ABSTRACT
ObjectiveSeveral attempts are done in order to control COVID-19 and promote a fair allocation of resources during the outbreak. The Italian society of obstetrics and gynecologist (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) are promoting research activities in the field of gynecologic oncology on a national basis, even in the era of COVID-19.MethodsThe SIGO and MITO group promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and the implementation of containment measures of COVID-19 diffusion.ResultsOverall, 604 participants completed the questionnaire with a response rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize the in-hospital diffusion of COVID-19. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease in the use of laparoscopy in favor of open (19%) and vaginal (2%) surgery. Interestingly, about 5% of the participants stated that the use of laparoscopic surgery has increased during the COVID-19 outbreak. However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10–15%), and to perform less radical surgical procedures (20–25%) during COVID-19 pandemic.ConclusionsInternational cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak
ABSTRACT
The WHO classified the novel coronavirus (ie, SARS-CoV-2 or Covid-19) as a global public health emergency. Covid-19 threatens to curtail patient access to evidence-based treatment. Medicine is changing, basically due to the limited available resources. In the field of gynecologic oncology we have to redesign our treatments' paradigm. During COVID-19 outbreak, the highest priority is to achieve the maximum benefit from less demanding procedures. Extensive procedures should be avoided, in order to reduce hospitalization and postoperative events that might increase the in-hospital spread of the virus. Here, we present outcomes of 13 patients affected by Covid- 19 and by gynecologcial cancer having treatment during the first months of the pandemic outbreak. In 80% patients treatments were dalayed, surgical plans changed in 70% of patients. 60% of patients required prolunged hospitalization in Covid-19 dedicated hubs. A patient developed a Covid-19 related acute pneumonia after surgery. The patient died due to Covid-19 in the 7th postoperative day. Covid-19 represent a real emergency. Treatments of cancer patients would performed only wheater it is not safely delayable. To date there are insufficient data to recommend for/against an open versus laparoscopy approach;however, the surgical team should choose an approach that minimizes OR time and maximizes safety for both patients and healthcare staff.