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. 2020 Nov;159(2):470-475.
doi: 10.1016/j.ygyno.2020.09.005. Epub 2020 Sep 25.

Gynecologic oncology care during the COVID-19 pandemic at three affiliated New York City hospitals

Melissa K Frey  1 , Rana K Fowlkes  2 , Nora M Badiner  2 , David Fishman  3 , Margaux Kanis  4 , Charlene Thomas  2 , Paul J Christos  2 , Peter Martin  2 , Charlotte Gamble  2 , Onyinye D Balogun  2 , Higinia Cardenes  2 , Constantine Gorelick  4 , Tara Pua  3 , Long Nguyen  3 , Kevin Holcomb  2 , Eloise Chapman-Davis  2
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Gynecologic oncology care during the COVID-19 pandemic at three affiliated New York City hospitals

Melissa K Frey et al. Gynecol Oncol. 2020 Nov.

Abstract

Background: New York City was among the epicenters during the COVID-19 pandemic. Oncologists must balance plausible risks of COVID-19 infection with the recognized consequences of delaying cancer treatment, keeping in mind the capacity of the health care system. We sought to investigate treatment patterns in gynecologic cancer care during the first two months of the COVID-19 pandemic at three affiliated New York City hospitals located in Brooklyn, Manhattan and Queens.

Methods: A prospective registry of patients with active or presumed gynecologic cancers receiving inpatient and/or outpatient care at three affiliated New York City hospitals was maintained between March 1 and April 30, 2020. Clinical and demographic data were abstracted from the electronic medical record with a focus on oncologic treatment. Multivariable logistic regression analysis was explored to evaluate the independent effect of hospital location, race, age, medical comorbidities, cancer status and COVID-19 status on treatment modifications.

Results: Among 302 patients with gynecologic cancer, 117 (38.7%) experienced a COVID-19-related treatment modification (delay, change or cancellation) during the first two months of the pandemic in New York. Sixty-four patients (67.4% of those scheduled for surgery) had a COVID-19-related modification in their surgical plan, 45 (21.5% of those scheduled for systemic treatment) a modification in systemic treatment and 12 (18.8% of those scheduled for radiation) a modification in radiation. Nineteen patients (6.3%) had positive COVID-19 testing. On univariate analysis, hospital location in Queens or Brooklyn, age ≤65 years, treatment for a new cancer diagnosis versus recurrence and COVID-19 positivity were associated with treatment modifications. On multivariable logistic regression analysis, hospital location in Queens and COVID-19 positive testing were independently associated with treatment modifications.

Conclusions: More than one third of patients with gynecologic cancer at three affiliated New York City hospitals experienced a treatment delay, change or cancellation during the first two months of the COVID-19 pandemic. Among the three New York City boroughs represented in this study, likelihood of gynecologic oncology treatment modifications correlated with the case burden of COVID-19.

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Conflict of interest statement

Declaration of Competing Interest Kevin Holcomb serves as a consultant for Johnson and Johnson and receives research support from Fujirebio Diagnostics. Peter Martin serves as a consultant for Beigene, Bayer, Celgene, Cellectar, Janssen, Karyopharm, Kite, Morphosys, Regeneron, Teneobio. Constantine Gorelick serves as a proctor for Intuitive Surgical. None of the remaining authors have a conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
COVID-19-related modifications in surgery, systemic treatment and radiation.
See this image and copyright information in PMC

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