancer.
Materials and method |
The FRANCOGYN group of the National College of French Gynecologists and Obstetricians (CNGOF) convened to develop recommendations based on the consensus conference model.
Results |
If a patient with a gynecologic cancer presents with COVID-19, surgical management should be postponed for at least 15 days. For cervical cancer, radiotherapy and concomitant radiochemotherapy could replace surgery as first-line treatment and the value of lymph node staging should be reviewed on a case-by-case basis. For advanced ovarian cancers, neoadjuvant chemotherapy should be preferred over primary cytoreduction surgery. It is legitimate not to perform hyperthermic intraperitoneal chemotherapy during the COVID-19 pandemic. For patients who are scheduled to undergo interval surgery, chemotherapy can be continued and surgery performed after 6 cycles. For patients with early stage endometrial cancer of low and intermediate preoperative ESMO risk, hysterectomy with bilateral adnexectomy combined with a sentinel lymph node procedure is recommended. Surgery can be postponed for 1–2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1–2 endometrioid cancer on endometrial biopsy). For patients of high ESMO risk, the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) should be applied to avoid pelvic and lumbar-aortic lymphadenectomy.
Conclusion |
During the COVID-19 pandemic, management of a patient with cancer should be adapted to limit the risks associated with the virus without incurring loss of chance.
El texto completo de este artículo está disponible en PDF.Keywords : Gynaecological cancer, COVID-19, Guideline, Management
Esquema
| ☆ | Groupe FRANCOGYN (Groupe de Recherche en chirurgie Oncologique et Gynécologique), Groupe D’intérêt du CNGOF (Collège National des Gynécologues Obstétriciens Français). 91, boulevard de Sébastopol. 75002 P. |
Vol 49 - N° 6
Artículo 101729- juin 2020 Regresar al número
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