101
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Del Pilar Estevez-Diz M, Bonadio RC, Miranda VC, Carvalho JP. Management of cervical cancer patients during the COVID-19 pandemic: a challenge for developing countries. Ecancermedicalscience 2020; 14:1060. [PMID: 32582375 PMCID: PMC7302891 DOI: 10.3332/ecancer.2020.1060] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Indexed: 12/24/2022] Open
Abstract
During the COVID-19 pandemic, health services worldwide are going through important adaptations to assist patients infected with COVID-19, at the same time as continuing to provide assistance to other potentially life-threatening diseases. Although patients with cancer may be at increased risk for severe events related to COVID-19 infection, their oncologic treatments frequently cannot be delayed for long periods without jeopardising oncologic outcomes. Considering this, a careful consideration for treatment management of different malignancies is required. Cervical cancer is concentrated mainly in low-middle income countries (LMICs), which face particular challenges during the COVID-19 pandemic due to the scarcity of health resources in many places. Although cervical cancer is the fourth cause of cancer death among women, it receives little attention from international Oncology societies and scientific research studies. In this review paper, we discuss the cervical cancer landscape and provide specialists recommendations for its management during the COVID-19 pandemic, particularly focused on LMICs’ reality.
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Affiliation(s)
- Maria Del Pilar Estevez-Diz
- Instituto do Cancer do Estado de Sao Paulo-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-000 2, Brazil.,Oncologia D'Or, Sao Paulo 04501-000, Brazil
| | - Renata Colombo Bonadio
- Instituto do Cancer do Estado de Sao Paulo-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-000 2, Brazil.,Oncologia D'Or, Sao Paulo 04501-000, Brazil
| | - Vanessa Costa Miranda
- Instituto do Cancer do Estado de Sao Paulo-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-000 2, Brazil.,Oncologia D'Or, Sao Paulo 04501-000, Brazil
| | - Jesus Paula Carvalho
- Instituto do Cancer do Estado de Sao Paulo-Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-000 2, Brazil
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102
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Chiofalo B, Baiocco E, Mancini E, Vocaturo G, Cutillo G, Vincenzoni C, Bruni S, Bruno V, Mancari R, Vizza E. Practical recommendations for gynecologic surgery during the COVID-19 pandemic. Int J Gynaecol Obstet 2020; 150:146-150. [PMID: 32471012 PMCID: PMC9087771 DOI: 10.1002/ijgo.13248] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 01/22/2023]
Abstract
Surgery in suspected/confirmed COVID‐19 patients is a high‐risk venture. In infected patients, COVID‐19 is present in the body cavity. During surgery it could be nebulized in the spray generated by surgical instruments and could theoretically infect members of the surgical team. Nevertheless, some surgical gynecologic pathologies cannot be postponed. We present a list of the most frequent gynecologic diseases and recommendations on their surgical management during the COVID‐19 pandemic, based on expert opinion, current available information, and international scientific society recommendations to support the work of gynecologists worldwide. In brief, any kind of surgical treatment should be scrutinized and postponed if possible. Nonoperative conservative treatment including pharmacological therapies for hormone‐sensitive pathologies should be implemented. Health risk assessment by patient history and COVID‐19 test before elective surgery are pivotal to protect both patients and healthcare providers. In confirmed COVID‐19 patients or highly suspected cases, elective surgery should be postponed until full recovery. The COVID‐19 pandemic required crucial reorganization of health services according to priorities. Recommendations for gynecologic surgery are presented.
