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Xiong DD, Bordeaux J. The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and outcomes of invasive cutaneous melanoma: A retrospective national cohort study. J Am Acad Dermatol 2023; 89:1167-1176. [PMID: 37625699 DOI: 10.1016/j.jaad.2023.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/24/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Prior multiinstitutional studies demonstrate that patients diagnosed with melanoma during the Coronavirus Disease 2019 (COVID-19) pandemic presented with more advanced melanomas. OBJECTIVES To further characterize patients diagnosed with melanoma during the COVID-19 pandemic. METHODS Retrospective population-based cohort study of the Surveillance, Epidemiology, and End-Results (SEER) registry of patients diagnosed with cutaneous melanoma from 2018-2020. RESULTS Patients diagnosed with melanoma in 2020 were more likely to have increased Breslow depth, more ulceration, nodular tumors, and more advanced stage at diagnosis despite less treatment delays. Patients tended to be from wealthier, more urban areas. Primary surgical treatment was more likely to be with Mohs surgery. Diagnosis in the year 2020 was not correlated with overall or disease specific survival. LIMITATIONS This is a retrospective cohort review and limited by short follow-up times, which could affect survival outcomes. There was a 15.5% drop in melanoma diagnosis in 2020 compared to prior years, which could relate to delayed presentation. CONCLUSIONS AND RELEVANCE Patients diagnosed with melanoma in 2020 tended to have thicker, more ulcerated, and more advanced tumors, but this was not associated with survival. Further studies are needed to characterize outcomes for patients diagnosed with melanoma during the COVID-19 pandemic.
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Affiliation(s)
- David D Xiong
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Jeremy Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio
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2
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Shannon AB, Karakousis GC. The impact of the COVID-19 pandemic on new diagnoses of melanoma: A response to additional multi-institution and international reports. J Am Acad Dermatol 2023; 89:e221-e222. [PMID: 37094655 DOI: 10.1016/j.jaad.2023.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/25/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Adrienne B Shannon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Giorgos C Karakousis
- Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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3
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Pauvels LSP, Fiegenbaum AB, Bakos RM. Skin cancer characteristics during the first year of the COVID-19 pandemic at a tertiary hospital in Latin America. Int J Dermatol 2023; 62:1378-1383. [PMID: 37737439 DOI: 10.1111/ijd.16848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND The influence of the novel human coronavirus disease (COVID-19) pandemic on skin cancer characteristics in Latin America is still poorly elucidated. METHODS This was a cross-sectional study which included patients diagnosed with skin cancer (basal cell carcinoma [BCC], cutaneous squamous cell carcinoma [cSCC], and primary cutaneous melanoma [cMM]) during the first year of the COVID-19 pandemic (from March 1, 2020, to February 28, 2021) and the preceding year at our institution. The total number of skin cancer diagnoses and surgeries, as well as their topography, clinicopathological staging at diagnosis, and treatment delay were compared between the two periods. RESULTS There was a 31.8% reduction in skin cancer diagnoses during the first year of the COVID-19 pandemic at our institution. There was an increase in the proportion of low-risk cancers according to the NCCN guidelines for BCCs (40.8-49%, P < 0.001) and cSCCs (41.7-49.6%, P = 0.03), but there was no difference in the distribution of other staging systems for the three types of cancer. We also found a significant reduction in surgeries for BCCs (-57.6%, P < 0.001) and cSCCs (-44.7%, P < 0.001) but not for cMM. CONCLUSIONS The first year of the COVID-19 pandemic was associated with reduced numbers of skin cancer diagnoses and surgeries at our institution. This study provides an assessment of skin cancer characteristics during the first year of the pandemic in the Latin American population.
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Affiliation(s)
- Lucas S P Pauvels
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Arthur B Fiegenbaum
- Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato M Bakos
- Department of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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4
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Drumm C, Griffin C, Van Baarsel S, Quigley C, Madden S, Naidoo J, Eustace K. Response to Trepanowski et al's "Delays in melanoma presentation during the COVID-19 pandemic: a nationwide multi-institutional cohort study". J Am Acad Dermatol 2023; 89:e223-e224. [PMID: 37088198 PMCID: PMC10165503 DOI: 10.1016/j.jaad.2023.02.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/08/2023] [Accepted: 02/19/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Claire Drumm
- Department of Dermatology Connolly Hospital Blanchardstown, Dublin, Ireland.
