Objective
This study examined the impact of lockdown for SARS-CoV-2 on breast cancer management via an online survey in a French multicentre setting
Material and methods
This is a multicentre retrospective study, over the strict lockdown period from March 16
th
to May 11
th
, 2020 in metropolitan France. 20 centres were solicited, of which 12 responded to the survey
Results
50% of the centres increased their surgical activity, 33% decreased it and 17% did not change it during containment.Some centres had to cancel (17%) or postpone (33%) patient-requested interventions due to fear of SARS-CoV-2. Four and 6 centres (33% and 50%) respectively cancelled and postponed interventions for medical reasons. In the usual period, 83% of the centres perform their conservative surgeries on an outpatient basis, otherwise the length of hospital stay was 24 to 48 hours. All the centres except one performed conservative surgery on an outpatient basis during the lockdown period, for which. 8% performed mastectomies on an outpatient basis during the usual period. During lockdown, 50% of the centres reduced their hospitalization duration (25% outpatient /25% early discharge on Day 1).
Conclusion
This study explored possibilities for management during the first pandemic lockdown. The COVID-19 pandemic required a total reorganization of the healthcare system, including the care pathways for cancer patients.
Background and objective: according to the latest ESMO−ESGO recommendations, laparotomy is the standard surgical approach to treat and stage patients with presumed early stage epithelial ovarian cancer (EOC). A few studies have investigated the efficacy and the safety of laparoscopy for the staging of early stage EOC, and this question is still in the center of debates. Recurrence-free survival (RFS) and overall survival (OS) benefits of the minimally invasive surgery (MIS) have still to be specified. The aim of this multicenter and retrospective study is to assess the survival outcomes of laparoscopic staging in comparison with laparotomic staging for patients presenting with an early stage EOC. Methods: data of patients with early stage EOC (FIGO I-IIA) who underwent primary surgery between 2000 and 2018 were extracted from the FRANCOGYN database. OS and RFS of these two groups, constituted according to the surgical route, were compared using Log rank test. Results: of the 144 patients included, 107 patients underwent laparotomy and 37 underwent laparoscopy for a staging purpose. The median follow-up was 36.0 months (18.0 to 58.0). For the laparoscopy and the laparotomy group, the median follow-up period was 24 (11.0 to 50.0) and 42.0 (24.0 to 66.0) months, respectively, (p < 0.001). Tumor recurrence occurred in 33 (23%) patients: 2 (5.4%) in the laparoscopy group and 31 (29%) in the laparotomy group (p = 0.08). The OS rate at 5 years was 97.3% after laparoscopy and 79.8% after laparotomy (p = 0.19). Conclusions: there is no difference associated with the laparoscopic approach for the staging of early stage EOC on RFS and OS in comparison with laparotomy. MIS may be proposed as a safe and adequate alternative to laparotomy when performed by well-trained surgeons.
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