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Information Journal Paper

Title

Protocol for Dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Institute of Tehran University of Medical Sciences

Pages

  187-192

Abstract

 Background: In March 2020, the World Health Organization (WHO) declared the novel COVID-19 infection a pandemic. Among high-risk patients infected by the virus, upper gastrointestinal cancer patients, similar to other immunosuppressed patients, are vulnerable to developing more severe infections. Most of the routine activities of medical centers, especially Cancer Surgery Centers worldwide, are affected by the epidemic. Thus, some modifications are needed to adjust international protocols to deal with Upper Gastrointestinal Cancers worldwide. Methods: The headings of upper gastrointestinal cancer management protocols have been discussed among the university-affiliated professors in different disciplines involved in upper gastrointestinal cancer management at the first peak of COVID-19 in Iran in March 2020. The discussions were done through an interactive application (WhatsApp and Telegram) in which participants considered the headlines and the latest news about COVID-19. Under each heading, we provide the consensus of all members in the related disciplines. Recommendations and Conclusion: All members agreed to choose the most effective and the least hazardous recommendations regarding patients and medical staff in each specialty. The members understand that some recommendations may intervene with the standard best practice and reduce the best outcome that the patient can gain with standard management. Therefore, these recommendations are legitimate simply at the peak of the epidemic COVID-19 situation or the surge of any other unknown situations that we may encounter in the future. According to the consensus of cancer surgery professors in several Cancer Surgery Centers, patients with T1 and T2 gastric cancer without lymph node involvement should undergo upfront surgery. Patients with T3 or more and/or lymph node involvement will have total neoadjuvant chemotherapy, and the surgery should be delayed until the end of the COVID-19 peak. Diagnostic laparoscopy should be postponed during the peak of COVID-19 till after the completion of neoadjuvant chemotherapy. Upfront surgery should be performed in patients with esophageal cancer (adenocarcinoma or SCC) with T1 or T2 and without lymph node involvement. In patients with T3 or more and/or lymph node involvement, neoadjuvant chemoradiotherapy (CRT) is recommended. Endoscopic stent placement is preferred for patients who complete neoadjuvant CRT during the peak of COVID 19 and have severe dysphagia. A PET-CT scan will be performed in patients without dysphagia. In the status of high uptake, surgery is reasonable, but in low uptake status without any dysphagia, only conservation is our suggestion.

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    Cite

    APA: Copy

    Farahzadi, Athena, MAHMOODZADEH, HABIBOLLAH, Hadjilooei, Farimah, Miri, Seyed Rouhollah, & Khoshdani Farahani, parham. (2021). Protocol for Dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Institute of Tehran University of Medical Sciences. BASIC & CLINICAL CANCER RESEARCH, 13(3), 187-192. SID. https://sid.ir/paper/1004057/en

    Vancouver: Copy

    Farahzadi Athena, MAHMOODZADEH HABIBOLLAH, Hadjilooei Farimah, Miri Seyed Rouhollah, Khoshdani Farahani parham. Protocol for Dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Institute of Tehran University of Medical Sciences. BASIC & CLINICAL CANCER RESEARCH[Internet]. 2021;13(3):187-192. Available from: https://sid.ir/paper/1004057/en

    IEEE: Copy

    Athena Farahzadi, HABIBOLLAH MAHMOODZADEH, Farimah Hadjilooei, Seyed Rouhollah Miri, and parham Khoshdani Farahani, “Protocol for Dealing with Upper Gastrointestinal Cancers in the COVID-19 Outbreak in Cancer Institute of Tehran University of Medical Sciences,” BASIC & CLINICAL CANCER RESEARCH, vol. 13, no. 3, pp. 187–192, 2021, [Online]. Available: https://sid.ir/paper/1004057/en

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