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1.
Anticancer Res ; 44(6): 2645-2652, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38821579

RESUMEN

BACKGROUND/AIM: The COVID-19 pandemic brought unprecedented global changes, necessitating adjustments to address public health challenges. The impact on advanced epithelial ovarian cancer (EOC) surgery, marked by increased perioperative risks, and changes in management plans was explored in this study based on promptly published British Gynaecologic Cancer Society (BGCS) and European Society of Gynaecologic Oncology (ESGO) guidelines. PATIENTS AND METHODS: Retrospective data from 332 patients with advanced EOC who underwent cytoreductive surgery at a UK tertiary center were analyzed, and the outcomes were compared between pre-COVID-19 (2018-2019) (n=189) and COVID-19 era (2020-2021) (n=143) cohorts, covering the same timeframe (March to December). Primary outcomes included residual disease (RD) and progression-free survival (PFS), while secondary outcomes were the ESGO quality indicators (QIs) for advanced EOC surgery. Kaplan-Meier curves were produced to illustrate PFS. RESULTS: Complete cytoreduction rates remained comparable at 74.07% and 72.03% for pre-COVID-19 and COVID-19 groups, respectively. Differences were observed in ECOG performance status (p=0.015), Intensive Care Unit (ICU) admissions (p=0.039) with less interval debulking surgeries (p=0.03), lower surgical complexity scores (p=0.02), and longer operative times in the COVID-19 group (p=0.01) compared to the pre-COVID-19 group. The median PFS rates were 37 months and 34 months in the pre-COVID-19 and COVID-19 groups, respectively (p=0.08). The surgical QIs 1-3 remained uncompromised during the COVID-19 era. CONCLUSION: Management modifications prompted by the COVID-19 pandemic did not adversely impact cytoreduction rates or PFS.


Asunto(s)
COVID-19 , Carcinoma Epitelial de Ovario , Procedimientos Quirúrgicos de Citorreducción , Neoplasias Ováricas , Humanos , Femenino , COVID-19/epidemiología , Procedimientos Quirúrgicos de Citorreducción/métodos , Persona de Mediana Edad , Neoplasias Ováricas/cirugía , Neoplasias Ováricas/patología , Estudios Retrospectivos , Anciano , Carcinoma Epitelial de Ovario/cirugía , Carcinoma Epitelial de Ovario/patología , Adulto , SARS-CoV-2 , Supervivencia sin Progresión , Neoplasia Residual , Anciano de 80 o más Años , Resultado del Tratamiento , Reino Unido
2.
J Pers Med ; 12(3)2022 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-35330419

RESUMEN

Vitamin D has known immunomodulatory activity and multiple indications exist supporting its potential use against SARS-CoV-2 infection in the setting of the current pandemic. The purpose of this systematic review is to examine the efficacy of vitamin D administered to adult patients following COVID-19 diagnosis in terms of length of hospital stay, intubation, ICU admission and mortality rates. Therefore, PubMed and Scopus databases were searched for original articles referring to the aforementioned parameters. Of the 1376 identified studies, eleven were finally included. Vitamin D supplements, and especially calcifediol, were shown to be useful in significantly reducing ICU admissions and/or mortality in four of the studies, but not in diminishing the duration of hospitalization of COVID-19 patients. Due to the large variation in vitamin D supplementation schemes no absolute conclusions can be drawn until larger randomized controlled trials are completed. However, calcifediol administered to COVID-19 patients upon diagnosis represents by far the most promising agent and should be the focus of upcoming research efforts.

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