Akladios C, Azais H, Ballester M, Bendifallah S, Bolze P-A, Bourdel N, Bricou A, Canlorbe G, Carcopino X, Chauvet P, Collinet P, Coutant C, Dabi Y, Dion L, Gauthier T, Graesslin O, Huchon C, Koskas M, Kridelka F, Lavoue V, Lecointre L, Mezzadri M, Mimoun C, Ouldamer L, Raimond E, Touboul C
Service de gynécologie, CHU de Hautepierre, 67000 Strasbourg, France.
Service de gynécologie, hôpital la Pitié-Salpêtrière, 75013 Paris, France.
Gynecol Obstet Fertil Senol. 2020 May;48(5):444-447. doi: 10.1016/j.gofs.2020.03.017. Epub 2020 Mar 25.
INTRODUCTION: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD: Recommendations based on the consensus conference model. RESULTS: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.
引言:COVID-19大流行期间妇科癌症患者的管理建议。 材料与方法:基于共识会议模型的建议。 结果:对于COVID-19检测呈阳性的患者,手术治疗应至少推迟15天。对于宫颈癌,必须根据放疗、同步放化疗重新评估手术地点,并且淋巴结分期手术的价值必须逐案审查。对于晚期卵巢癌,即使可以考虑进行初次肿瘤细胞减灭术,也应优先选择新辅助化疗。在COVID-19大流行期间不进行热灌注化疗是合理的。对于必须接受间隔手术的患者,可以继续化疗,并在化疗6个周期后进行手术。对于早期子宫内膜癌,术前ESMO风险低和中等时,应优先选择子宫切除加双侧附件切除并联合前哨淋巴结活检术。对于低风险子宫内膜癌(MRI显示为FIGO Ia期且子宫内膜活检为1-2级子宫内膜样癌),可以考虑将手术推迟1至2个月。对于ESMO高风险患者,可以优先采用MSKCC算法(结合PET-CT和前哨淋巴结活检)以省略盆腔和腹主动脉旁淋巴结清扫术。 结论:在COVID-19大流行期间,癌症患者不应失去生命机会,同时要限制与病毒相关的风险。
Gynecol Obstet Fertil Senol. 2020-5
J Gynecol Obstet Hum Reprod. 2020-6
Br J Surg. 2020-7
Cancer Rep (Hoboken). 2020-10
Int J Gynecol Cancer. 2020-6
Int J Gynecol Cancer. 2020-5
Eur J Obstet Gynecol Reprod Biol. 2020-8-26
Gynecol Obstet Fertil Senol. 2020-11
Int J Gynecol Cancer. 2020-8
J Minim Invasive Surg. 2020-12-15
Aging (Albany NY). 2020-11-24
Gynecol Obstet Fertil Senol. 2020-11
J Gynecol Obstet Hum Reprod. 2020-9
Crit Rev Oncol Hematol. 2020-4-22
Gynecol Obstet Fertil Senol. 2020-6