COVID-19 and Ovarian Cancer: Shared Experiences From Japan and Korea
Posted: Tuesday, June 23, 2020
Management of women with ovarian cancer is being amended in different countries due to the COVID-19 pandemic. Jae-Weon Kim, MD, PhD, of the Department of Obstetrics and Gynecology, Seoul, and colleagues, shared the management courses of several gynecologic cancer cases in Japan and Korea to assist both patients and health-care providers globally.
“Guidelines allow to consider extending the chemotherapy plan to six cycles before the interval cytoreductive surgery in women who have already started neoadjuvant chemotherapy despite no high-level evidence supporting this,” the authors reported. However, “five cycles of adjuvant chemotherapy after optimal cytoreductive surgery without residual tumor might not damage the survival outcomes expected for this stage.”
The consensus in both Japan and Korea has been to discontinue neoadjuvant chemotherapy and follow-up with maintenance in patients who may test positive for COVID-19. In some cases, therapy may be continued after a 14-day isolation period and a negative COVID-19 status. However, the investigators proposed that five cycles of neoadjuvant chemotherapy may be enough following optimal cytoreductive surgery without reducing survival outcomes for patients. Therefore, they suggest modifying the treatment regimen based on the severity of the ovarian cancer to provide the most therapeutic benefit for patients.
The case studies also revealed clinical findings diagnostic of COVID-19 pneumonia consistent with a report of 101 cases from China. These diagnostic criteria included ground-glass opacities (86%), consolidations (64.4%), reticulations (48.5%), as well as bilateral (87.1%) and peripheral (82.2%) lesions predominantly in the lower lung (54.5%). Although these findings were common among patients, “whether a patient has COVID-19 should be determined comprehensively by interview, general condition, oxygen saturation, blood test, chest CT scan, and, if in doubt, by polymerase chain reaction testing,” advised Dr. Kim and colleagues.
Disclosure: The study authors reported no conflicts of interest.