Background: The COVID-19 pandemic has put enormous pressure on hospital resources, and has affected all aspects of patient care. As operative volumes decrease, cancer surgeries must be triaged and prioritized with careful thought and attention to ensure maximal benefit for the maximum number of patients. Peritoneal malignancies present a unique challenge, as surgical management can be resource intensive, but patients have limited non-surgical treatment options. This review summarizes current data on outcomes and resource utilization to help inform decision-making and case prioritization in times of constrained health care resources. Methods: A rapid literature review was performed, examining surgical and non-surgical outcomes data for peritoneal malignancies. Narrative data synthesis was cross-referenced with relevant societal guidelines. Peritoneal malignancy surgeons and medical oncologists reviewed recommendations to establish a national perspective on case triage and mitigating treatment strategies. Results and Conclusions: Triage of peritoneal malignancies during this time of restricted health care resource is nuanced and requires multidisciplinary discussion with consideration of individual patient factors. Prioritization should be given to patients where delay may compromise resectability of disease, and where alternative treatment options are lacking. Mitigating strategies such as systemic chemotherapy and/or surgical deferral may be utilized with close surveillance for disease stability or progression, which may affect surgical urgency. Unique hospital capacity, and ability to manage the complex post-operative course for these patients must also be considered to ensure patient and system needs are aligned.

中文翻译：

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在卫生保健资源限制期间治疗腹膜恶性肿瘤的循证策略：COVID-19 大流行

背景：COVID-19 大流行给医院资源带来了巨大压力，并影响了患者护理的方方面面。随着手术量的减少，必须仔细考虑和关注癌症手术的分类和优先级，以确保为最大数量的患者带来最大利益。腹膜恶性肿瘤提出了独特的挑战，因为手术治疗可能需要大量资源，但患者的非手术治疗选择有限。本综述总结了有关结果和资源利用的当前数据，以帮助在医疗资源有限的情况下为决策和病例优先排序提供信息。方法：进行快速文献回顾，检查腹膜恶性肿瘤的手术和非手术结果数据。叙事数据合成与相关的社会指南相互参照。腹膜恶性肿瘤外科医生和医学肿瘤学家审查了建议，以建立国家对病例分类和缓解治疗策略的看法。结果和结论：在医疗资源有限的这段时间内，腹膜恶性肿瘤的分类是微妙的，需要多学科讨论并考虑到个体患者的因素。应优先考虑延迟可能影响疾病可切除性以及缺乏替代治疗方案的患者。可以使用全身化疗和/或手术延期等缓解策略，密切监测可能影响手术紧迫性的疾病稳定性或进展情况。独特的医院容量，