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Affiliation(s)
- Benito Chiofalo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Ermelinda Baiocco
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Emanuela Mancini
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Vocaturo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Cutillo
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Cristina Vincenzoni
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Simone Bruni
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Bruno
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Rosanna Mancari
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
| | - Enrico Vizza
- Gynecologic Oncology Unit, Department of Experimental Clinical Oncology, IRCCS-Regina Elena National Cancer Institute, Rome, Italy
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103
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Bhandoria G, Shylasree TS, Bhandarkar P, Ahuja V, Maheshwari A, Sekhon R, Somashekhar SP. Impact of COVID-19 Pandemic on Gynecological Oncology Care: Glimpse into Association of Gynecological Oncologists of India (AGOI) Perspective. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2020; 18:71. [PMID: 32974418 PMCID: PMC7294765 DOI: 10.1007/s40944-020-00421-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/26/2020] [Accepted: 05/30/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care worldwide in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of the Association of Gynecological Oncologists of India (AGOI), a registered professional society founded in 1991. METHODS We developed and administered a cross-sectional, flash survey to members of AGOI in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were described as a spectrum of findings, and related inferences were drawn. RESULTS Among approached practitioners, 90 responded to the survey, more than 80% were practicing consultants, and more than 50% from academic institutions. The results of the study showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all respondents. There were modifications in diagnostic pathways, interventions, and follow-ups across all organ sites. There was a near-unanimous opinion on the use of general safety measures to combat the virus and to use complete PPEs in a high-risk situation. There were mixed responses to alternative educational activities, especially using electronic technology and distant learning methods. There was optimism among respondents with regards to the current situation normalizing in 3-6 months. CONCLUSION This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. A significant effect on all aspects of cancer care was observed. Technological learning methods, both for patient care and educational activities, were being adopted by many respondents.
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Affiliation(s)
- Geetu Bhandoria
- Department of Obstetrics and Gynecology, Command Hospital, Pune, Maharashtra India
| | | | | | - Vijay Ahuja
- Manipal Comprehensive Cancer Centre, Bangalore, Karnataka India
| | | | - Rupinder Sekhon
- Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India
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104
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A review of the international early recommendations for departments organization and cancer management priorities during the global COVID-19 pandemic: applicability in low- and middle-income countries. Eur J Cancer 2020; 135:130-146. [PMID: 32580130 PMCID: PMC7834380 DOI: 10.1016/j.ejca.2020.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/07/2020] [Indexed: 02/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new virus that has never been identified in humans before. COVID-19 caused at the time of writing of this article, 2.5 million cases of infections in 193 countries with 165,000 deaths, including two-third in Europe. In this context, Oncology Departments of the affected countries had to adapt quickly their health system care and establish new organizations and priorities. Thus, numerous recommendations and therapeutic options have been reported to optimize therapy delivery to patients with chronic disease and cancer. Obviously, while these cancer care recommendations are immediately applicable in Europe, they may not be applicable in certain emerging and low- and middle-income countries (LMICs). In this review, we aimed to summarize these international guidelines in accordance with cancer types, making a synthesis for daily practice to protect patients, staff and tailor anti-cancer therapy delivery taking into account patients/tumour criteria and tools availability. Thus, we will discuss their applicability in the LMICs with different organizations, limited means and different constraints.
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105
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Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center. Updates Surg 2020; 72:281-289. [PMID: 32500431 PMCID: PMC7271142 DOI: 10.1007/s13304-020-00825-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/28/2020] [Indexed: 01/01/2023]
Abstract
COVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a tertiary referral COVID-19 center. The official bulletins of the Italian National Institute for the Infectious Diseases “L. Spallanzani” were reviewed to retrieve the number of daily COVID-19 patients. Records of consecutive oncological and transplant procedures performed during the outbreak were reviewed. Patients with a high probability of postoperative intensive care unit (ICU) admission were considered as high risk and defined by an ASA score ≥ III and/or a Charlson Comorbidity Index (CCI) ≥ 6 and/or a Revised Cardiac Risk Index for Preoperative Risk (RCRI) ≥ 3. 72 patients were operated, including 12 (16.6%) liver and kidney transplantations. Patients had few comorbidities (26.3%), low ASA score (1.9 ± 0.5), CCI (3.7 ± 1.3), and RCRI (1.2 ± 0.6) and had overall a low risk of postoperative ICU admission. Few patients had liver cirrhosis (12.5%) or received preoperative systemic therapy (16.6%). 36 (50%) high-risk surgical procedures were performed, including major hepatectomies, pancreaticoduodenectomies, total gastrectomies, multivisceral resections, and transplantations. Despite this, only 15 patients (20.8%) were admitted to the ICU. Only oncologic cases and transplantations were performed during the COVID-19 outbreak. Careful selection of patients allowed to perform major cancer surgeries and transplantations without further stressing hospital resources, meanwhile minimizing collateral damage to patients.
