Sarcoma European and Latin American Network (SELNET) Recommendations on Prioritization in Sarcoma Care During the COVID-19 Pandemic

Javier Martin-Broto, Nadia Hindi, Samuel Aguiar, Ronald Badilla-González, Victor Castro-Oliden, Matias Chacón, Raquel Correa-Generoso, Enrique de Álava, Davide Maria Donati, Mikael Eriksson, Martin Falla-Jimenez, Gisela German, Maria Leticia Gobo Silva, Francois Gouin, Alessandro Gronchi, Juan Carlos Haro-Varas, Natalia Jiménez-Brenes, Bernd Kasper, Celso Abdon Lopes de Mello, Robert MakiPaula Martínez-Delgado, Hector Martínez-Said, Jorge Luis Martinez-Tlahuel, Jose Manuel Morales-Pérez, Francisco Cristobal Muñoz-Casares, Suely A Nakagawa, Eduardo Jose Ortiz-Cruz, Emanuela Palmerini, Shreyaskumar Patel, David S Moura, Silvia Stacchiotti, Marie Pierre Sunyach, Claudia M Valverde, Federico Waisberg, Jean-Yves Blay

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The COVID-19 outbreak has resulted in collision between patients infected with SARS-CoV-2 and those with cancer on different fronts. Patients with cancer have been impacted by deferral, modification, and even cessation of therapy. Adaptive measures to minimize hospital exposure, following the precautionary principle, have been proposed for cancer care during COVID-19 era. We present here a consensus on prioritizing recommendations across the continuum of sarcoma patient care.

MATERIAL AND METHODS: A total of 125 recommendations were proposed in soft-tissue, bone, and visceral sarcoma care. Recommendations were assigned as higher or lower priority if they cannot or can be postponed at least 2-3 months, respectively. The consensus level for each recommendation was classified as "strongly recommended" (SR) if more than 90% of experts agreed, "recommended" (R) if 75%-90% of experts agreed and "no consensus" (NC) if fewer than 75% agreed. Sarcoma experts from 11 countries within the Sarcoma European-Latin American Network (SELNET) consortium participated, including countries in the Americas and Europe. The European Society for Medical Oncology-Magnitude of clinical benefit scale was applied to systemic-treatment recommendations to support prioritization.

RESULTS: There were 80 SRs, 35 Rs, and 10 NCs among the 125 recommendations issued and completed by 31 multidisciplinary sarcoma experts. The consensus was higher among the 75 higher-priority recommendations (85%, 12%, and 3% for SR, R, and NC, respectively) than in the 50 lower-priority recommendations (32%, 52%, and 16% for SR, R, and NC, respectively).

CONCLUSION: The consensus on 115 of 125 recommendations indicates a high-level of convergence among experts. The SELNET consensus provides a tool for sarcoma multidisciplinary treatment committees during the COVID-19 outbreak.

IMPLICATIONS FOR PRACTICE: The Sarcoma European-Latin American Network (SELNET) consensus on sarcoma prioritization care during the COVID-19 era issued 125 pragmatical recommendations distributed as higher or lower priority to protect critical decisions on sarcoma care during the COVID-19 pandemic. A multidisciplinary team from 11 countries reached consensus on 115 recommendations. The consensus was lower among lower-priority recommendations, which shows reticence to postpone actions even in indolent tumors. The European Society for Medical Oncology-Magnitude of Clinical Benefit scale was applied as support for prioritizing systemic treatment. Consensus on 115 of 125 recommendations indicates a high level of convergence among experts. The SELNET consensus provides a practice tool for guidance in the decisions of sarcoma multidisciplinary treatment committees during the COVID-19 outbreak.

Original languageEnglish
Pages (from-to)e1562-e1573
Number of pages12
JournalThe oncologist
Volume25
Issue number10
DOIs
Publication statusE-pub ahead of print - Sep 5 2020

Keywords

  • COVID-19
  • Guidelines
  • Multidisciplinary
  • Patient care
  • Sarcoma

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