| | - Ciara Griffin
- Department of Plastic Surgery, Connolly Hospital Blanchardstown, Dublin, Ireland
| | | | - Claire Quigley
- Department of Dermatology, Beaumont Hospital, Dublin, Ireland
| | - Stephen Madden
- Department of Biostatistics, Royal College of Surgeons, Dublin, Ireland
| | | | - Karen Eustace
- Department of Dermatology Connolly Hospital Blanchardstown, Dublin, Ireland; Department of Dermatology, Beaumont Hospital, Dublin, Ireland
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Bowers JM, Seidenberg AB, Kemp JM. Skin Cancer Diagnosis Among People With Disabilities. Am J Prev Med 2023; 65:896-900. [PMID: 37062527 PMCID: PMC10576008 DOI: 10.1016/j.amepre.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION People with disabilities face unique challenges that may affect skin cancer prevention, diagnosis, and access to treatment. These challenges could be exacerbated by the COVID-19 pandemic. In 2022, the prevalence of self-reported skin cancer diagnoses, delayed medical care because of the coronavirus disease 2019 (COVID-19) pandemic, and skin cancer risk factors among people with disabilities were estimated. METHODS Data from the 2020 National Health Interview Survey (N=31,568 U.S. adults) were analyzed. Skin cancer diagnosis, age at the time of skin cancer diagnosis, skin cancer risk factors (e.g., sun protection), and delayed medical care because of the COVID-19 pandemic were included. Disability status was measured using the Washington Group Short Set on Functioning, which includes vision, hearing, mobility, communication, self-care, and cognitive disabilities. RESULTS Although 8.8% of U.S. adults reported having a disability, people with disabilities accounted for 14.7% of all self-reported skin cancer diagnoses, including 17.5% of melanoma diagnoses. Notably, people with disabilities were on average, older (mean age=59.8 years) than people without disabilities (mean age=46.8 years). Models that adjusted for age and other demographics revealed that people with disabilities had higher odds of delaying medical care because of the COVID-19 pandemic (OR=1.65, 95% CI=1.41, 1.94); people with disabilities reported being diagnosed with skin cancer later in life (age 61.5 vs 54.0 years; p<0.001) but had odds of reporting any skin cancer (OR=1.11, 95% CI=0.93, 1.32) or melanoma diagnosis (OR=1.33, 95% CI=0.95, 1.87) similar to those of people without disabilities. CONCLUSIONS Because of disability-related challenges, older age, and delaying medical care during the pandemic, people with disabilities may be at increased risk for inequitable skin cancer outcomes.
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Affiliation(s)
- Jennifer M Bowers
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD.
| | - Andrew B Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD; Truth Initiative Schroeder Institute, Washington, DC
| | - Jacqueline M Kemp
- Massachusetts Dermatology Associates, Beverly, MA; Department of Dermatology, Harvard Medical School, Boston, MA
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Śmigielska P, Sławińska M, Sikorska M, Sobjanek M. The impact of the COVID-19 pandemic on the characteristics of melanoma: a single-centre cohort study. Postepy Dermatol Alergol 2023; 40:638-641. [PMID: 38028407 PMCID: PMC10646706 DOI: 10.5114/ada.2023.132247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/02/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The COVID-19 pandemic had, in a broad sense, a negative impact on populational health and well-being. Countries around the world struggled to address a spike in demand for the management of viral pneumonia and, at the same time, to efficiently treat the conditions which deteriorate severely when the treatment is delayed. Several studies published so far have analysed the impact of the COVID-19 pandemic on skin cancer epidemiology and management, however the results have been inconsistent. Aim To examine the influence of the COVID-19 pandemic on the cutaneous melanoma epidemiology diagnosed in a tertiary referral centre in Northern Poland. Material and methods This was a retrospective study that gathered the data on all the cutaneous melanoma cases treated in our facility during the official lockdown period in Poland and compared them to those diagnosed during the corresponding period from before the pandemic. Results The number of cutaneous melanoma cases diagnosed during the pandemic decreased substantially. Interestingly, it was mostly due to a decrease in the number of patients with cutaneous melanoma localised on the trunk and early melanoma cases (melanoma in situ and pT1a stage). Conclusions Our data suggest that, similarly to the reports emerging worldwide, the COVID-19 pandemic impaired the capability of our healthcare system to diagnose and treat cutaneous melanoma in our region. The data are limited, and further research will be necessary to determine the whole extent of those changes, especially the long-term effects.
