Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study.
[EN]The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted...
| Autores: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Recursos: | Universidad de Salamanca (USAL) |
| Repositorio: | GREDOS. Repositorio Institucional de la Universidad de Salamanca |
| OAI Identifier: | oai:gredos.usal.es:10366/161040 |
| Acesso em linha: | http://hdl.handle.net/10366/161040 |
| Access Level: | acceso abierto |
| Palavra-chave: | Ginecología Oncología Cáncer Supervivencia COVID-19 Cirugía Pandemics Prospective Studies Humans Gynecologic Surgical Procedures 3213 Cirugía 3207.13 Oncología humanos pandemias procedimientos quirúrgicos ginecológicos estudios prospectivos |
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Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study.Fotopoulou, ChristinaKhan, TabassumBracinik, JurajGlasbey, JamesAbu-Rustum, NadeemChiva, LuisFagotti, AnnaFujiwara, KeiichiGhebre, RahelGutelkin, MuratKonney, Thomas ONg, JosephPareja, ReneKottayasamy Seenivasagam, RajkumarSehouli, JalidSundar, SudhaSurappa, Shylasree T. S.Bhangu, AneelLeung, ElaineSundar, SudhaAlcázar Montero, José AntonioGinecologíaOncologíaCáncerSupervivenciaCOVID-19CirugíaPandemicsProspective StudiesHumansGynecologic Surgical Procedures3213 Cirugía3207.13 Oncologíahumanospandemiasprocedimientos quirúrgicos ginecológicosestudios prospectivos[EN]The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during the COVID-19 pandemic, which are currently unclear. This study aimed to evaluate the changes in care and short-term outcomes of surgical patients with gynecologic cancers during the COVID-19 pandemic. We hypothesized that the COVID-19 pandemic had led to a delay in surgical cancer care, especially in patients who required more extensive surgery, and such delay had an impact on cancer outcomes. This was a multicenter, international, prospective cohort study. Consecutive patients with gynecologic cancers who were initially planned for nonpalliative surgery, were recruited from the date of first COVID-19-related admission in each participating center for 3 months. The follow-up period was 3 months from the time of the multidisciplinary tumor board decision to operate. The primary outcome of this analysis is the incidence of pandemic-related changes in care. The secondary outcomes included 30-day perioperative mortality and morbidity and a composite outcome of unresectable disease or disease progression, emergency surgery, and death. We included 3973 patients (3784 operated and 189 nonoperated) from 227 centers in 52 countries and 7 world regions who were initially planned to have cancer surgery. In 20.7% (823/3973) of the patients, the standard of care was adjusted. A significant delay (>8 weeks) was observed in 11.2% (424/3784) of patients, particularly in those with ovarian cancer (213/1355; 15.7%; P<.0001). This delay was associated with a composite of adverse outcomes, including disease progression and death (95/424; 22.4% vs 601/3360; 17.9%; P=.024) compared with those who had operations within 8 weeks of tumor board decisions. One in 13 (189/2430; 7.9%) did not receive their planned operations, in whom 1 in 20 (5/189; 2.7%) died and 1 in 5 (34/189; 18%) experienced disease progression or death within 3 months of multidisciplinary team board decision for surgery. Only 22 of the 3778 surgical patients (0.6%) acquired perioperative SARS-CoV-2 infections; they had a longer postoperative stay (median 8.5 vs 4 days; P<.0001), higher predefined surgical morbidity (14/22; 63.6% vs 717/3762; 19.1%; P<.0001) and mortality (4/22; 18.2% vs 26/3762; 0.7%; P<.0001) rates than the uninfected cohort. One in 5 surgical patients with gynecologic cancer worldwide experienced management modifications during the COVID-19 pandemic. Significant adverse outcomes were observed in those with delayed or cancelled operations, and coordinated mitigating strategies are urgently needed.Elsevier202420242022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/161040reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1610402026-06-07T06:28:51Z |
| dc.title.none.fl_str_mv |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| title |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| spellingShingle |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. Fotopoulou, Christina Ginecología Oncología Cáncer Supervivencia COVID-19 Cirugía Pandemics Prospective Studies Humans Gynecologic Surgical Procedures 3213 Cirugía 3207.13 Oncología humanos pandemias procedimientos quirúrgicos ginecológicos estudios prospectivos |
| title_short |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| title_full |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| title_fullStr |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| title_full_unstemmed |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| title_sort |
Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: an international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study. |
| dc.creator.none.fl_str_mv |
