What to do as a gynecologic oncologist during the COVID-19 pandemic? MEMAGO statement

Abstract

The SARS-Cov-2 virus pandemic causes an acute public health emergency with millions of infected patients and thousands of deaths. The infection makes adults prone to severe and fatal consequences, especially when they suffer several comorbidities. Our oncologic patients are the most susceptible to its severe repercussions because of their initial diagnosis and the immunosuppressive adjuvant and neoadjuvant treatments they receive. The Chinese CDC reported a 5.6% risk of mortality among cancer patients compared to 0.9% in the general population; likewise, other studies showed a twofold higher risk of death in this patients’ subgroup. In order to maintain the best quality of medical services during this crisis, along with the safety of healthcare providers, accurate triage of our oncologic patients must be done before any medical or surgical intervention to decide whether or not postponing treatments may be considered, without risking the disease progression and patients’ worsening outcomes, otherwise inpatient and outpatient special precautions must be followed whenever interventions are currently scheduled, according to each gynecologic cancer type. The disease is worldwide but local and regional circumstances vary, thus practice guidelines must be individualized according to each country virus prevalence and available medical resources, in order to limit the burden of the COVID-19 infection on the health system during the crisis and the upcoming months after its resolution. © 2020 Lebanese Order of Physicians. All rights reserved.