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The impact of the COVID-19 coronavirus pandemic on the surgical management of gynecological cancers: Analysis of the multicenter database of the French SCGP and the FRANCOGYN group - 17/09/21

Doi : 10.1016/j.jogoh.2021.102133 
Théo Jouen a, Tristan Gauthier b, Henri Azais c, Sofiane Bendifallah d, Pauline Chauvet e, Herve Fernandez f, Yohan Kerbage g, Vincent Lavoue h, Lise Lecointre i, Camille Mimoun j, Lobna Ouldamer k, Stéphanie Seidler c, Marc Siffert l, Anne-Lyse Vallin m, Andrew Spiers a, Philippe Descamps a, Aymeline Lacorre b, Guillaume Legendre a, n,
a Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France 
b Departement of Obstetrics and Gynecology, Limoges University Hospital, Limoges, France 
c Departement of Obstetrics and Gynecology, Georges-Pompidou European Hospital AP-HP, Paris, France 
d Departement of Obstetrics and Gynecology, Tenon Hospital AP-HP, Paris, France 
e Departement of Obstetrics and Gynecology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France 
f Departement of Obstetrics and Gynecology, Bicêtre Hospital AP-HP, Paris, France 
g Departement of Obstetrics and Gynecology, Lille University Hospital, Lille, France 
h Departement of Obstetrics and Gynecology, Rennes University Hospital, Rennes, France 
i Departement of Obstetrics and Gynecology, Strasbourg University Hospital, Strasbourg, France 
j Departement of Obstetrics and Gynecology, Lariboisière Hospital AP-HP, Paris, France 
k Departement of Obstetrics and Gynecology, Tours University Hospital, Tours, France 
l Departement of Obstetrics and Gynecology, Bichat Hospital AP-HP, Paris, France 
m Departement of Obstetrics and Gynecology, Creteil University Hospital, Créteil, France 
n CESP-INSERM, U1018, Team 7, Reproductive and sexual health, Paris-Sud University, 94276 Villejuif, France 

Corresponding author at: Prof. Guillaume Legendre, Departement of Obstetrics and Gynecology, Angers University Hospital, Angers, France.Departement of Obstetrics and GynecologyAngers University HospitalAngersFrance

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Abstract

Introduction

The coronavirus SARS-CoV-2 (COVID-19) pandemic has put tremendous pressure on the French healthcare system. Almost all hospital departments have had to profoundly modify their activity to cope with the crisis. In this context, the surgical management of cancers has been a topic of debate as care strategies were tailored to avoid any delay in treatment that could be detrimental to patient wellbeing while being careful not to overload intensive care units.

The primary objective of this study was to observe changes in the surgical management of pelvic cancers during the COVID-19 pandemic in France.

Material and Methods

This study analyzed data from the prospective multi-center cohort study conducted by the French Society for Pelvic and Gynecological Surgery (SCGP) with methodological support from the French (FRANCOGYN) Group. All members of the SCGP received by e-mail a link allowing them to include patients who were scheduled to undergo gynecological carcinologic surgery between March 16th 2020 and May 11th 2020. Demographic data, the characteristics of cancers and the impact of the crisis in terms of changes to the usual recommended coarse of care were collected.

Results

A total of 181 patients with a median age 63 years were included in the cohort. In total, 31 patients had cervical cancer, 76 patients had endometrial cancer, 52 patients had ovarian or tubal cancer, 5 patients had a borderline tumor of the ovary, and 17 patients had vulvar cancer. During the study period, the care strategy was changed for 49 (27%) patients with postponed for 35 (19.3%) patients, and canceled for 7 (3.9%) patients. Surgical treatment was maintained for 139 (76.8%) patients. Management with neoadjuvant chemotherapy was offered to 19 (10,5%) patients and a change in surgical choice was made for 5 (2,8%) patients.

In total, 8 (4,4%) patients tested positive for COVID-19.

Data also shows a greater number of therapeutic changes in cases of ovarian cancer as well as a cancelation of a lumbo-aortic lymphadenectomy in one patient with cervical cancer.

Hospital consultants estimated a direct detrimental impact of the COVID-19 pandemic for 39 patients, representing 22% of gynecological cancers.

Conclusion

This study provided observational data of the impact of the COVID-19 health crisis on the surgical management of gynecological cancers.

Le texte complet de cet article est disponible en PDF.

Keywords : Cancers, Gynecologic, Pelvic, Cervical cancer, Endometrial cancer, Ovarian cancer, Borderline tumor, Cancer of vulva, Women, COVID-19, SARS-CoV-2, Pandemic, VIRUS


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Vol 50 - N° 8

Article 102133- octobre 2021 Retour au numéro
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