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Affiliation(s)
- Paulina Śmigielska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Monika Sikorska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
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Toma AO, Prodan M, Reddyreddy AR, Seclaman E, Crainiceanu Z, Bloanca V, Bratosin F, Dumitru C, Pilut CN, Alambaram S, Vasamsetti NG, Decean L, Pricop M. The Epidemiology of Malignant Melanoma during the First Two Years of the COVID-19 Pandemic: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:305. [PMID: 36612627 PMCID: PMC9819675 DOI: 10.3390/ijerph20010305] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
It is hypothesized that the COVID-19 pandemic had a major impact on the epidemiology of malignant melanoma owing to diminished screening, diagnostic, and treatment capacities, resulting in a more advanced stage at initial presentation. The goal of this study is to undertake a systematic analysis of all epidemiological and clinical data on the trends and patient outcomes with malignant melanoma during the ongoing pandemic. Records were identified from PubMed, Cochrane, and Web of Science, selecting a total of 39 articles, narrative reviews, and editorial letters, following the PRISMA guidelines. The vast majority of the studies were published in Europe (28/39), and North America (7/39). A total of 99,860 patients were analyzed during 2020 and 2021 of the COVID-19 pandemic, and it was observed that malignant melanoma TNM staging increased significantly compared to the pre-pandemic period. Before the pandemic, 25.88% of patients had TNM stage II or above, compared to 36.25% during 2020-2021. During the COVID-19 pandemic, the malignant melanoma Breslow depth index grew from 1.59 mm before 2020 to 1.86 mm in 2020 and 2021. Patients decreased by 19.58% in 2020 and 2021 compared to pre-pandemic numbers. The patient-loss ratio indicated lower screening activity and patient addressability to dermatology and plastic surgery departments with skin cancer concerns during the COVID-19 pandemic. This systematic study shows that the identification and management of malignant melanoma during the COVID-19 pandemic faced major challenges which should alert medical systems to the high number of patients with advanced disease stages who may need emergency treatment and become incurable.
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Affiliation(s)
- Ana-Olivia Toma
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mihaela Prodan
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Akash Reddy Reddyreddy
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | - Edward Seclaman
- Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Center for Complex Networks Science, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Zorin Crainiceanu
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Nicolae Pilut
- Kaloji Narayana Rao University of Health Sciences, Nizampura, Warangal, Telangana 506007, India
| | - Satish Alambaram
- School of General Medicine, Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India
| | | | - Luminita Decean
- Faculty of General Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Strada Gheorghe Marinescu 38, 540139 Targu Mures, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Jeremić J, Suđecki B, Radenović K, Mihaljević J, Radosavljević I, Jovanović M, Milić N, Pavlović V, Brašanac D, Jović M. Impact of the COVID-19 Pandemic on Melanoma Diagnosis: Increased Breslow Thickness in Primary Melanomas-A Single Center Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16806. [PMID: 36554683 PMCID: PMC9779520 DOI: 10.3390/ijerph192416806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Early melanoma diagnosis plays a key role in ensuring best prognosis with good survival rates. The ongoing global COVID-19 pandemic has greatly impacted global and national healthcare systems, thus making it a real challenge. The aim of this study was to evaluate the impact of the pandemic on diagnostic delay in melanoma patients in Serbia. In this retrospective study, we included patients treated at the university hospital in Serbia's capitol over a period of five years and three months. We compared the prepandemic (01/JAN/17-14/MAR/20) and pandemic periods (15/MAR/20-31/MAR/22) by evaluating patient demographic data, melanoma subtype, Breslow thickness, Clark level, ulceration status, mitotic index rate and pT staging. We observed a significant reduction in the number of diagnosed patients (86.3 vs. 13.7%; p = 0.036), with melanomas having an increased median Breslow thickness (1.80 vs. 3.00; p = 0.010), a higher percentage of Clark IV-V level lesions (44.0% vs. 63.0%; p = 0.009), an increase in median mitotic index rate (2 vs. 5; p < 0.001) and a trend of increase in lesions thicker than 2 mm (37.8% vs. 53.7%; p = 0.026). We believe that this study can be a useful scenario guide for future similar events, highlighting the importance of preventive measures and timely diagnosis for the best patient outcomes.
