Article (Scientific journals)
Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic - FRANCOGYN group for the CNGOF.
Akladios, Cherif; Azais, Henri; Ballester, Marcos et al.
2020In Journal of Gynecology Obstetrics and Human Reproduction, 49 (6), p. 101729
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Keywords :
Betacoronavirus; Chemotherapy, Adjuvant; Coronavirus Infections/complications/epidemiology/prevention & control; Endometrial Neoplasms/pathology/surgery; Female; France; Genital Neoplasms, Female/complications/pathology/surgery/therapy; Gynecology; Humans; Interdisciplinary Communication; Obstetrics; Ovarian Neoplasms/drug therapy/pathology; Pandemics/prevention & control; Pneumonia, Viral/complications/epidemiology/prevention & control; Receptors, Lymphocyte Homing; Risk; Societies, Medical; Trophoblastic Neoplasms/drug therapy; Uterine Cervical Neoplasms/therapy; Vaginal Neoplasms/therapy; Vulvar Neoplasms/surgery; COVID-19; Guideline; Gynaecological cancer; Management
Abstract :
[en] 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.
Disciplines :
Oncology
Author, co-author :
Akladios, Cherif
Azais, Henri
Ballester, Marcos
Bendifallah, Sofiane
Bolze, Pierre-Adrien
Bourdel, Nicolas
Bricou, Alexandre
Canlorbe, Geoffroy
Carcopino, Xavier
Chauvet, Pauline
Collinet, Pierre
Coutant, Charles
Dabi, Yohann
Dion, Ludivine
Gauthier, Tristan
Graesslin, Olivier
Huchon, Cyrille
Koskas, Martin
Kridelka, Frédéric ;  Université de Liège - ULiège > Département des sciences cliniques > Gynécologie-Obstétrique
Lavoue, Vincent
Lecointre, Lise
Mezzadri, Matthieu
Mimoun, Camille
Ouldamer, Lobna
Raimond, Emilie
Touboul, Cyril
More authors (16 more) Less
Language :
English
Title :
Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic - FRANCOGYN group for the CNGOF.
Publication date :
2020
Journal title :
Journal of Gynecology Obstetrics and Human Reproduction
eISSN :
2468-7847
Publisher :
Elsevier Masson
Volume :
49
Issue :
6
Pages :
101729
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright © 2020 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.
Available on ORBi :
since 30 October 2020

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