ISSPP members are currently faced in their daily practice with an increasing lack of resources for treating patients with peritoneal and pleural metastasis. This concerns in particular limited access to intensive postoperative care, but also lacking operating room capacities for elective surgery.
ISSPP, as a young and emerging society, has no authority to provide its own recommendations in this difficult situation. However, ISSPP would like to support her members by facilitating access to the most recent recommendations in the field. Against this framework, ISSPP endorses a recommendation published on March 23rd, 2020 in the New England Journal of Medicine: “There should be no difference in allocating scarce resources between patients with Covid-19 and those with other medical conditions. If the Covid-19 pandemic leads to absolute scarcity, that scarcity will affect all patients, including those with heart failure, cancer, and other serious and life-threatening conditions requiring prompt medical attention. Fair allocation of resources that prioritizes the value of maximizing benefits applies across all patients who need resources.”
Concerning patients with peritoneal metastasis, is important to note that systemic chemotherapy is commonly associated with some degree of impairment in the adaptive immune response, which could favor severe course of disease after Covid-19 exposure. Whereas some loco-regional approaches such as laparoscopic HIPEC or PIPAC might circumvent these challenges to some degree, they are not available everywhere and their additional benefit in a pandemia situation is hypothetical.
Further information:
US recommendations (NCCN) please click here
US recommendations (ACS) please click here
Italian recommendations (SIAARTI) please click here
French recommendations (SNFGE) please click here
French surgical recommendations please JVisSurg Covid-19 Oncological surgery
French RENAPE group recommendations please click here
German recommendations (DGAV) please click here
ISSPP would be happy to add further recommendations, in particular from Asia and from emerging countries, and to post them on this website. If you can provide such validated recommendation, please contact secretary@isspp.org
