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Gynecol Obstet Fertil Senol ; 48(5): 444-447, 2020 05.
Article in French | MEDLINE | ID: covidwho-832614

ABSTRACT

INTRODUCTION: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD: Recommendations based on the consensus conference model. RESULTS: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Genital Neoplasms, Female/surgery , Gynecologic Surgical Procedures , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/transmission , Cytoreduction Surgical Procedures , Female , France , Genital Neoplasms, Female/complications , Gynecologic Surgical Procedures/adverse effects , Humans , Minimally Invasive Surgical Procedures , Pandemics , Pneumonia, Viral/transmission , Practice Guidelines as Topic , SARS-CoV-2 , Societies, Medical
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