Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;165(2):330-338.
doi: 10.1016/j.ygyno.2022.02.013. Epub 2022 Feb 22.

Impact of the COVID-19-pandemic on patients with gynecological malignancies undergoing surgery: A Dutch population-based study using data from the 'Dutch Gynecological Oncology Audit'

M D Algera  1 , W J van Driel  2 , B F M Slangen  3 , R F P M Kruitwagen  3 , M W J M Wouters  4 ; participants of the Dutch Gynecological Oncology Collaborator group
Collaborators, Affiliations

Impact of the COVID-19-pandemic on patients with gynecological malignancies undergoing surgery: A Dutch population-based study using data from the 'Dutch Gynecological Oncology Audit'

M D Algera et al. Gynecol Oncol. 2022 May.

Abstract

Objective: The COVID-19-pandemic caused drastic healthcare changes worldwide. To date, the impact of these changes on gynecological cancer healthcare is relatively unknown. This study aimed to assess the impact of the COVID-19-pandemic on surgical gynecological-oncology healthcare.

Methods: This population-based cohort study included all surgical procedures with curative intent for gynecological malignancies, registered in the Dutch Gynecological Oncology Audit, in 2018-2020. Four periods were identified based on COVID-19 hospital admission rates: 'Pre-COVID-19', 'First wave', 'Interim period', and 'Second wave'. Surgical volume, perioperative care processes, and postoperative outcomes from 2020 were compared with 2018-2019.

Results: A total of 11,488 surgical procedures were analyzed. For cervical cancer, surgical volume decreased by 17.2% in 2020 compared to 2018-2019 (mean 2018-2019: n = 542.5, 2020: n = 449). At nadir (interim period), only 51% of the expected cervical cancer procedures were performed. For ovarian, vulvar, and endometrial cancer, volumes remained stable. Patients with advanced-stage ovarian cancer more frequently received neoadjuvant chemotherapy in 2020 compared to 2018-2019 (67.7% (n = 432) vs. 61.8% (n = 783), p = 0.011). Median time to first treatment was significantly shorter in all four malignancies in 2020. For vulvar and endometrial cancer, the length of hospital stay was significantly shorter in 2020. No significant differences in complicated course and 30-day-mortality were observed.

Conclusions: The COVID-19-pandemic impacted surgical gynecological-oncology healthcare: in 2020, surgical volume for cervical cancer dropped considerably, waiting time was significantly shorter for all malignancies, while neoadjuvant chemotherapy administration for advanced-stage ovarian cancer increased. The safety of perioperative healthcare was not negatively impacted by the pandemic, as complications and 30-day-mortality remained stable.

Keywords: Cervical cancer; Endometrial cancer; Gynecological oncology; Impact COVID-19; Ovarian cancer; Pandemic; Perioperative care processes; Postoperative outcomes; Surgical volume; Vulvar cancer.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare that there are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Surgical procedures for gynecological malignancies per week in the Netherlands. Observed number of surgical procedures for ovarian, vulvar, endometrial and cervical cancer in 2020 plotted against expected number of surgical procedures (mean 2018–2019).
See this image and copyright information in PMC

References

    1. Nepogodiev D., et al. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br. J. Surg. 2020;107(11):1440–1449. - PMC - PubMed
    1. Frey M.K., et al. Gynecologic oncology care during the COVID-19 pandemic at three affiliated New York City hospitals. Gynecol. Oncol. 2020;159:470–475. - PMC - PubMed
    1. Nepogodiev D., Bhangu A., Glasbey J.C., Li E., Omar O.M., Simoes J.F. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396:27–38. - PMC - PubMed
    1. El Boghdady M., Ewalds-Kvist B.M. January, 2020. Laparoscopic Surgery and the debate on its safety during COVID-19 pandemic: A systematic review of recommendations. Surgeon, no. - PMC - PubMed
    1. Leung E., et al. Maintaining surgical care delivery during the COVID-19 pandemic: a comparative cohort study at a tertiary gynecological cancer centre. Gynecol. Oncol. 2020;160(January):649–654. - PMC - PubMed