{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T03:28:42Z","timestamp":1794281322490,"version":"4.9.0"},"reference-count":41,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The COVID-19 pandemic impacted health systems worldwide, particularly cancer care. Because the actual implications of these changes on gynecological oncology healthcare are still unclear, we aim to evaluate the impact of this pandemic on the diagnosis and management of gynecological cancer. Materials and Methods: This is a single-center retrospective observational study, including patients diagnosed with gynecological malignancies between January 2019 and December 2021. Patients were included into three groups based on the timing of cancer diagnosis: pre-pandemic (2019), pandemic with high restrictions (2020) and pandemic recovery (2021). Results: Overall, 234 patients were diagnosed with gynecological cancer during the period of study. A decrease in the number of newly diagnosed cervical cancers and other rare tumors (leiomyosarcoma, invasive hydatidiform mole) was apparent in 2020. Some aggressive histological types of endometrial and ovarian cancer were more commonly diagnosed in the pandemic recovery group (p &lt; 0.05), although no differences were demonstrated concerning tumor staging in all gynecological cancers. The median time between the first multidisciplinary team meeting and the treatment initiation was higher after the COVID-19 pandemic in endometrial cancer (23.0 vs. 34.0 vs. 36.0 days, p &lt; 0.05). Patients with ovarian cancer were more frequently proposed for neoadjuvant therapy in 2020 compared to the other periods (33.3% vs. 55.0% vs. 10.0% p &lt; 0.05). A significant reduction in the laparoscopic approach was observed during 2020 in endometrial cancer (32.1% vs. 14.3% vs. 36.4%, p &lt; 0.05). No significant differences were registered regarding median hospitalization days or intra- and post-operative complications between these periods. Conclusions: The COVID-19 pandemic had a significant impact on the diagnosis and management of most gynecological malignancies, namely, on time to first treatment, chosen oncological therapies and surgical approaches. These results suggest important clinical and healthcare implications that should be addressed in future prospective studies.<\/jats:p>","DOI":"10.3390\/medicina58121862","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T05:55:43Z","timestamp":1671429343000},"page":"1862","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of the COVID-19 Pandemic on Diagnosis and Management of Gynecological Cancer: A Single-Center Analysis"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9536-8243","authenticated-orcid":false,"given":"Dora","family":"Antunes","sequence":"first","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar e Universit\u00e1rio de Coimbra, Praceta Prof. Mota Pinto, 3004-561 Coimbra, Portugal"},{"name":"Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Celas, 3000-548 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisandra","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar Tondela-Viseu, Avenida Rei Dom Duarte, 3504-509 Viseu, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c2ngela","family":"Melo","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar Tondela-Viseu, Avenida Rei Dom Duarte, 3504-509 Viseu, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f3nia","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar Tondela-Viseu, Avenida Rei Dom Duarte, 3504-509 Viseu, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Nogueira Martins","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar Tondela-Viseu, Avenida Rei Dom Duarte, 3504-509 Viseu, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno","family":"Nogueira Martins","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Hospitalar Tondela-Viseu, Avenida Rei Dom Duarte, 3504-509 Viseu, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, September 21). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19\u201411 March 2020. Available online: https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/s41571-020-0370-6","article-title":"Provision of cancer care during the COVID-19 pandemic","volume":"17","author":"Spicer","year":"2020","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/S1470-2045(20)30240-0","article-title":"COVID-19: Impact on cancer workforce and delivery of care","volume":"21","author":"Mayor","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/ijgo.13868","article-title":"COVID-19 and the impact on gynecologic cancer care","volume":"155","author":"Manchanda","year":"2021","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/S1470-2045(20)30442-3","article-title":"COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: A prospective cohort study","volume":"21","author":"Lee","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S1470-2045(20)30096-6","article-title":"Cancer patients in SARS-CoV-2 infection: A nationwide analysis in China","volume":"21","author":"Landman","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_7","unstructured":"COVIDSurg Collaborative (2020). Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study. Lancet, 396, 27\u201338."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1136\/ijgc-2020-001634","article-title":"COVID-19 and gynecological cancer: A review of the published guidelines","volume":"30","author":"Uwins","year":"2020","journal-title":"Int. J. Gynecol. Cancer BMJ Publ. Group"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1002\/bjs.11670","article-title":"Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services","volume":"107","author":"Hallet","year":"2020","journal-title":"Br. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"COVIDSurg Collaborative, Bhangu, A., Lawani, I., Ng-Kamstra, J.S., Wang, Y., Chan, A., Futaba, K., Ng, S., Ebele, E., and Lederhuber, H. (2020). Global guidance for surgical care during the COVID-19 pandemic. Br. J. Surg., 107, 1097\u20131103.","DOI":"10.1002\/bjs.11646"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41571-020-00446-0","article-title":"Consequences of COVID-19 for cancer care\u2014A CRUK perspective","volume":"18","author":"Greenwood","year":"2021","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_12","unstructured":"(2020). COVIDSurg CollaborativeElective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br. J. Surg., 107, 1440\u20131449."},{"key":"ref_13","unstructured":"(2022, September 21). ESGO-ENGAGe SURVEY: Perspective of Gynecological Cancer Patients During COVID-19 Pandemia. Available online: https:\/\/engage.esgo.org\/esgo-engage-survey-perspective-gynecological-cancer-patients-covid-19-pandemia\/."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.ygyno.2020.09.005","article-title":"Gynecologic oncology care during the COVID-19 pandemic at three affiliated New York City hospitals","volume":"159","author":"Frey","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.ygyno.2020.12.013","article-title":"Maintaining surgical care delivery during the COVID-19 pandemic: A comparative cohort study at a tertiary gynecological cancer centre","volume":"160","author":"Leung","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.3802\/jgo.2020.31.e92","article-title":"Impact of COVID-19 in gynecologic oncology: A Nationwide Italian Survey of the SIGO and MITO groups","volume":"31","author":"Bogani","year":"2020","journal-title":"J. Gynecol. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s11864-021-00905-5","article-title":"COVID-19 and Gynecologic Oncology: What Have We Learned?","volume":"22","author":"Leibold","year":"2021","journal-title":"Curr. Treat. Options Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"359","DOI":"10.2147\/CMAR.S287152","article-title":"Impact of COVID-19 Pandemic on Ovarian Cancer Management: Adjusting to the New Normal","volume":"13","author":"Jacome","year":"2021","journal-title":"Cancer Manag. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.ijgo.2009.02.012","article-title":"Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium","volume":"105","author":"Pecorelli","year":"2009","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijgo.2013.10.001","article-title":"Staging classification for cancer of the ovary, fallopian tube, and peritoneum","volume":"124","author":"Prat","year":"2014","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/ijgo.12749","article-title":"Revised FIGO staging for carcinoma of the cervix uteri","volume":"145","author":"Bhatla","year":"2019","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Edge","year":"2017","journal-title":"CA Cancer, J. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100928","DOI":"10.1016\/j.gore.2022.100928","article-title":"Impact of the COVID-19 pandemic on referral to and delivery of gynecologic oncology care","volume":"39","author":"Bruce","year":"2022","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.ygyno.2022.02.013","article-title":"Impact of the COVID-19-pandemic on patients with gynecological malignancies undergoing surgery: A Dutch population-based study using data from the \u2018Dutch Gynecological Oncology Audit","volume":"165","author":"Algera","year":"2022","journal-title":"\u2019 Gynecol Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s13048-021-00784-2","article-title":"Challenges and opportunities for ovarian cancer management in the epidemic of Covid-19: Lessons learned from Wuhan, China","volume":"14","author":"Chen","year":"2021","journal-title":"J. Ovarian Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"725.e1","DOI":"10.1016\/j.ajog.2020.06.049","article-title":"Impact of the coronavirus disease 2019 pandemic on the quality of life for women with ovarian cancer","volume":"223","author":"Frey","year":"2020","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4274\/jtgga.galenos.2020.2020.0071","article-title":"Management of gynecological cancers in the COVID-19 era: A survey from Turkey","volume":"21","author":"Khatib","year":"2020","journal-title":"J. Turk. -Ger. Gynecol. Assoc."