Table 2.
Agreement percentage by country according to survey question.
| Question | Agreement (%) | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MX | BR | CO | AR | CL | PE | VE | CR | BO | PA | UY | GT | EC | SV | Overall | |
| 1. Do you consider that patients with a high suspicion of gynecological neoplasia (adnexal mass) or with confirmed histological diagnosis of gynecological cancer should be evaluated in person for the first time? 11 | 92.9 | 97.7 | 93.8 | 89.1 | 92.7 | 90.3 | 100.0 | 82.4 | 81.3 | 100.0 | 91.7 | 100.0 | 85.7 | 100.0 | 93.4 |
| 2. Do you consider that review of pathology reports after surgery for gynecological cancer should be evaluated in person? 11 | 36.1 | 81.1 | 46.9 | 28.1 | 24.4 | 22.6 | 25.0 | 17.6 | 18.8 | 50.0 | 41.7 | 45.5 | 14.3 | 14.3 | 43.6 |
| 3. Do you think that patients diagnosed with gynecological neoplasia should be contacted by teleconsultation for post‐treatment follow‐up, queried about symptoms that may lead to suspicion of recurrent disease and, if present, direct them to physical examination and paraclinical tests to rule out tumor relapse? 12 | 96.8 | 90.2 | 98.8 | 93.8 | 95.1 | 90.3 | 95.8 | 94.1 | 93.8 | 100.0 | 100.0 | 90.9 | 85.7 | 100.0 | 94.6 |
| 4. Do you think that patients diagnosed with gynecological neoplasia should be contacted by teleconsultation for post‐treatment follow‐up, queried about symptoms that may lead to suspicion of recurrent disease and, in the event of no symptoms, schedule the next visit in 3 mo, after the pandemic is controlled, to continue institutional monitoring? 12 | 96.8 | 91.7 | 97.5 | 93.8 | 100.0 | 96.8 | 95.8 | 94.1 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 95.9 |
| 5. Do you think that teleconsultation should be carried out by the gynecologist‐oncologist who treats at the institutions? 11 , 12 | 96.1 | 90.9 | 97.5 | 96.9 | 82.9 | 93.5 | 100.0 | 76.5 | 81.3 | 100.0 | 100.0 | 100.0 | 100.0 | 85.7 | 93.6 |
| 6. If you consider that the patient should be evaluated in person, do you suggest that a triage should be done by teleconsultation to screen for a suspected case of COVID‐19, according to current epidemiological criteria? 11 | 96.1 | 89.4 | 96.3 | 95.3 | 97.6 | 96.8 | 87.5 | 100.0 | 100.0 | 100.0 | 83.3 | 100.0 | 100.0 | 100.0 | 94.6 |
| 7. Do you agree that patients presenting with cervicovaginal cytology who report a low‐grade lesion with or without an HPV‐DNA (+) test could be deferred for colposcopic evaluation for at least 6 mo? 13 | 96.8 | 90.2 | 100.0 | 98.4 | 100.0 | 93.5 | 100.0 | 88.2 | 100.0 | 91.7 | 100.0 | 90.9 | 85.7 | 100.0 | 95.7 |
| 8. Do you agree that patients presenting with cervicovaginal cytology reporting a high‐grade epithelial lesion with or without an HPV‐DNA (+) test could be deferred for colposcopic evaluation for 3 mo? 13 | 71.0 | 65.9 | 86.4 | 73.4 | 75.6 | 74.2 | 70.8 | 58.8 | 75.0 | 83.3 | 66.7 | 90.9 | 85.7 | 57.1 | 73.0 |
| 9. Do you agree that for patients who present a biopsy with CIN II‐III, or adenocarcinoma in situ, without suspected infiltration, excision management could be delayed for 3 mo? 13 | 64.5 | 46.2 | 81.5 | 71.9 | 78.0 | 64.5 | 66.7 | 47.1 | 56.3 | 75.0 | 58.3 | 90.9 | 71.4 | 57.1 | 64.4 |
| 10. Do you agree that for patients who present a biopsy with a high‐grade lesion and suspected microinvasion on colposcopy, excision management could be delayed for a maximum of 1 mo? 13 | 80.0 | 80.3 | 84.0 | 84.4 | 87.8 | 74.2 | 79.2 | 82.4 | 93.8 | 100.0 | 83.3 | 90.9 | 85.7 | 100.0 | 82.6 |
| 11. Do you agree that for patients who present a lack of correlation between cytology/colposcopy/biopsy result or a positive endocervical curettage, excision management could be delayed for 3 mo? 13 | 73.5 | 46.2 | 88.9 | 71.9 | 80.5 | 61.3 | 66.7 | 76.5 | 75.0 | 83.3 | 58.3 | 90.9 | 57.1 | 71.4 | 69.2 |
| 12. Do you agree to offer primary treatment with radiotherapy (+concomitant chemotherapy) to a postmenopausal patient (>50 y) with early stage cervical cancer, with a visible lesion or with postconization positive margins, who would normally be a candidate for surgical management? 14 | 38.1 | 31.1 | 54.3 | 37.5 | 43.9 | 48.4 | 29.2 | 35.3 | 75.0 | 75.0 | 25.0 | 45.5 | 28.6 | 85.7 | 41.1 |
