Introduction/Background*This survey describes the German-wide impact of the COVID-19 pandemic on provision of clinical care and recruitment in clinical trials of patients with gynecologic malignancies from a physician’s perspective.
Methodology We performed an online anonymous multicentric prospective survey across clinicians in Germany. The multiple-choice questionnaire was administered at 4-6 weekly intervals from April 2020 to October 2020 for a total of four series.
Result(s)*483 questionnaires were completed. The majority of participants were gynecological oncologists (83.3%) in certified gynecologic cancer centers (61%) and breast cancer (BC) centers (80.4%). The majority stated a 50% reduction in surgical interventions for gyne-oncological cases. Cases that were prioritized for surgery across all tumors were those with early stage disease, at primary situation and with a good ECOG status. For BC, patients following neoadjuvant chemotherapy treatment and those with high-risk or locally-advanced BC were prioritized. The majority (73%) continued to conduct clinical trials throughout the pandemic. In cases were trials were discontinued, this decision was made by sponsors, and hospital officers. Other reasons for discontinuation included lack of patient-participation (due to fear of attending appointments). Almost 100% of the responders refuted any increased tendency to treat with a neoadjuvant approach (cytotoxic, hormonal, radiation) patients that would qualify for surgery under normal circumstances . This comes in direct contrast to the increased attitude to treat with neoadjuvant anticancer therapy of advanced cancers in other European countries.
Only 18% of the clinicians reported feeling adequately informed about established safety pathways for COVID-19 positive patients with gynecological cancers. More than 43% of the clinicians felt that the COVID-19 pandemic will continue to impact on clinical care for up to 2 years.
Conclusion*Targeted emergency algorithms for patients with gynecological cancers need to be developed to protect and preserve care and treatment options for our patients in future pandemics.
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