Table 3.
The French consensus recommendations for classification and management in oncologic patients requiring surgical management of head and neck cancer during the COVID-19 pandemic [38].
| Group A | Group B | Group C | |
|---|---|---|---|
| Disease/condition | life-threatening conditions: -bleeding -dyspnea |
-HNSCC, - aggressive salivary glands, -aggressive skin cancers |
-slowly enlarging salivary glands carcinomas, - atypical masses localized in the salivary glands not clinically classified as malignant, -laryngeal leukoplakia, -well-differentiated cancers of the thyroid gland |
| Urgency of the surgery | immediate treatment is needed | delaying treatment for more than 4 weeks could negatively influence patients’ prognosis | delaying treatment for 1.5–2 months or more is considered not to have a negative influence on patients’ prognosis |
| Proceeding | nasopharyngeal swabs for SARS-CoV-2 detection using RT-PCR + chest CT should be performed within 24 h prior to the operation |
After the postponement duration: nasopharyngeal swabs for SARS-CoV-2 detection using RT-PCR + chest CT should be performed within 24 h prior to the operation |
After the postponement duration subjects should be evaluated to detect a possible rapid disease progression |
| Additional information | If RT-PCR and chest CT are not available, patient should be considered COVID-19 positive and further management of this individual must be adjusted for SARS-CoV-2 positive cases Patients who tested negative for SARS-CoV-2 must be managed with caution as the test may give false-negative result if performed on samples that did not comprise a sufficient amount of intact viral RNA |
Diagnostic imaging and pre-radiotherapy dental treatment, if required, should be done in a one-day hospitalization Urgent tracheostomy should be performed if absolutely necessary, in all other cases non-surgical alternative treatment was advised. |
HNSCC- head and neck squamous cell carcinoma.
SARS-CoV-2 - Severe Acute Respiratory Syndrome Coronavirus 2.
RT-PCT - real-time a reverse transcriptase-polymerase chain reaction.
CT – computed tomography.
RNA – ribonucleic acid.