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106
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Nohuz E, Dubernard G, Lamblin G, Lebail-Carval K, Chabert P, Chêne G. [Gynecological surgery during the COVID-19 pandemic: Take home messages]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:526-529. [PMID: 32311508 PMCID: PMC7165081 DOI: 10.1016/j.gofs.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Indexed: 12/15/2022]
Affiliation(s)
- E Nohuz
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69120 Lyon-Bron, France.
| | - G Dubernard
- Service de gynécologie-obstétrique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - G Lamblin
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69120 Lyon-Bron, France
| | - K Lebail-Carval
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69120 Lyon-Bron, France
| | - P Chabert
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69120 Lyon-Bron, France
| | - G Chêne
- Service de gynécologie-obstétrique, hôpital Femme-Mère-Enfant (HFME), hospices civils de Lyon, 59, boulevard Pinel, 69120 Lyon-Bron, France; EMR 3738, université Claude-Bernard Lyon 1, 69000 Lyon, France
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107
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Bogani G, Casarin J, Pinelli C, Di Donato V, Bosio S, Ruisi S, Brusadelli C, Guerrisi R, Sarpietro G, Ditto A, Ghezzi F, Raspagliesi F. Management of patients with ovarian cancer in the COVID-19 era. J Surg Oncol 2020; 122:122-123. [PMID: 32476155 PMCID: PMC7300981 DOI: 10.1002/jso.26057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022]
Abstract
At the beginning of 2020, coronavirus disease 2019 (COVID‐19) spreads worldwide. Patients with ovarian cancer should be considered at high‐risk of developing severe morbidity related to COVID‐19. Most of them are diagnosed in advanced stages of disease, and they are fragile. Here, we evaluated the major impact of COVID‐19 on patients with ovarian cancer, discussing the effect of the outbreak on medical and surgical treatment.
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Affiliation(s)
- Giorgio Bogani
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Jvan Casarin
- Obstetrics and Gynecology Department of the University of Insubria, Varese, Italy
| | - Ciro Pinelli
- Obstetrics and Gynecology Department of the University of Insubria, Varese, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Sara Bosio
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Department of Obstetrics and Gynecology, Ospedale San Paolo, University of Milan, Milan, Italy
| | - Simona Ruisi
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Department of Obstetrics and Gynecology, Ospedale San Paolo, University of Milan, Milan, Italy
| | - Claudia Brusadelli
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Obstetrics and Gynecology Department of the University of Insubria, Varese, Italy
| | - Rocco Guerrisi
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Obstetrics and Gynecology Department of the University of Insubria, Varese, Italy
| | - Giuseppe Sarpietro
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.,Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic University of Catania, Catania, Italy
| | - Antonino Ditto
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Fabio Ghezzi
- Obstetrics and Gynecology Department of the University of Insubria, Varese, Italy
| | - Francesco Raspagliesi
- Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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108
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Pezzulla D, Macchia G, Taccari F, Sticca G, Deodato F. Radiotherapy in Southern Italy at the time of COVID-19: options for radiation oncology units. Int J Gynecol Cancer 2020; 30:917-919. [DOI: 10.1136/ijgc-2020-001523] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 04/27/2020] [Accepted: 04/30/2020] [Indexed: 11/04/2022] Open
Abstract
IntroductionThe outbreak of coronavirus disease 2019 (COVID-19) has spread to many countries and has been declared a global health emergency. Our center is located in the south of Italy where the infection rates were low and the clusters of COVID-19 positive patients were small and inhomogeneous. The aim of this short report is to share our experience as a starting point for the management of the steady state of the pandemic.MethodsThe safety of the patients and department staff required a strict plan to minimize the risk of infection between operators whose absence would have made it impossible to carry out the radiotherapy treatments. The head of the radiotherapy unit and members of the Hospital Crisis Unit have put in place a series of measures to manage the emergency.ResultsA “clean” team has been established whose members are kept out of the radiotherapy unit for 2 weeks on rotation. Several separate work areas have been made in order to reduce direct contact between the staff. Each staff member has to wear protective equipment if close contact with patients is required. Before confirming a radiotherapy consult or a follow-up visit, telephone clinical and epidemiological screening is performed by nurses through a questionnaire regarding the presence of respiratory symptoms or eventual social contacts with COVID-19 positive people. Once the patients arrive in the hospital, a triage point at the entrance to the hospital performs a second screening and a temperature check.ConclusionsThis management experience of a radiotherapy unit in Southern Italy could serve as a useful example for the future. In fact, in the steady state of infection many centers may face epidemiologically contagious numbers similar to those that we currently have in our region. These numbers require the maintenance of alert and precautionary measures which in our case seem to have worked.
