Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Bogani, Giorgio; Scambia, Giovanni; Cimmino, Chiara; Fanfani, Francesco; Costantini, Barbara; Loverro, Matteo; Ferrandina, Gabriella; Landoni, Fabio; Bazzurini, Luca; Grassi, Tommaso; Vitobello, Domenico; Siesto, Gabriele; Perrone, Anna Myriam; Zanagnolo, Vanna; De Iaco, Pierandrea; Multinu, Francesco; Ghezzi, Fabio; Casarin, Jvan; Berretta, Roberto; Capozzi, Vito A; Zupi, Errico; Centini, Gabriele; Pellegrino, Antonio; Corso, Silvia; Stevenazzi, Guido; Montoli, Serena; Boschi, Anna Chiara; Comerci, Giuseppe; Greco, Pantaleo; Martinello, Ruby; Sopracordevole, Francesco; Giorda, Giorgio; Simoncini, Tommaso; Caretto, Marta; Sartori, Enrico; Ferrari, Federico; Cianci, Antonio; Sarpietro, Giuseppe; Matarazzo, Maria Grazia; Zullo, Fulvio; Bifulco, Giuseppe; Morelli, Michele; Ferrero, Annamaria; Biglia, Nicoletta; Barra, Fabio; Ferrero, Simone; Maggiore, Umberto Leone Roberti; Cianci, Stefano; Chiantera, Vito; Ercoli, Alfredo; Sozzi, Giulio; Martoccia, Angela; Schettini, Sergio; Orlando, Teresa; Cannone, Francesco G; Ettore, Giuseppe; Puppo, Andrea; Borghese, Martina; Martinelli, Canio; Muzii, Ludovico; Donato, Violante Di; Driul, Lorenza; Restaino, Stefano; Bergamini, Alice; Candotti, Giorgio; Bocciolone, Luca; Plotti, Francesco; Angioli, Roberto; Mantovani, Giulia; Ceccaroni, Marcello; Cassani, Chiara; Dominoni, Mattia; Giambanco, Laura; Amodeo, Silvia; Leo, Livio; Thomasset, Raphael; Raimondo, Diego; Seracchioli, Renato; Malzoni, Mario; Gorlero, Franco; Luca, Martina Di; Busato, Enrico; Kilzie, Sami; Dell'Acqua, Andrea; Scarfone, Giovanna; Vercellini, Paolo; Petrillo, Marco; Dessole, Salvatore; Capobianco, Giampiero; Ciavattini, Andrea; Carpini, Giovanni Delli

J Gynecol Oncol. 2022 Jan;33(1):e10. 10.3802/jgo.2022.33.e10.

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Affiliations

¹Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
²Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
³Department of Obstetrics and Gynaecology, University of Insubria, F. Del Ponte Hospital, Varese, Italy
⁴Department of Obstetrics and Gynaecology, San Gerardo Hospital, Monza, Italy
⁵Unit of Gynecology, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
⁶Unit of Gynecology, AOU S. Orsola-Malpighi, Bologna, Italy
⁷Department of Gynecologic Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
⁸Department of Obstetrics and Gynaecology, University of Parma, Parma, Italy
⁹Department of Obstetrics and Gynaecology, University of Siena, Siena, Italy
¹⁰Department of Obstetrics and Gynaecology, ASST Lecco - Ospedale Alessandro Manzoni, Lecco, Italy
¹¹Department of Obstetrics and Gynaecology, ASST OVEST MI, Legnano (Milan) Hospital, Legnano, Italy
¹²Department of Obstetrics and Gynaecology, AUSL Romagna, Ospedale “Santa Maria delle Croci”, Ravenna, Italy
¹³Clinica Ostetrica e Ginecologica - Dipartimento Scienze Mediche - Università di Ferrara, Ferarra, Italy
¹⁴Gynecological Oncology Unit, Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
¹⁵Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
¹⁶Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
¹⁷Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, Catania, Italy
¹⁸Department of Obstetrics and Gynaecology, Azienda Ospedaliera Universitaria - Federico II, Naples, Italy
¹⁹Department of Obstetrics and Gynaecology, AO “S.S. Annunziata”, Cosenza, Italy
²⁰Academic Department of Obstetrics and Gynecology, Mauriziano Hospital, Torino, Italy
²¹Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
²²Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital G. Martino, University of Messina, Messina, Italy
²³Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
²⁴Department of Obstetrics and Gynaecology, AOR San Carlo, Potenza, Italy
²⁵Department of Obstetrics and Gynaecology, ARNAS Garibaldi Catania, Catania, Italy
²⁶Department of Obstetrics and Gynaecology, ASO Santa Croce e Carle, Cuneo, Italy
²⁷Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
²⁸Department of Maternal and Child Health, University-Hospital of Udine, Udine, Italy
²⁹Department of Obstetrics and Gynaecology, IRCCS San Raffaele Hospital, Milan, Italy
³⁰Department of Obstetrics and Gynecology, Campus Bio-Medico University of Rome, Rome, Italy
³¹Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy, Sacred Heart Hospital Negrar, Verona, Italy
³²Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo and University of Pavia, Pavia, Italy
³³Department of Obstetrics and Gynecology, S. Antonio Abate Hospital, Trapani, Italy and Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
³⁴Departments of Gynecology & Obstetrics, Hopital Beauregard, AUSL Valleè d'Aoste, Aosta, Italy
³⁵Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna. S. Orsola Hospital, University of Bologna, Bologna, Italy
³⁶Endoscopica Malzoni, Center for Advanced Endoscopic Gynecologic Surgery, Avellino, Italy
³⁷Department of Obstetrics and Gynaecology, Ente Ospedaliero Ospedali Galliera, Genova, Italy
³⁸Department of Obstetrics and Gynaecology, Ospedale di Treviso, Treviso, Italy
³⁹Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
⁴⁰Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
⁴¹Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
⁴²Gynecological Oncology Unit, Santa Chiara Hospital, Trento, Italy
⁴³Gynecology Unit, Careggi University Hospital, Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence, Italy
⁴⁴Department of Obstetrics and Gynaecology, Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy
⁴⁵Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
⁴⁶Department of Obstetrics and Gynaecology, Madonna delle Grazie Hospital ASM, Matera, Italy
⁴⁷Gynecology Unit, Ospedale Valduce, Como, Italy
⁴⁸Unit of Obstetrics and Gynaecology, Valle D'Itra Hospital, Martina Franca, Taranto, Italy
⁴⁹Unit of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy
⁵⁰Unit of Obstetrics and Gynecology, GOM of Reggio Calabria & Magna Græcia University of Catanzaro, Catanzaro, Italy
⁵¹Unit of Obstetrics and Gynecology, University G. D'Annunzio of Chieti, Pescara, Italy
⁵²Unit of Obstetrics and Gynecology, Santo Spirito Hospital, Pescara, Italy
⁵³Unit of Obstetrics and Gynecology, Università “Magna Graecia” di Catanzaro - AO “Pugliese - Ciaccio” Catanzaro, Italy
⁵⁴Unit of Obstetrics and Gynecology, University of Eastern Piedmont, Novara, Italy
⁵⁵Gynecology Unit, Ospedale Valduce, Como - ASST Lariana, S. Anna, Como, Italy

KMID: 2536015
DOI: http://doi.org/10.3802/jgo.2022.33.e10

Abstract

Objective
Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.
Methods
This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.
Results
Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).
Conclusion
Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

Keyword

Endometrial Cancer; COVID-19; Uterine cancer; SARS-CoV-2

Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Abstract

Keyword

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