๐ Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic - FRANCOGYN group for the CNGOF.
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 to 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.
keywords
๐ COVID-19 (1240)
๐ Guideline (5)
๐ Gynaecological cancer ()
๐ Management (291)
๐ lymph node (56)
author
๐ค Akladios, Cherif
๐ค Azais, Henri
๐ค Ballester, Marcos
๐ค Bendifallah, Sofiane
๐ค Bolze, Pierre-Adrien
๐ค Bourdel, Nicolas
๐ค Bricou, Alexandre
๐ค Canlorbe, Geoffroy
๐ค Carcopino, Xavier
๐ค Chauvet, Pauline
๐ค Collinet, Pierre
๐ค Coutant, Charles
๐ค Dabi, Yohann
๐ค Dion, Ludivine
๐ค Gauthier, Tristan
๐ค Graesslin, Olivier
๐ค Huchon, Cyrille
๐ค Koskas, Martin
๐ค Kridelka, Frederic
๐ค Lavoue, Vincent
๐ค Lecointre, Lise
๐ค Mezzadri, Matthieu
๐ค Mimoun, Camille
๐ค Ouldamer, Lobna
๐ค Raimond, Emilie
๐ค Touboul, Cyril
year
โฐ 2020
journal
๐ J Gynecol Obstet Hum Reprod
issn
๐
volume
number
page
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0
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