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Covid-19:在冠状病毒大流行期间,妇科肿瘤患者管理的最佳方法是什么?

Covid-19: What is the best approach in gynecological oncology patient management during the coronavirus pandemic?

机构信息

Fellowship of Gynecology Oncology, Mashhad Medical Science School, Mashhad, Iran.

Fellowship of Gynecology Oncology, Isfahan, Medical Science School, Isfahan, Iran.

出版信息

Asia Pac J Clin Oncol. 2021 Aug;17(4):312-320. doi: 10.1111/ajco.13476. Epub 2020 Oct 20.

Abstract

Coronavirus (COVID-19) infection is a new major concern and a global emergency in almost all countries worldwide; due to the higher sensibility of cancer patients, they are more susceptible to severe and fatal infections, being nearly 10 times more likely than in healthy individuals infected with this virus. Although the aggressive nature of a cancer is a matter of concern, our exact role as oncologists in this time of restricted resources is not fully clarified. Regarding some consensus recommendation for postponing surgery, there is still an essential need for a single approved protocol regarding each type of malignancy. Iran, as one of the first involved countries in this crisis in Asia, which also has a high prevalence of gynecological malignancies, will certainly require an individualized decision-making schedule based on the most accepted global consensus opinion. Considering our restricted health system resources, herein we tried to introduce a logical gynecologic cancer management protocol based on the stage and survival expectancy of each tumor, along with reviewing all recent recommendations. The limited statistics published in this short period of time have obliged us to mainly focus on expert opinions, and the individualized clinical judgments should be agreed upon by multidisciplinary tumor board consensus. In conclusion, the COVID-19 pandemic overshadows all aspects of medicine, and decision making in gynecological oncology patients requires precise and appropriate judgment based on the available local resources.

摘要

冠状病毒(COVID-19)感染是全世界几乎所有国家的一个新的主要关注点和全球紧急情况;由于癌症患者的敏感性更高,他们更容易受到严重和致命的感染,感染这种病毒的可能性比健康个体高近 10 倍。尽管癌症的侵袭性是一个令人关注的问题,但我们作为肿瘤学家在资源有限的情况下的确切作用尚未完全明确。尽管有一些关于推迟手术的共识建议,但仍需要针对每种恶性肿瘤制定一个单一的批准方案。伊朗是亚洲首批涉及这一危机的国家之一,也是妇科恶性肿瘤高发的国家,它肯定需要根据最可接受的全球共识意见制定个体化的决策时间表。考虑到我们有限的卫生系统资源,我们在此尝试根据每个肿瘤的阶段和生存预期,引入一个合乎逻辑的妇科癌症管理方案,并对所有最新建议进行了回顾。在这段时间内有限的统计数据迫使我们主要关注专家意见,而个体化的临床判断应该得到多学科肿瘤委员会的共识。总之,COVID-19 大流行掩盖了医学的各个方面,妇科肿瘤患者的决策需要根据可用的当地资源进行精确和适当的判断。

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