British Gynaecological Cancer Society recommendations for women with gynecological cancer who received non-standard care during the COVID-19 pandemic

Taylor, Alexandra; Sundar, Sudha; Bowen, Rebecca; Clayton, Rick; Coleridge, Sarah; Fotopoulou, Christina; Ghaem‐Maghami, Sadaf; Ledermann, Jonathan A.; Manchanda, Ranjit; Maxwell, Hilary; Michael, Agnieszka; Miles, Tracie; Nicum, Shibani; Nordin, Andrew; Ramsay, Bruce A.; Rundle, Stuart; Williams, Sarah; Wood, Nicholas; Yiannakis, Dennis; Morrison, Jo

doi:10.1136/ijgc-2021-002942

Cited by 9 publications

(1 citation statement)

References 41 publications

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“…Yet, few health systems have established consensus agreements to date. 1,8 These results will also add to the evidence for future pandemics and the planning of relevant studies during a worldwide crisis in the future.…”

Section: Discussionmentioning

confidence: 74%

Outcomes of Gynecologic Cancer Surgery During the COVID-19 Pandemic: An International, Multicenter, Prospective CovidSurg–Gynecologic Oncology Cancer Study

Fotopoulou

Khan

Braciník

et al. 2023

Obstetrical &Amp; Gynecological Survey

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The logistic strain on the health care system during the COVID-19 pandemic disproportionally affected women with gynecologic cancers and surgical care delivery. Surgeries were being delayed or replaced by systemic or palliative care options with less favorable outcomes. The true impact of pandemic-related modifications to clinical management of surgical gynecologic cancer patients remains unknown.This international prospective cohort study aimed to analyze the clinical and surgical outcomes of patients with gynecologic cancer who had or were planned to have first-line treatment during the COVID-19 pandemic. This study was part of an umbrella study exploring the impact of COVID-19 in surgical patients across all solid cancer types and multiple specialties (GlobalSurg-CovidSurg Consortium). All hospitals that included patients discussed for surgery regardless of whether they were operated on or not were included in this study. Patients who were planned for curative or life-prolonging surgery or underwent surgery for gynecologic cancer during the COVID-19 pandemic were included. Patients were followed up from the time of multidisciplinary team decision for surgery for the next 3 months, representing the first peak period of the pandemic. The primary outcome was the incidence in pandemic-related changes in care, whereas secondary outcomes included perioperative morbidity and mortality, wait time before surgery, postoperative hospital stay time, proportion of patients not operated on with progression to incurable disease or death, and a composite adverse outcome to measure the potential impact of any treatment delays or adjustment.A total of 3973 patients from 227 centers across 52 countries were included, of whom 3784 (95.2%) ultimately underwent surgery. The majority of patients had uterine or ovarian cancer (n = 3270 [82%]) and were from high-income countries (n = 2906 [73%]). A total of 189 operations (7.9%) were canceled. Although the median time from multidisciplinary team decision to surgery was 3 weeks, 11.2% (424/3784) of patients underwent surgery more than 8 weeks later. Among ovarian cancer patients with stage III/IV disease and a significant delay (>8 weeks) of surgery, 83.6% had neoadjuvant chemotherapy compared with 21% for those who did not experience a delay ( P < 0.0001). The overall 30-day postoperative complication rate was 19.3%, and the postoperative COVID-19 infection rate was 0.6%. The length of stay was significantly longer for 277 Gynecologic Oncology

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Section: Discussionmentioning

confidence: 74%

Outcomes of Gynecologic Cancer Surgery During the COVID-19 Pandemic: An International, Multicenter, Prospective CovidSurg–Gynecologic Oncology Cancer Study

Fotopoulou

Khan

Braciník

et al. 2023

Obstetrical &Amp; Gynecological Survey

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COVID‐19 and the impact on gynecologic cancer care

Manchanda

Oxley

Ghaem‐Maghami

et al. 2021

Intl J Gynecology & Obste

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The COVID‐19 pandemic resulted in significant reconfiguration of gynecologic cancer services and care pathways across the globe, with a transformation of working practices. Services had to adapt to protect their vulnerable patients from infection, whilst providing care despite reduced resources/capacity and staffing. The international gynecologic cancer community introduced modified clinical care guidelines. Remote working, reduced hospital visiting, routine COVID‐testing, and use of COVID‐free surgical areas/hubs enabled the ongoing and safe delivery of complex cancer care, with priority levels for cancer treatments established to guide decision‐making by multidisciplinary tumor boards. Some 2.3 million cancer surgeries were delayed or cancelled during the first peak, with many patients reporting significant anxiety/concern for cancer progression and COVID infection. Although COVID trials were prioritized, recruitment to other cancer trials/research activity was significantly reduced. The impact of resultant protocol deviations on outcomes remains to be established. During the recovery healthcare services must maintain capacity and flexibility to manage future surges of infection, address the large backlog of patients with altered or delayed treatments, along with salvaging screening and prevention services. Training needs/mental well‐being of trainees need addressing and staff burnout prevented. Future research needs to fully evaluate the impact of COVID‐19 on long‐term patient outcomes.

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Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study

Braciník

Abu‐Rustum

Chiva

et al. 2022

American Journal of Obstetrics and Gynecology

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British Gynaecological Cancer Society recommendations for women with gynecological cancer who received non-standard care during the COVID-19 pandemic

Cited by 9 publications

References 41 publications

Outcomes of Gynecologic Cancer Surgery During the COVID-19 Pandemic: An International, Multicenter, Prospective CovidSurg–Gynecologic Oncology Cancer Study

Outcomes of Gynecologic Cancer Surgery During the COVID-19 Pandemic: An International, Multicenter, Prospective CovidSurg–Gynecologic Oncology Cancer Study

COVID‐19 and the impact on gynecologic cancer care

Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study

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