Impact of the COVID-19 Pandemic on Gynecologic Oncology Surgical Treatment Modifications in Tertiary Cancer Centers of Bangladesh

Author(s): Shirin Akter Begum, Mehriban Amatullah, Tasfia Mahmud, Farhana Khatoon, Afroza Khanom, Rowson Ara, Asma Akter Sonia, Razia Sultana, Rahima Khatun

Introduction: Global healthcare has changed dramatically as a result of the COVID-19 epidemic. The effect of these modifications on the treatment of gynecological cancer is yet largely unknown. However, due to the panic created among the patients and the adverse situation prevailing during the pandemic, many patients refrained from taking the treatment and in many cases, the surgical treatment had to be modified. This study aimed to evaluate the impact of the COVID-19 pandemic on patients with gynecological malignancies undergoing different oncology treatments. Methods: This prospective study was conducted in the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University and National Institute of Cancer Research & Hospital, Dhaka, Bangladesh from March 2020 to December 2022. Our study included 143 patients with gynaecological malignancies scheduled to receive surgical treatment. Result: The study showed that during the pandemic period, a sizable proportion of patients 43.4% scheduled for surgical treatment lost to follow-up leaving 56.6% to receive treatment with some modifications from the planned treatment. The differences between the scheduled and the observed treatment in cases of three major gynaecological malignancies (endometrial, cervical, and ovarian cancers) were not statistically significant (p = 0.997, p = 0.986, and p = 0.999 respectively). Conclusion: The study concluded that surgical volume for gynaecological cancer dropped considerably, and during the pandemic to avoid surgery, radiotherapy was done. Over half of the patients received the care. However, the pattern of care they received differed in many cases from what was originally planned.

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