Fotopoulou, Christina Khan, Tabassum Bracinik, Juraj Glasbey, James Abu-Rustum, Nadeem Chiva, Luis Fagotti, Anna Fujiwara, Keiichi Ghebre, Rahel Gutelkin, Murat Konney, Thomas O Ng, Joseph Pareja, Rene Kottayasamy Seenivasagam, Rajkumar Sehouli, Jalid Sundar, Sudha Surappa, Shylasree T. S. Bhangu, Aneel Leung, Elaine Sundar, Sudha Alcázar Montero, José Antonio |
| author |
Fotopoulou, Christina |
| author_facet |
Fotopoulou, Christina Khan, Tabassum Bracinik, Juraj Glasbey, James Abu-Rustum, Nadeem Chiva, Luis Fagotti, Anna Fujiwara, Keiichi Ghebre, Rahel Gutelkin, Murat Konney, Thomas O Ng, Joseph Pareja, Rene Kottayasamy Seenivasagam, Rajkumar Sehouli, Jalid Sundar, Sudha Surappa, Shylasree T. S. Bhangu, Aneel Leung, Elaine Alcázar Montero, José Antonio |
| author_role |
author |
| author2 |
Khan, Tabassum Bracinik, Juraj Glasbey, James Abu-Rustum, Nadeem Chiva, Luis Fagotti, Anna Fujiwara, Keiichi Ghebre, Rahel Gutelkin, Murat Konney, Thomas O Ng, Joseph Pareja, Rene Kottayasamy Seenivasagam, Rajkumar Sehouli, Jalid Sundar, Sudha Surappa, Shylasree T. S. Bhangu, Aneel Leung, Elaine Alcázar Montero, José Antonio |
| author2_role |
author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Ginecología Oncología Cáncer Supervivencia COVID-19 Cirugía Pandemics Prospective Studies Humans Gynecologic Surgical Procedures 3213 Cirugía 3207.13 Oncología humanos pandemias procedimientos quirúrgicos ginecológicos estudios prospectivos |
| topic |
Ginecología Oncología Cáncer Supervivencia COVID-19 Cirugía Pandemics Prospective Studies Humans Gynecologic Surgical Procedures 3213 Cirugía 3207.13 Oncología humanos pandemias procedimientos quirúrgicos ginecológicos estudios prospectivos |
| description |
[EN]The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during the COVID-19 pandemic, which are currently unclear. This study aimed to evaluate the changes in care and short-term outcomes of surgical patients with gynecologic cancers during the COVID-19 pandemic. We hypothesized that the COVID-19 pandemic had led to a delay in surgical cancer care, especially in patients who required more extensive surgery, and such delay had an impact on cancer outcomes. This was a multicenter, international, prospective cohort study. Consecutive patients with gynecologic cancers who were initially planned for nonpalliative surgery, were recruited from the date of first COVID-19-related admission in each participating center for 3 months. The follow-up period was 3 months from the time of the multidisciplinary tumor board decision to operate. The primary outcome of this analysis is the incidence of pandemic-related changes in care. The secondary outcomes included 30-day perioperative mortality and morbidity and a composite outcome of unresectable disease or disease progression, emergency surgery, and death. We included 3973 patients (3784 operated and 189 nonoperated) from 227 centers in 52 countries and 7 world regions who were initially planned to have cancer surgery. In 20.7% (823/3973) of the patients, the standard of care was adjusted. A significant delay (>8 weeks) was observed in 11.2% (424/3784) of patients, particularly in those with ovarian cancer (213/1355; 15.7%; P<.0001). This delay was associated with a composite of adverse outcomes, including disease progression and death (95/424; 22.4% vs 601/3360; 17.9%; P=.024) compared with those who had operations within 8 weeks of tumor board decisions. One in 13 (189/2430; 7.9%) did not receive their planned operations, in whom 1 in 20 (5/189; 2.7%) died and 1 in 5 (34/189; 18%) experienced disease progression or death within 3 months of multidisciplinary team board decision for surgery. Only 22 of the 3778 surgical patients (0.6%) acquired perioperative SARS-CoV-2 infections; they had a longer postoperative stay (median 8.5 vs 4 days; P<.0001), higher predefined surgical morbidity (14/22; 63.6% vs 717/3762; 19.1%; P<.0001) and mortality (4/22; 18.2% vs 26/3762; 0.7%; P<.0001) rates than the uninfected cohort. One in 5 surgical patients with gynecologic cancer worldwide experienced management modifications during the COVID-19 pandemic. Significant adverse outcomes were observed in those with delayed or cancelled operations, and coordinated mitigating strategies are urgently needed. |
| publishDate |
2022 |
| dc.date.none.fl_str_mv |
2022 2024 2024 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10366/161040 |
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http://hdl.handle.net/10366/161040 |
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Inglés |
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Inglés |
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Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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Elsevier |
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Elsevier |
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reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca instname:Universidad de Salamanca (USAL) |
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Universidad de Salamanca (USAL) |
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GREDOS. Repositorio Institucional de la Universidad de Salamanca |
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GREDOS. Repositorio Institucional de la Universidad de Salamanca |
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