},{"key":"ref_28","unstructured":"Sundar, S., Wood, N., and Ghaem-Maghami, S. (2022, September 21). BGCS RCOG Framework for Care of Patients with Gynaecological Cancer during the COVID-19 Pandemic. Available online: https:\/\/www.bgcs.org.uk\/wp-content\/uploads\/2021\/07\/BGCS-Website-Post-Covid-Recommendations_July-2021.pdf."},{"key":"ref_29","unstructured":"Society of Gynecologic Oncology (2022, September 21). Gynecologic Oncology Considerations during the COVID-19 Pandemic. Available online: https:\/\/www.sgo.org\/resources\/gyn-onc-considerations-during-covid-19\/."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101729","DOI":"10.1016\/j.jogoh.2020.101729","article-title":"Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic\u2014FRANCOGYN group for the CNGOF","volume":"49","author":"Akladios","year":"2020","journal-title":"J. Gynecol. Obs. Hum. Reprod."},{"key":"ref_31","first-page":"A123.2","article-title":"594\u2005Impact of the covid pandemic on gynaecological cancer surgery\u2014Results from the covidsurg gynaecological cancer international study","volume":"30","author":"Sundar","year":"2020","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"735.e1","DOI":"10.1016\/j.ajog.2022.06.052","article-title":"Outcomes of gynecologic cancer surgery during the COVID-19 pandemic: An international, multicenter, prospective CovidSurg-Gynecologic Oncology Cancer study","volume":"227","author":"Fotopoulou","year":"2022","journal-title":"Am. J. Obs. Gynecol."},{"key":"ref_33","unstructured":"Royal College of Obstetricians and Gynaecologists, British Society for Gynaecological Endoscopy (2022, September 21). Joint RCOG\/BSGE Statement on Gynaecological Laparoscopic Procedures and COVID-19. Available online: https:\/\/www.bsge.org.uk\/wp-content\/uploads\/2020\/03\/Joint-RCOG-BSGE-Statement-on-gynaecological-laparoscopic-procedures-and-COVID-19.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.ygyno.2020.06.001","article-title":"When to Operate, Hesitate and Reintegrate: Society of Gynecologic Oncology Surgical Considerations during the COVID-19 Pandemic","volume":"158","author":"Fader","year":"2020","journal-title":"Gynecol. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1016\/j.jmig.2020.12.026","article-title":"Transmission of SARS-CoV-2 in Surgical Smoke during Laparoscopy: A Prospective, Proof-of-concept Study","volume":"28","author":"Bogani","year":"2021","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_36","unstructured":"(2022, September 22). ESGE Recommendations on Gynaecological Laparoscopic Surgery during COVID-19 Outbreak. Available online: https:\/\/www.esgo.org\/media\/2020\/04\/Covid19StatementESGE.pdf."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1200\/JCO.20.01933","article-title":"Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study","volume":"39","author":"Glasbey","year":"2021","journal-title":"J. Clin. Oncology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.3802\/jgo.2020.31.e69","article-title":"Recommendations for gynecologic cancer care during the COVID-19 pandemic","volume":"31","author":"Lee","year":"2020","journal-title":"J. Gynecol. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1136\/ijgc-2021-002784","article-title":"Impact of COVID-19 on medical treatment patterns in gynecologic oncology: A MITO group survey","volume":"31","author":"Cioffi","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_40","unstructured":"Cancer Research UK (2022, September 21). Cancer Research UK Cancer Patient Experience Survey 2020. The Impact of COVID-19 on Cancer Patients in the UK. Available online: https:\/\/www.cancerresearchuk.org\/sites\/default\/files\/pes_covid_2020.pdf."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1002\/cam4.3605","article-title":"Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe)","volume":"10","author":"Gultekin","year":"2021","journal-title":"Cancer Med."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1862\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:53Z","timestamp":1760146973000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1862"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":41,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["medicina58121862"],"URL":"https:\/\/doi.org\/10.3390\/medicina58121862","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]}}}