Alternative management for gynecological cancer care during the COVID-2019 pandemic: A Latin American survey

Int J Gynaecol Obstet. 2020 Sep;150(3):368-378. doi: 10.1002/ijgo.13272. Epub 2020 Jul 17.

Abstract

Objective: To determine the acceptance rate of treatment alternatives for women with either preinvasive conditions or gynecologic cancers during the COVID-19 pandemic among Latin American gynecological cancer specialists.

Methods: Twelve experts in gynecological cancer designed an electronic survey, according to recommendations from international societies, using an online platform. The survey included 22 questions on five topics: consultation care, preinvasive cervical pathology, and cervical, ovarian, and endometrial cancer. The questionnaire was distributed to 1052 specialists in 14 Latin American countries. A descriptive analysis was carried out using statistical software.

Results: A total of 610 responses were received, for an overall response rate of 58.0%. Respondents favored offering teleconsultation as triage for post-cancer treatment follow-up (94.6%), neoadjuvant chemotherapy in advanced stage epithelial ovarian cancer (95.6%), and total hysterectomy with bilateral salpingo-oophorectomy and defining adjuvant treatment with histopathological features in early stage endometrial cancer (85.4%). Other questions showed agreement rates of over 64%, except for review of pathology results in person and use of upfront concurrent chemoradiation for early stage cervical cancer (disagreement 56.4% and 58.9%, respectively).

Conclusion: Latin American specialists accepted some alternative management strategies for gynecological cancer care during the COVID-19 pandemic, which may reflect the region's particularities. The COVID-19 pandemic led Latin American specialists to accept alternative management strategies for gynecological cancer care, especially regarding surgical decisions.

Keywords: COVID-19; Cancer management; Coronavirus; Gynecologic cancer; Gynecologic neoplasms; Latin America; Survey.

MeSH terms

  • COVID-19 / therapy*
  • Female
  • Genital Neoplasms, Female / therapy*
  • Health Planning Guidelines
  • Humans
  • Hysterectomy
  • Latin America
  • Neoadjuvant Therapy
  • Ovarian Neoplasms / therapy
  • Pregnancy
  • Pregnancy Complications, Neoplastic / therapy*
  • SARS-CoV-2*
  • Salpingo-oophorectomy
  • Uterine Cervical Neoplasms / therapy