Impact of COVID-19 in gynecologic oncology: a Nationwide Italian Survey of the SIGO and MITO groups

Abstract

Objective Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion. Methods The survey consisted of a self-administered, anonymous, online questionnaire. The survey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020. Results Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%–15%), and to perform less radical surgical procedures (20%–25%) during COVID-19 pandemic. Conclusions National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.

Impact of COVID-19 Pandemic on Ovarian Cancer Management: Adjusting to the New Normal

“…43 A national online survey was established by the Italian Society of Gynecology and Obstetrics, and the Multicenter Italian Trials in OC and gynecologic malignancies evaluated the impact of COVID-19 on the clinical activity of gynecologist oncologists and assessed the changes that have been implemented to reduce the risks of COVID-19 infection. 44 This study suggests that out of the 604 participants, 38% of the gynecologic surgeons expressed concern about the impact of COVID-19 on the treatment. Also, 21% of the total participants indicated a decrease in the use of laparoscopy.…”

“…In addition, 20-25% of the total participants affirmed a decline in the use of radical surgical procedures. 44 It is suggested that only those procedures that are less demanding should be continued. While more extensive procedures should only be continued on an absolute necessary case.…”

The Effects of Modified Lymphoscintigraphy Techniques on Sentinel Lymph Node Biopsy Success During the COVID-19 Pandemic Period

“…During the pandemic, it is necessary to find ways to protect health activities, especially in cancer patients, because some continue their own treatment algorithm while others continue the same treatment or delay treatment. Therefore, international cooperation is required [8].…”

Sentinel Node Mapping at the Time of COVID-19 Outbreak

“…6,7 The current ongoing COVID-19 outbreak is changing our practice as COVID-19 threatens to curtail patient access to evidence-based treatment. [8][9][10][11][12][13][14] Reducing the in-hospital risk of COVID-19 transmission is a priority. In the paper published in this issue, 15 the authors evaluated the impact of not performing delayed lymphoscintigraphic images for minimizing the in-hospital waiting time.…”

“…Recently published recommendations on managing cancer patients during COVID 19 pandemic mostly focus on prioritization and optimization of treatments for these patients based on breast cancer type and preoperative staging. [8][9][10][11][12][13][14] Future studies will have to evaluate their overall impact on clinical outcomes.…”