Impact of the COVID-19 pandemic on the care of patients with ovarian cancer

ObjectivesWe studied the impact of the COVID-19 pandemic on the care of patients with epithelial ovarian cancer (EOC) in the Netherlands.MethodsData of the Netherlands Cancer Registry was used to perform a retrospective cohort study on women of 18+ years diagnosed with EOC in the period 2017–2020 who were treated in the Netherlands. Waiting times and treatment characteristics were compared for the period before the COVID-19 pandemic (2017–2019) with the period during the COVID-19 pandemic (2020).ResultsDuring the pandemic, more women were diagnosed with FIGO stage IV (28.7%) compared to the period before the pandemic (23.7%, p=0.034). Mean time between first hospital consultation and first treatment did not differ significantly between both periods;for stage I-IIA it was 34 days during the pandemic and 36 days before the pandemic, for stage IIB-IIIC it was 35 vs 37 days and for stage IV 37 vs 35 days, respectively. Time between cytoreductive surgery (CRS) and adjuvant chemotherapy was significantly shorter during the pandemic for stage IIB-IIIC (24 days vs 30 days before the pandemic, p<0.001).ConclusionsIn the Netherlands during the COVID-19 pandemic (2020), an increase in FIGO stage IV EOC was observed compared to the period before the pandemic (2017–2019). This might be due to patient-delay and/or delay in referral or to the introduction of HIPEC for stage IIIC. A decrease in the interval between CRS and adjuvant chemotherapy was observed. A decrease in elective procedures and treatments may be an important cause of the reduction in waiting time for chemotherapy.

Caregiver experience during the COVID-19 pandemic in the Netherlands

ObjectivesWe evaluated the experience of caregivers on the healthcare of gynaecological cancer patients during the first wave (March-June) of the COVID-19 pandemic in 2020 in the Netherlands.MethodsAn online questionnaire was sent to gynaecologists, gynaecological oncologists, medical- and radiation oncologists throughout the Netherlands. The self-developed questionnaire consisted of questions about gynaecological cancer in general and endometrial, ovarian, cervical and vulvar cancer specifically.ResultsSixty-four (63%) physicians participated: 33 gynaecologists (52%), 13 gynaecological oncologists (20%), 7 medical oncologists (11%) and 11 radiation oncologists (17%). Fifty-nine percent of the respondents (35/59) reported a change in the way of contact with patients during the ‘diagnostic phase’ : patients were more often contacted by telephone during the pandemic (80%, 28/35, e.g. first consult or discussing results). For ovarian cancer 17% (4/23) reported a change in type of surgery and 22% (11/49) in (neo)adjuvant treatment (e.g. delay, more cycles, referral). For endometrial 21% (12/56), cervical 26% (7/27) and vulvar cancer 32% (6/19) longer waiting times for surgery were reported (3% <1 week, 58% 1–3 weeks, 39% >3 weeks). Eighty-nine percent of the respondents (46/52) reported a change in follow-up: 91% (42/46) reported follow-up consultation by telephone or video, 63% (32/51) reported postponed follow-up appointments.ConclusionsThe questionnaire showed that during the first wave of the COVID-19 pandemic, most caregivers experienced a different way of contact during the diagnostic and follow-up phase. Consultation by telephone could a good alternative in the follow-up phase, e.g. for low risk patients without symptoms, even after the pandemic.