ESMO management and treatment adapted recommendations in the COVID-19 era: gynaecological malignancies
Ilaria Colombo # 1 , Eleonora Zaccarelli # 2 , Maria Del Grande 1 , Federica Tomao 2 , Francesco Multinu 2 , Ilaria Betella 2 , Jonathan A Ledermann 3 , Antonio Gonzalez-Martin 4 , Cristiana Sessa 1 , Nicoletta Colombo 5
(1) Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
(2) Department of Gynecologic Oncology, European Institute of Oncology, Milano, Italy.
(3) Department of Oncology and Cancer Trials, UCL Cancer Institute, London, UK.
(4) Medical Oncology Department, Clínica Universidad de Navarra, Pamplona, Spain.
(5) Department of Gynecologic Oncology, European Institute of Oncology, Milano, Italy
The rapid spread of severe acute respiratory syndrome coronavirus 2 infection and its related disease (COVID-19) has required an immediate and coordinate healthcare response to face the worldwide emergency and define strategies to maintain the continuum of care for the non-COVID-19 diseases while protecting patients and healthcare providers.
The dimension of the COVID-19 pandemic poses an unprecedented risk especially for the more vulnerable populations. To manage patients with cancer adequately, maintaining the highest quality of care, a definition of value-based priorities is necessary to define which interventions can be safely postponed without affecting patients' outcome.
The European Society for Medical Oncology (ESMO) has endorsed a tiered approach across three different levels of priority (high, medium, low) incorporating information on the value-based prioritisation and clinical cogency of the interventions that can be applied for different disease sites.
Patients with gynaecological cancer are at particular risk of COVID-19 complications because of their age and prevalence of comorbidities. The definition of priority level should be based on tumour stage and histology, cancer-related symptoms or complications, aim (curative vs palliative) and magnitude of benefit of the oncological intervention, patients' general condition and preferences.
The decision-making process always needs to consider the disease-specific national and international guidelines and the local healthcare system and social resources, and a changing situation in relation to COVID-19 infection.
These recommendations aim to provide guidance for the definition of deferrable and undeferrable interventions during the COVID-19 pandemic for ovarian, endometrial and cervical cancers within the context of the ESMO Clinical Practice Guidelines.
CITA DEL ARTÍCULO ESMO Open . 2020 Jul;5(Suppl 3):e000827.