COVID‐19 and adnexal tumours: did the first year of the pandemic modify the care or the profile of our patients?

Abstract

Objectives Our objective is to analyse the impact of the pandemic on the diagnosis and treatment of adnexal tumours and on the support available to women living with the disease.

Methods We retrospectively analysed pre and post COVID-19 medical records of those patients submitted for adnexal tumour suspicious of malignancy or benign prior to surgery. Diagnosis and treatment algorithms did not change compared to previous ones. The explorations were performed by the same IOTA certified sonographer. The tumours were classified as low or high risk of malignancy by IOTA ADNEX and patients with low-risk tumours with non-surgical management were cited every 3 months.

Results We considered pre COVID-19 those patients from January/17 to December/19, and post COVID-19 those from January to December/20. 608 patients were included, 453 pre COVID-19 and 155 post COVID-19. During pre COVID-19 era, 67,5% (306) were classified as low risk tumours and 32,5% (147) high risk. 299 patients required surgery during this period: 66,8% (200) were benign, 8,6% (26) were stage I ovarian cancer, 14% (42) were stage II-IV, 2,6% (8) were metastasis and 7,3% (22) were borderline. During post COVID-19 era, 69,6% (108) were classified as low risk tumours and 30,4% (47) high risk. 103 patients required surgery during this period: 57,2% (59) were benign, 10,6% (11) were stage I ovarian cancer, 21,3% (22) were stage II-IV, 0,97% (1) were metastasis and 9,7% (10) were borderline.

Conclusions In our population, we haven't observed a decrease in the total number of patients referred as suspicious of ovarian cancer but we observed an increase of patients from emergency units. We objectified an increasing of stage I, stage II-IV and borderline tumours during the pandemic compared to the period before. We consider these findings to be related to the fears of the patients themselves about accessing medical assistance, since attending oncological or suspicious pathology remained an essential activity in our hospital. IOTA ADNEX allows us to discriminate between patients with high risks tumours and low risks tumour, which could have a non-surgical management.