The rapid spread of severe acute respiratory syndrome
coronavirus 2 infection and its related disease (COVID-19)
has required an immediate and coordinate healthcare
response to face the worldwide emergency and define
strategies to maintain the continuum of care for the
non-COVID-19 diseases while protecting patients and
healthcare providers. The dimension of the COVID-19
pandemic poses an unprecedented risk especially for the
more vulnerable populations. To manage patients with
cancer adequately, maintaining the highest quality of
care, a definition of value-based priorities is necessary
to define which interventions can be safely postponed
without affecting patients’ outcome. The European
Society for Medical Oncology (ESMO) has endorsed a
tiered approach across three different levels of priority
(high, medium, low) incorporating information on the
value-based prioritisation and clinical cogency of the
interventions that can be applied for different disease
sites. Patients with gynaecological cancer are at particular
risk of COVID-19 complications because of their age and
prevalence of comorbidities. The definition of priority
level should be based on tumour stage and histology,
cancer-related symptoms or complications, aim (curative
vs palliative) and magnitude of benefit of the oncological
intervention, patients’ general condition and preferences.
The decision-making process always needs to consider
the disease-specific national and international guidelines
and the local healthcare system and social resources,
and a changing situation in relation to COVID-19 infection.
These recommendations aim to provide guidance for the
definition of deferrable and undeferrable interventions
during the COVID-19 pandemic for ovarian, endometrial
and cervical cancers within the context of the ESMO
Clinical Practice Guidelines