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109
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Vermel M, Lecointre L, Faller É, Boisramé T, Akladios C. [Care management and elective carcinological surgery place during the COVID-19 pandemic: A case report]. ACTA ACUST UNITED AC 2020; 48:774-776. [PMID: 32417400 PMCID: PMC7224657 DOI: 10.1016/j.gofs.2020.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Indexed: 12/15/2022]
Affiliation(s)
- M Vermel
- Service de chirurgie gynécologique, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France.
| | - L Lecointre
- Service de chirurgie gynécologique, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - É Faller
- Service de chirurgie gynécologique, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - T Boisramé
- Service de chirurgie gynécologique, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - C Akladios
- Service de chirurgie gynécologique, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
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110
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Rodriguez Gallego A, Puentes Puentes LO, Mendoza Quevedo J, Valencia Franco M. Índice de manejo quirúrgico en pacientes con cáncer ginecológico durante la pandemia por Covid-19: Propuesta para instituciones y profesionales en ginecología oncológica. REPERTORIO DE MEDICINA Y CIRUGÍA 2020. [DOI: 10.31260/repertmedcir.01217372.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
El mundo vive una pandemia por un Coronavirus, llamado SARS-COV-2, que produce la COVID-19 (acrónimo del inglés coronavirus disease 2019), la cual ha generado un colapso en los sistemas de salud, haciendo que el manejo de otras enfermedades se convierta en un reto. De igual forma para los grupos oncológicos, la presencia de esta enfermedad, genera muchas dudas en la aplicación de los tratamientos estándares, los cuales se deben realizar lo antes posible, con el fin de ofrecer mejores resultados oncológicos.
Se propone la creación de un índice ( COVID-19 Cáncer Index) , teniendo en cuenta variables clínicas, epidemiológicas y la disponibilidad de los recursos hospitalarios, útil para la toma de decisiones y el establecimiento del mejor tratamiento para una paciente con confirmación o alta sospecha de neoplasia ginecológica.
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111
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Tsamakis K, Gavriatopoulou M, Schizas D, Stravodimou A, Mougkou A, Tsiptsios D, Sioulas V, Spartalis E, Sioulas AD, Tsamakis C, Charalampakis N, Mueller C, Arya D, Zarogoulidis P, Spandidos DA, Dimopoulos MA, Papageorgiou C, Rizos E. Oncology during the COVID-19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients. Oncol Lett 2020; 20:441-447. [PMID: 32565968 PMCID: PMC7285823 DOI: 10.3892/ol.2020.11599] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022] Open
Abstract
COVID-19 has caused unprecedented societal turmoil, triggering a rapid, still ongoing, transformation of healthcare provision on a global level. In this new landscape, it is highly important to acknowledge the challenges this pandemic poses on the care of the particularly vulnerable cancer patients and the subsequent psychosocial impact on them. We have outlined our clinical experience in managing patients with gastrointestinal, hematological, gynaecological, dermatological, neurological, thyroid, lung and paediatric cancers in the COVID-19 era and have reviewed the emerging literature around barriers to care of oncology patients and how this crisis affects them. Moreover, evolving treatment strategies and novel ways of addressing the needs of oncology patients in the new context of the pandemic are discussed.