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Affiliation(s)
- Jelena Jeremić
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Branko Suđecki
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Kristina Radenović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Jovan Mihaljević
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ivan Radosavljević
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milan Jovanović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nataša Milić
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vedrana Pavlović
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Dimitrije Brašanac
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marko Jović
- Department of Plastic Surgery, Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Ungureanu L, Apostu AP, Vesa ȘC, Cășeriu AE, Frățilă S, Iancu G, Bejinariu N, Munteanu M, Șenilă SC, Vasilovici A. Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania-Data from Two University Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15129. [PMID: 36429847 PMCID: PMC9690697 DOI: 10.3390/ijerph192215129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic affected the healthcare system in our country and led non-COVID patients to postpone medical visits that were not urgent. The purpose of this study was to investigate the impact of the first year of the COVID-19 pandemic on the trends in melanoma diagnosis and to compare the pathological characteristics of melanoma patients before and during the pandemic. The number of primary cutaneous melanomas diagnosed each month between 1 March 2019 and 29 February 2020 (pre-COVID-19) and between 1 March 2020 and 28 February 2021 (COVID-19) in the North-Western Region of Romania (Cluj and Bihor counties) was determined. The pathological characteristics of melanomas diagnosed in the two intervals were compared. The number of melanoma diagnoses substantially decreased during the pandemic, with 66 (-19.3%) fewer cutaneous melanomas being diagnosed in the first year of the pandemic when compared with the previous year. The tumor thickness and mitotic rate were significantly higher in cases found during the COVID-19 pandemic. Our study suggests that COVID-19 has delayed diagnosis in patients with melanoma, leading to the detection of thicker melanomas that may increase morbidity and mortality. Further studies are needed to determine the consequences of this delay on outcomes.
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Affiliation(s)
- Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Alexandra Elena Cășeriu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania
- Clinical Emergency County Hospital, 410039 Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, 550245 Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, 400350 Cluj-Napoca, Romania
| | - Maximilian Munteanu
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, 400015 Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
| | - Alina Vasilovici
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania
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10
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Sangers TE, Wakkee M, Kramer‐Noels EC, Nijsten T, Louwman MW, Jaspars EH, Hollestein LM. Limited impact of COVID-19-related diagnostic delay on cutaneous melanoma and squamous cell carcinoma tumour characteristics: a nationwide pathology registry analysis. Br J Dermatol 2022; 187:196-202. [PMID: 35141890 PMCID: PMC9111693 DOI: 10.1111/bjd.21050] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/02/2022] [Accepted: 02/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic reduced the number of skin cancer diagnoses, potentially causing a progression to unfavourable tumour stages. OBJECTIVES To identify the impact of delayed diagnostics on primary invasive melanoma and cutaneous squamous cell carcinoma (cSCC) by comparing tumour (pT) stage, Breslow thickness and invasion depth from before to after the first and second lockdown periods. METHODS In this population-based cohort study, histopathology reports registered between 1 January 2018 and 22 July 2021 were obtained from the nationwide histopathology registry in the Netherlands. The Breslow thickness of melanomas, invasion depth of cSCCs, and pT stage for both tumour types were compared across five time periods: (i) pre-COVID, (ii) first lockdown, (iii) between first and second lockdowns, (iv) second lockdown and (v) after second lockdown. Breslow thickness was compared using an independent t-test. pT-stage groups were compared using a χ2 -test. Outcomes were corrected for multiple testing using the false discovery rate. RESULTS In total, 20 434 primary invasive melanomas and 68 832 cSCCs were included in this study. The mean primary melanoma Breslow thickness of the prepandemic era (period i) and the following time periods (ii-v) showed no significant difference. A small shift was found towards unfavourable pT stages during the first lockdown compared with the pre-COVID period: pT1 52·3% vs. 58·6%, pT2 18·9% vs. 17·8%, pT3 13·2% vs. 11·0%, pT4 9·1% vs. 7·3% (P = 0·001). No relevant changes were seen in subsequent periods. No significant change in pT stage distribution was observed between the pre-COVID (i) and COVID-affected periods (ii-v) for cSCCs. CONCLUSIONS To date, the diagnostic delay caused by COVID-19 has not resulted in relatively more unfavourable primary tumour characteristics of melanoma or cSCC. Follow-up studies in the coming years are needed to identify a potential impact on staging distribution and survival in the long term.
