ESMO management and treatment adapted recommendations in the COVID-19 era: Gynaecological malignancies

Ilaria Colombo, Eleonora Zaccarelli, Maria Del Grande, Federica Tomao, Francesco Multinu, Ilaria Betella, Jonathan A. Ledermann, Antonio Gonzalez-Martin, Cristiana Sessa, Nicoletta Colombo

Research output: Contribution to journalReview articlepeer-review


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.

Original languageEnglish
Article numbere000827
JournalESMO Open
Publication statusPublished - Jul 27 2020


  • cervical cancer
  • COVID-19
  • endometrial cancer
  • ovarian cancer
  • value-based priorities

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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