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Affiliation(s)
- Konstantinos Tsamakis
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK
| | - Maria Gavriatopoulou
- Department of Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
| | - Athina Stravodimou
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, CH-1011 Lausanne, Switzerland
| | - Aikaterini Mougkou
- Paediatric Infectious Diseases Dept, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Dimitrios Tsiptsios
- Department of Neurophysiology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR47TP, UK
| | - Vasileios Sioulas
- Department of Gynaecologic Oncology MITERA Hospital, 15123 Athens, Greece
| | - Eleftherios Spartalis
- 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens School of Medicine, 11527 Athens, Greece
| | | | - Charalampos Tsamakis
- Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | | | - Christoph Mueller
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Donna Arya
- Thornford Park, Elysium Healthcare, Berkshire RG19 8ET, UK
| | - Paul Zarogoulidis
- 3rd Department of Surgery, 'AHEPA' University Hospital, Aristotle University of Thessaloniki, Medical School, 54621 Thessaloniki, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Meletios A Dimopoulos
- Hematology and Medical Oncology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, 11527 Athens, Greece
| | - Charalabos Papageorgiou
- First Department of Psychiatry, University of Athens, 'EGINITION' Hospital, 11528 Athens, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, University of Athens, 'ATTIKON' University Hospital, 12462 Athens, Greece
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112
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Lee SJ, Kim T, Kim M, Suh DH, Park JY, Lim MC, Lee JY, Kim JW, Kim YB, Eom KY, Kim SC. Recommendations for gynecologic cancer care during the COVID-19 pandemic. J Gynecol Oncol 2020; 31:e69. [PMID: 32406213 PMCID: PMC7286756 DOI: 10.3802/jgo.2020.31.e69] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023] Open
Affiliation(s)
- Sung Jong Lee
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Taehun Kim
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Miseon Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong Yeol Park
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Myong Cheol Lim
- Division of Tumor Immunology, Research Institute, and Center for Gynecologic Cancer & Center for Clinical Trial, Hospital, and Department of Cancer Control & Population Health, GSCSP, National Cancer Center, Goyang, Korea
| | - Jung Yun Lee
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Keun Yong Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Cheol Kim
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea.
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Perrone AM, De Palma A, De Iaco P. COVID-19 global pandemic: options for management of gynecologic cancers. The experience in surgical management of ovarian cancer in the second highest affected Italian region. Int J Gynecol Cancer 2020; 30:902. [DOI: 10.1136/ijgc-2020-001489] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/04/2022] Open
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114
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Kobayashi Y, Suh DH, Aoki D, Kim JW. Management of ovarian cancer patients in affected areas during COVID-19 pandemic: Japan and Korea. J Gynecol Oncol 2020; 31:e65. [PMID: 32342678 PMCID: PMC7189076 DOI: 10.3802/jgo.2020.31.e65] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/25/2020] [Indexed: 02/08/2023] Open
Affiliation(s)
- Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Jae Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
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Thomakos N, Pandraklakis A, Bisch SP, Rodolakis A, Nelson G. ERAS protocols in gynecologic oncology during COVID-19 pandemic. Int J Gynecol Cancer 2020; 30:728-729. [PMID: 32354796 DOI: 10.1136/ijgc-2020-001439] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/06/2020] [Accepted: 04/09/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Nikolaos Thomakos
- Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Pandraklakis
- Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Steven Peter Bisch
- Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Alexandros Rodolakis
- Division of Gynecologic Oncology, 1st Department of Obstetrics and Gynaecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregg Nelson
- Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
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116
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Bhatla N, Singhal S. The COVID-19 Pandemic and Implications for Gynaecologic Cancer Care. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2020; 18:48. [PMID: 32974417 PMCID: PMC7180676 DOI: 10.1007/s40944-020-00395-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/06/2020] [Accepted: 04/11/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE The impact of the COVID-19 pandemic on world healthcare system and economy is unprecedented. Currently routine surgical procedures are at a halt globally, but whether one can delay cancer procedures remains an ethical issue, and still there is no clarity on how women with gynaecological cancers should be managed in these critical times. METHODS Currently available literature on impact of COVID-19 on cancer was reviewed with special reference to its applicability to the Indian context. RESULTS Cancer cases are more susceptible for COVID-19 infection and rapid deterioration if they get infected. A tumour board should plan their management with a "do no harm" approach as the guiding principle. Teleconsultation may be used to advise patients for therapy and symptom control measures, as well as to advise new patients regarding diagnostic tests. Surgical decision making may be stratified into three categories: patients with low (not life threatening) or intermediate (potential for future morbidity or mortality) acuity may be delayed; those with high acuity may be taken up for planned therapy after explaining the risks. Assessment of the severity of disease, comorbid conditions, and logistic challenges, along with COVID census in their area are important variables for informed and individualized decision making. Safety of healthcare personnel needs to be ensured at the same time. CONCLUSION Currently available evidence is limited by small sample size, and full impact of this pandemic on cancer is yet to be seen. However, cancer care needs to be individualized taking all variables into consideration.
