446 Impact of COVID-19 pandemic on gynaecological oncology healthcare in the Netherlands: data from the prospective dutch gynaecological oncology audit

Abstract

Introduction/Background ∗ The COVID-19 pandemic caused drastic healthcare changes worldwide. To date, the impact of these pandemic-induced alterations in gynaecological oncology healthcare is unknown. We assessed the impact of the COVID-19 pandemic on gynaecological oncology healthcare in the Netherlands by analysing data of the Dutch Gynaecological Oncology Audit (DGOA). Methodology All patients in The Netherlands undergoing surgery for ovarian, vulvar, endometrial or cervical cancer are registered in the DGOA since 2014. To evaluate whether the COVID-19 pandemic influenced care, we compared the following parameters that are available in the DGOA: surgical volume, time to first treatment (TTFT), length of hospital stay (LOHS), postoperative complications and 30-day mortality. Four periods were identified in 2020 based on incidence of COVID-19 infections in The Netherlands: 'Pre-COVID-19', 'First wave', 'Interim period' and 'Second wave'. Using descriptive statistics, results from 2020 were compared with the same four periods of 2018-2019 combined. Result(s)∗ A total of 12.447 surgical procedures were analysed. Analysing the four periods in 2020, compared to the average volumes of 2018-2019, the surgical volume for the four tumour types decreased during the first COVID-19 wave and interim period (figure 1). This was due to a decrease in surgical volume for cervical cancer only (17.2% in 2020), while volumes for ovarian, vulvar and endometrial cancer remaining stable. Moreover, during the interim period, only 51% of the expected cervical cancer procedures were performed. A significantly shorter median TTFT was observed in all four malignancies in 2020, compared to 2018-2019 (table 1). No differences in LOHS, postoperative complications and 30-day mortality were observed (table 1). Conclusion∗ The COVID-19 pandemic clearly impacted gynaecological oncology healthcare in The Netherlands. During the first COVID-19 wave, surgical volume for gynaecological oncological procedures dropped considerably, mainly due to a substantial drop in surgical volume for cervical cancer. This is probably caused by the temporary interruption of the population screening program. During the COVID-19 pandemic, waiting time to start therapy was shorter. The quality of perioperative healthcare was not negatively impacted by the pandemic.