Personalizing vulvar cancer workflow in COVID-19 era: a proposal from Vul.Can MDT
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ORIGINAL ARTICLE – CANCER RESEARCH
Personalizing vulvar cancer workflow in COVID‑19 era: a proposal from Vul.Can MDT Giorgia Garganese1,2 · Luca Tagliaferri3 · Simona Maria Fragomeni2 · Valentina Lancellotta3 · Giuseppe Colloca3 · Giacomo Corrado2 · Stefano Gentileschi4,5 · Gabriella Macchia6 · Enrica Tamburrini7 · Maria Antonietta Gambacorta3,8 · Anna Fagotti2,9 · Giovanni Scambia2,9 · Gemelli Vul.Can MDT Received: 16 May 2020 / Accepted: 3 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 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. Keywords Vulvar neoplasms · COVID-19 · Workflow · Patient care · Treatment
Background The outbreak of the novel Coronavirus disease 2019 (COVID-19), consisting in a severe acute respiratory syndrome often associated to multiple organ dysfunction, has rapidly spread globally, being declared a pandemic by the
Giorgia Garganese and Luca Tagliaferri contributed equally to this work and share the first authorship. * Simona Maria Fragomeni [email protected] Extended author information available on the last page of the article
World Health Organization (WHO) on 11 March (Coronavirus disease 2019). The risk to develop a severe illne
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