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Affiliation(s)
- Neerja Bhatla
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Singhal
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
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117
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Frey MK, Blank SV. Coronavirus concerns: What do women with gynecologic cancer need to know during the COVID-19 crisis? Gynecol Oncol 2020; 158:32-33. [PMID: 32402631 PMCID: PMC7180379 DOI: 10.1016/j.ygyno.2020.04.697] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 12/30/2022]
Abstract
COVID-19 is likely uniquely unsettling to gynecologic oncology patients. Resources addressing the questions of patients with cancer during the COVID-19 crises remain scarce. Women with gynecologic cancer were invited to participate in a webinar on COVID-19 and cancer concerns. We share participant questions to understand concerns and utilize this knowledge to improve patient education and support.
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Affiliation(s)
| | - Stephanie V Blank
- Icahn School of Medicine at Mount Sinai, Blavatnik Family Women's Health Research Institute, United States of America
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118
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Management of Gynaecological oncology diseases during COVID-19 global pandemic. Eur J Surg Oncol 2020; 46:1182-1183. [PMID: 32359918 PMCID: PMC7165089 DOI: 10.1016/j.ejso.2020.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 11/23/2022] Open
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119
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Goel A. Management of cancer during the COVID pandemic: Treatment of gynecological malignancies. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_108_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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120
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Somashekhar SP, Ahuja V, Olawaiye A. Impact of COVID-19 on gynecological cancer patients. CANCER RESEARCH, STATISTICS, AND TREATMENT 2020. [DOI: 10.4103/crst.crst_181_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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121
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Hojaij FC, Chinelatto LA, Boog GHP, Kasmirski JA, Lopes JVZ, Sacramento FM. Surgical Practice in the Current COVID-19 Pandemic: A Rapid Systematic Review. Clinics (Sao Paulo) 2020; 75:e1923. [PMID: 32428115 PMCID: PMC7213672 DOI: 10.6061/clinics/2020/e1923] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 12/21/2022] Open
Abstract
The coronavirus disease (COVID-19) outbreak </mac_aq>started in Wuhan, China, in December 2019, and evolved into a global problem in a short period. The pandemic has led to many social and health-care challenges. In this context, surgery is an area that is facing the need for many adaptations. In this systematic literature review, we analyzed different perspectives concerning this situation, aiming to provide recommendations that could guide surgeons and </mac_aq>entities toward screening, elective and emergency surgeries, decision making, and operating room management. A computerized search in PubMed, Scopus, and Scientific Electronic Library Online (SciELO) for relevant literature up to April 4, 2020, was performed. Articles were included if they were related to surgery dynamics in the context of the COVID-19 pandemic. Of the 281 articles found in our initial search and 15 articles from alternative sources, 39 were included in our review after a systematic evaluation. Concerning preoperative testing </mac_aq>for severe acute respiratory syndrome coronavirus 2 infection, 29 (74.4%) articles recommended some kind of </mac_aq>screening. Another major suggestion was postponing all (or at least selected) elective operations (29 articles, </mac_aq>74.4%). Several additional recommendations with respect to surgical practice or surgical staff were also assessed and discussed, such as performing laparoscopic surgeries and avoiding the use of electrocauterization. On the basis of the current literature, we concluded that any surgery that can be delayed should be postponed. COVID-19 screening is strongly recommended for all surgical cases. Moreover, surgical staff should be reduced to the essential members and provided with institutional psychological support.
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Affiliation(s)
- Flávio Carneiro Hojaij
- Departamento de Cirurgia, Laboratorio de Investigacao Medica (LIM 02), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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