Management of patients with gynecological cancers during the COVID-19 pandemic

Abstract

Coronavirus disease 2019 (COVID-19) pandemic is on the rise. There is an urgent need for triaging cancer patients for treatment. Gynecological malignancies require complicated surgical procedures, complex prolonged radiation techniques, and myelosuppressive chemotherapy. Therefore, judicious decision-making is required, balancing the risk of fatality because of COVID-19 infection with the benefit of therapy. The guidelines need to be tailored according to the local situation. These guidelines are specifically written with respect to the current situation in India. Some procedures are urgent, while some can be deferred. Surgeries for suspected ovarian cancer and early-stage cervical cancer are considered urgent. Surgeries for early-stage endometrium can be deferred for 4–6 weeks. Surgery for advanced ovarian cancer can be deferred by administering neoadjuvant chemotherapy. Chemoradiation for advanced-stage cervical cancer is considered urgent. Similarly, chemotherapy in gestational trophoblastic neoplasm, adjuvant chemotherapy for ovarian cancer, and neoadjuvant and concurrent chemotherapy for cervical cancer and germ cell tumor of the ovary is considered urgent. These guidelines will help us to provide effective treatment for gynecological cancers in the current situation.