• Cherif Akladios, Henri Azais, Marcos Ballester, Sofiane Bendifallah, Pierre-Adrien Bolze, Nicolas Bourdel, Alexandre Bricou, Geoffroy Canlorbe, Xavier Carcopino, Pauline Chauvet, Pierre Collinet, Charles Coutant, Yohann Dabi, Ludivine Dion, Tristan Gauthier, Olivier Graesslin, Cyrille Huchon, Martin Koskas, Frederic Kridelka, Vincent Lavoue, Lise Lecointre, Matthieu Mezzadri, Camille Mimoun, Lobna Ouldamer, Emilie Raimond, and Cyril Touboul.
• Service de gynécologie, CHU de Hautepierre, 67000 Strasbourg, France.
• J Gynecol Obstet Hum Reprod. 2020 Jun 1; 49 (6): 101729.

IntroductionIn the context of the COVID-19 pandemic, specific recommendations are required for the management of patients with gynecologic cancer.Materials And MethodThe FRANCOGYN group of the National College of French Gynecologists and Obstetricians (CNGOF) convened to develop recommendations based on the consensus conference model.ResultsIf 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 1-2 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.ConclusionDuring 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.Copyright © 2020 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

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