Upper Gastrointestinal Cancer Management in the COVID-19 Era: Risk of Infection, Adapted Role of Endoscopy, and Potential Treatment Algorithm Alterations.

The safety of upper gastrointestinal cancer patients in the SARS-CoV-2 outbreak is extremely important and most surgeons need to establish a contingency management. In this study, we present the surgical outlines of patients suffering from upper gastrointestinal cancers. Data were obtained from PubMed, Cochrane Database of Controlled Trials, and SCOPUS of reports up to September 2020. The COVID-19 outbreak makes surgical procedures extremely difficult to be performed. The most common criteria to prioritize patients for surgical treatment are stage, tumor biology, presence of tumor-related symptoms, the risk of tumor to become non-resectable, and time interval from neoadjuvant therapy. The multidisciplinary teams can help assigning a priority level to each clinical case. We have to continue providing treatment to oncologic patients in the face of COVID-19 uncertainty, with higher caution and responsibility in order to develop a safer and more effective personalized treatment plan.