Gynecological cancers and the global COVID-19 pandemic.
Gynecological cancers and the global COVID-19 pandemic.
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DOI：
10.4274/jtgga.galenos.2020.2020.0119
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发表时间：
2020-12-04
期刊：
影响因子：
--
通讯作者：
Allahqoli L
中科院分区：
文献类型：
--
作者：
Alkatout I;Karimi-Zarchi M;Allahqoli L
2019冠状病毒病（COVID-19）减少了卫生资源的可用性，这将影响妇科癌症的治疗。本研究旨在为全球COVID-19大流行期间的妇科癌症患者提供治疗方案。全面检索了国际数据库，关键词为COVID-19;严重急性呼吸综合征;中东呼吸综合征;妇科癌症;宫颈癌;阴道癌、外阴癌、卵巢癌、子宫内膜癌、肿瘤、择期手术、化疗、放疗、癌症、指南、指导、女性、管理、门诊就诊和分诊。对所获得的指南进行了研究，并对内容进行了总结。于COVID-19大流行期间，早期子宫内膜癌首选激素治疗，而晚期则首选放射治疗。宫颈上皮内瘤变3和高度鳞状上皮内病变应在诊断后立即治疗，至少使用环形电切术，而任何大手术应推迟10-12周。在宫颈癌的早期阶段，手术可能会延迟2-4周，并在干预期间进行放射治疗。如果卵巢肿块的肿瘤标志物阴性，影像学检查无癌症迹象，无腹水，血清CA-125水平低，囊肿底部无乳头状突起或赘生物，患者可给予激素治疗2-3个月。对于新诊断的卵巢癌，应尽早进行手术（最长：2-3周）。外阴和阴道癌可以在诊断后10-12周内治疗，但在这种情况下应优先给予放射治疗。葡萄胎妊娠是一种肿瘤急症，必须进行吸引刮除术;必须监测患者是否有转移。关于选择开放手术还是腹腔镜手术的信息有限。考虑到任何患者都可能是冠状病毒的无症状携带者，为了检测肺部病变，大手术前应进行胸部计算机断层扫描，使用或不使用造影剂。由于COVID-19大流行的新颖性和未知性，有关这些建议的证据有限。此外，关于延迟治疗和偏离现行指南的治疗方法的伦理辩论的数据也很有限。
Coronavirus disease-2019 (COVID-19) has reduced the availability of health resources which will affect treatment of gynecological cancers. The present study aimed to provide a treatment protocol for patients with gynecological cancers during the global COVID-19 pandemic. International databases with keywords of COVID-19; Severe Acute Respiratory Syndrome; Middle East Respiratory Syndrome; gynecologic cancer; cervical cancer; and vaginal cancer, vulvar cancer, ovarian cancer, endometrial cancer, tumor, elective surgery, chemotherapy, radiotherapy, cancer, guideline, guidance, women, management, outpatient clinic visits, and triage were comprehensively searched. All the obtained guidelines were studied and the contents were summarized. During the COVID-19 pandemic, early stage endometrial cancer was preferably treated with hormone therapy while radiotherapy was given in preference in later stages. Cervical intraepithelial neoplasia 3 and high-grade squamous intraepithelial lesions should be treated immediately after diagnosis using at least a loop electrosurgical excision procedure while any major surgery should be postponed by 10-12 weeks. In the early stage of cervical cancer, surgery may be delayed by 2-4 weeks, and radiotherapy prescribed for the intervening period. In cases of an ovarian mass with negative tumor markers, no sign of cancer on imaging investigations, no ascites, a low serum CA-125 level, and no papillary projection or vegetation in the base of the cyst, the patient may be given hormone therapy for 2-3 months. In cases of newly diagnosed confirmed ovarian cancers, surgery should be performed as early as possible (maximum: 2-3 weeks). Vulvar and vaginal cancers can be treated within 10-12 weeks of diagnosis, but radiotherapy should be given in preference in this situation. A molar pregnancy is an oncological emergency for which a suction curettage is mandatory; the patient must be monitored for metastases. Information concerning the choice between open or laparoscopic surgery is limited. Given that any patient may be an asymptomatic carrier of the coronavirus, major surgery should be preceded by chest computerized tomography, with and without contrast medium, in order to detect lung lesions. Evidence concerning these recommendations is limited because of the novel and unknown nature of the COVID-19 pandemic. Furthermore, data pertaining to ethical debates about delayed treatment and treatment approaches deviating from current guidelines are also limited.
DOI：
10.26355/eurrev_202003_20715
发表时间：
2020-03-01
影响因子：
3.3
作者：
Bizzarri, M.;Lagana, A. S.;Unfer, V
通讯作者：
Unfer, V
影响因子：
0.9
作者：
Alkatout, Ibrahim
通讯作者：
Alkatout, Ibrahim