| 13. Do you agree to defer minimum definitive treatment by 3 mo for a patient with cervical cancer with postconization negative margins, or with a biopsy diagnosis without a visible cervical disease, with no desire to preserve fertility, with no suspicion of lymph node involvement by imaging? 15 , 16 | 85.2 | 67.4 | 85.2 | 84.4 | 63.4 | 80.6 | 62.5 | 82.4 | 100.0 | 91.7 | 75.0 | 100.0 | 100.0 | 100.0 | 79.5 |
| 14. Do you agree that it is not necessary to perform laparoscopic surgical staging in patients with locally advanced cervical cancer before treatment with chemoradiotherapy? 17 | 92.3 | 90.9 | 97.5 | 96.9 | 90.2 | 87.1 | 95.8 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | 93.9 |
| 15. Do you agree not to schedule surgery for patients with central recurrence of cervical cancer with more than a 6‐mo disease‐free period (candidates for exenteration) and instead refer them to clinical oncology for chemotherapy treatment? 18 | 78.7 | 50.8 | 80.2 | 84.4 | 82.9 | 83.9 | 70.8 | 82.4 | 81.3 | 100.0 | 75.0 | 90.9 | 100.0 | 1000 | 74.9 |
| 16. Do you agree that for patients with apparent advanced ovarian epithelial cancer who have ascites and carcinomatosis, CA 125 elevation, with pathology demonstrated by cytology or by cutting needle biopsy (if possible, not laparoscopic Fagotti triage), it is preferable to use neoadjuvant chemotherapy with carboplatin–paclitaxel for 3–4 cycles, and then interval surgery, according to clinical and imaging evolution? 19 | 98.7 | 94.7 | 95.1 | 92.2 | 97.6 | 90.3 | 95.8 | 94.1 | 93.8 | 91.7 | 100.0 | 90.9 | 100.0 | 100.0 | 95.6 |
| 17. Do you agree that in platinum‐sensitive patients with current recurrence of more than one site, platinum‐based chemotherapy (with or without bevacizumab) is recommended, rather than secondary cytoreduction? 20 | 89.7 | 83.3 | 96.3 | 96.9 | 97.6 | 80.6 | 83.3 | 100.0 | 87.5 | 100.0 | 83.3 | 100.0 | 100.0 | 85.7 | 90.3 |
| 18. Do you agree that patients with pelvic masses and suspected ovarian cancer should be selected by gynecologic oncologists? Those with a significant risk of malignancy, based on clinical criteria, images and available markers, will undergo surgery with frozen section biopsy (according to the availability of this service). Others will be managed by gynecologists and obstetricians 21 , 22 | 91.0 | 75.8 | 93.8 | 79.7 | 87.8 | 93.5 | 91.7 | 100.0 | 75.0 | 100.0 | 83.3 | 100.0 | 85.7 | 85.7 | 86.7 |
| 19. Do you agree that all patients with presumed early stage endometrial cancer receive exclusive initial management with total hysterectomy and bilateral salpingo‐oophorectomy with or without sentinel lymph node (according to availability) and define adjuvant treatment with uterine histopathological features? 23 , 24 | 82.6 | 87.9 | 90.1 | 84.4 | 82.9 | 77.4 | 83.3 | 94.1 | 81.3 | 91.7 | 91.7 | 81.8 | 85.7 | 85.7 | 85.4 |
| 20. Do you agree to defer hysterectomy + adnexectomy in patients with endometrial cancer FIGO Stage I without myometrial invasion on MRI, offering them temporary hormonal management with levonorgestrel IUDs (when the resource is available) or oral hormone therapy? 25 , 26 | 76.8 | 58.3 | 65.4 | 81.3 | 78.0 | 71.0 | 50.0 | 70.6 | 75.0 | 91.7 | 41.7 | 81.8 | 71.4 | 71.4 | 69.8 |
| 21. Do you agree that patients with advanced stage endometrial cancer (Stage III) undergoing surgical management are provided sequential adjuvant therapy initially with radiotherapy and later with chemotherapy, but chemotherapy differs for grade 1 and 2 during the pandemic? 23 , 27 , 28 | 76.8 | 53.0 | 74.1 | 67.2 | 68.3 | 74.2 | 83.3 | 58.8 | 87.5 | 58.3 | 41.7 | 90.9 | 71.4 | 71.4 | 68.7 |
| 22. Would you consider it appropriate to offer hormonal management in palliative patients with endometrioid FIGO grade 1 and 2 relapse without acute symptoms, while medical treatment with chemotherapy or radiotherapy (as appropriate) could be started after pandemic control? 29 | 94.8 | 73.5 | 97.5 | 92.2 | 95.1 | 90.3 | 95.8 | 82.4 | 93.8 | 100.0 | 83.3 | 100.0 | 100.0 | 100.0 | 89.8 |
Abbreviations: AR, Argentina, CL, Chile; BO, Bolivia; BR, Brazil; CO, Colombia; CR, Costa Rica; EC, Ecuador; GT, Guatemala; MX, Mexico; PA, Panamá; PE, Perú; SV, El Salvador; UY, Uruguay; VE, Venezuela.