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. 2020 Oct;146(10):2535-2545.
doi: 10.1007/s00432-020-03312-9. Epub 2020 Jul 12.

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

Giorgia Garganese  1   2 , Luca Tagliaferri  3 , Simona Maria Fragomeni  4 , Valentina Lancellotta  3 , Giuseppe Colloca  3 , Giacomo Corrado  2 , Stefano Gentileschi  5   6 , Gabriella Macchia  7 , Enrica Tamburrini  8 , Maria Antonietta Gambacorta  3   9 , Anna Fagotti  2   10 , Giovanni Scambia  2   10 ; Gemelli Vul.Can MDT
Affiliations

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

Giorgia Garganese et al. J Cancer Res Clin Oncol. 2020 Oct.

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.

Keywords: COVID-19; Patient care; Treatment; Vulvar neoplasms; Workflow.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Clinical pathways for management of patients with SARS-CoV2 infection and vulvar cancer. DACT diagnostic tests and anti-cancer treatments
See this image and copyright information in PMC

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