Introduction: Since the community spread of Coronavirus disease 2019 (COVID-19), the practice of oncologic care at our comprehensive cancer center has changed. Postponing cancer treatment without consideration of its implications could cost more lives than can be saved. In this special situation, we must continue to provide our cancer patients with the highest quality of medical services assuring the safety. This article provides general guidance on supporting curative treatment strategies in vulvar cancer patients. Methods: At our institution, a vulvar cancer multidisciplinary team (Vul.Can MDT) of specialists is responsible for personalized treatment of this disease. The phase 2 period necessarily requires specific procedures for both outpatient and inpatient pathways and to provide strategies concerning the management of vulvar cancer patients even in case of an eventually concomitant SARS-CoV-2 infection. In brief, an accurate remote and in person triage must be provided routinely and patients submitted to specific diagnostic tests prior to every major treatment or procedure (surgery, RT, and CT) or in case of suspicion for COVID-19 syndrome. The decisional workflow for these women often old and frail, have been rapidly adjusted by our Vul.Can MDT to mitigate the potential risks of COVID-19. Results: The team produced two types of recommendations concerning: (1) safety regulations of care pathways, patients and health care providers, (2) personalized treatment strategies. We present a protocol that can be applied in clinical practice: the flowcharts provided, include the modulation of treatment intensity designed for surgical procedures and radiation, stratified for FIGO stage of disease and intention. Conclusion: We suggest that our proposals are applicable in this setting of patients, considering anyway current international recommendations and guidelines.

Garganese, G., Tagliaferri, L., Fragomeni, S. M., Lancellotta, V., Colloca, G. F., Corrado, G., Gentileschi, S., Macchia, G., Tamburrini, E., Gambacorta, M. A., Fagotti, A., Scambia, G., Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul.Can MDT, <<JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY>>, 2020; 146 (10): 2535-2545. [doi:10.1007/s00432-020-03312-9] [http://hdl.handle.net/10807/198609]

Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul.Can MDT

Garganese, Giorgia;Tagliaferri, Luca;Fragomeni, Simona Maria;Colloca, Giuseppe Ferdinando;Gentileschi, Stefano;Macchia, Gabriella;Tamburrini, Enrica;Gambacorta, Maria Antonietta;Fagotti, Anna;Scambia, Giovanni
2020

Abstract

Introduction: Since the community spread of Coronavirus disease 2019 (COVID-19), the practice of oncologic care at our comprehensive cancer center has changed. Postponing cancer treatment without consideration of its implications could cost more lives than can be saved. In this special situation, we must continue to provide our cancer patients with the highest quality of medical services assuring the safety. This article provides general guidance on supporting curative treatment strategies in vulvar cancer patients. Methods: At our institution, a vulvar cancer multidisciplinary team (Vul.Can MDT) of specialists is responsible for personalized treatment of this disease. The phase 2 period necessarily requires specific procedures for both outpatient and inpatient pathways and to provide strategies concerning the management of vulvar cancer patients even in case of an eventually concomitant SARS-CoV-2 infection. In brief, an accurate remote and in person triage must be provided routinely and patients submitted to specific diagnostic tests prior to every major treatment or procedure (surgery, RT, and CT) or in case of suspicion for COVID-19 syndrome. The decisional workflow for these women often old and frail, have been rapidly adjusted by our Vul.Can MDT to mitigate the potential risks of COVID-19. Results: The team produced two types of recommendations concerning: (1) safety regulations of care pathways, patients and health care providers, (2) personalized treatment strategies. We present a protocol that can be applied in clinical practice: the flowcharts provided, include the modulation of treatment intensity designed for surgical procedures and radiation, stratified for FIGO stage of disease and intention. Conclusion: We suggest that our proposals are applicable in this setting of patients, considering anyway current international recommendations and guidelines.
2020
Inglese
Garganese, G., Tagliaferri, L., Fragomeni, S. M., Lancellotta, V., Colloca, G. F., Corrado, G., Gentileschi, S., Macchia, G., Tamburrini, E., Gambacorta, M. A., Fagotti, A., Scambia, G., Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul.Can MDT, <<JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY>>, 2020; 146 (10): 2535-2545. [doi:10.1007/s00432-020-03312-9] [http://hdl.handle.net/10807/198609]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/198609
Citazioni
  • ???jsp.display-item.citation.pmc??? 8
  • Scopus 11
  • ???jsp.display-item.citation.isi??? 12
social impact