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Gynecol Obstet Fertil Senol · May 2020
[Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period - FRANCOGYN group for the CNGOF].
- C Akladios, H Azais, M Ballester, S Bendifallah, P-A Bolze, N Bourdel, A Bricou, G Canlorbe, X Carcopino, P Chauvet, P Collinet, C Coutant, Y Dabi, L Dion, T Gauthier, O Graesslin, C Huchon, M Koskas, F Kridelka, V Lavoue, L Lecointre, M Mezzadri, C Mimoun, L Ouldamer, E Raimond, and C Touboul.
- Service de gynécologie, CHU de Hautepierre, 67000 Strasbourg, France.
- Gynecol Obstet Fertil Senol. 2020 May 1; 48 (5): 444-447.
IntroductionRecommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period.Material And MethodRecommendations based on the consensus conference model.ResultsIn 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.ConclusionDuring COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.Copyright © 2020 Elsevier Masson SAS. All rights reserved.
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