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Affiliation(s)
- Tobias E. Sangers
- Department of DermatologyErasmus MC Cancer Institute, University Medical CenterRotterdamthe Netherlands
| | - Marlies Wakkee
- Department of DermatologyErasmus MC Cancer Institute, University Medical CenterRotterdamthe Netherlands
| | | | - Tamar Nijsten
- Department of DermatologyErasmus MC Cancer Institute, University Medical CenterRotterdamthe Netherlands
| | | | | | - Loes M. Hollestein
- Department of DermatologyErasmus MC Cancer Institute, University Medical CenterRotterdamthe Netherlands
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Impact of the COVID-19 Pandemic on the Diagnosis and Prognosis of Melanoma. J Clin Med 2022; 11:jcm11144181. [PMID: 35887944 PMCID: PMC9321960 DOI: 10.3390/jcm11144181] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Early detection of melanoma is one of the main diagnostic goals of dermatologists worldwide, due to the increasing incidence of the disease in our environment. However, the irruption of the SARS-CoV-2 pandemic has posed a challenge to global healthcare, forcing systems to focus their resources on the fight against COVID-19. Methods: Retrospective cohort study. The exposed cohort were patients diagnosed with melanoma in the year after the general confinement in Spain (15 March 2020) and the unexposed cohort were patients with melanoma diagnosed in the previous year. Results: 130 patients were included. No differences were observed between demographic characteristics in both cohorts. The mean Breslow of melanoma before the onset of the pandemic was 1.08, increasing to 2.65 in the year after the onset of the pandemic (p < 0.001). On the other hand, the percentage of melanomas in situ decreased from 38.96% to 16.98% in the year after the declaration of the state of alarm in Spain. Conclusions: The SARS-CoV-2 outbreak has led to a reduction in the early diagnosis of melanoma, with an increase in invasive melanomas with poor prognosis histological factors. This could lead to an increase in melanoma-related mortality in the coming years in our environment.
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12
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Carvalho AS, Brito Fernandes Ó, de Lange M, Lingsma H, Klazinga N, Kringos D. Changes in the quality of cancer care as assessed through performance indicators during the first wave of the COVID-19 pandemic in 2020: a scoping review. BMC Health Serv Res 2022; 22:786. [PMID: 35715795 PMCID: PMC9204363 DOI: 10.1186/s12913-022-08166-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/06/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cancer comprises a high burden on health systems. Performance indicators monitoring cancer outcomes are routinely used in OECD countries. However, the development of process and cancer-pathway based information is essential to guide health care delivery, allowing for better monitoring of changes in the quality of care provided. Assessing the changes in the quality of cancer care during the COVID-19 pandemic requires a structured approach considering the high volume of publications. This study aims to summarize performance indicators used in the literature to evaluate the impact of the COVID-19 pandemic on cancer care (January-June 2020) in OECD countries and to assess changes in the quality of care as reported via selected indicators. METHODS Search conducted in MEDLINE and Embase databases. Performance indicators and their trends were collated according to the cancer care pathway. RESULTS This study included 135 articles, from which 1013 indicators were retrieved. Indicators assessing the diagnostic process showed a decreasing trend: from 33 indicators reporting on screening, 30 (91%) signalled a decrease during the pandemic (n = 30 indicators, 91%). A reduction was also observed in the number of diagnostic procedures (n = 64, 58%) and diagnoses (n = 130, 89%). The proportion of diagnoses in the emergency setting and waiting times showed increasing trends (n = 8, 89% and n = 14, 56%, respectively). A decreasing trend in the proportion of earliest stage cancers was reported by 63% of indicators (n = 9), and 70% (n = 43) of indicators showed an increasing trend in the proportion of advanced-stage cancers. Indicators reflecting the treatment process signalled a reduction in the number of procedures: 79%(n = 82) of indicators concerning surgeries, 72%(n = 41) of indicators assessing radiotherapy, and 93%(n = 40) of indicators related to systemic therapies. Modifications in cancer treatment were frequently reported: 64%(n = 195) of indicators revealed changes in treatment. CONCLUSIONS This study provides a summary of performance indicators used in the literature to assess the cancer care pathway from January 2020 to June 2020 in OECD countries, and the changes in the quality of care signalled by these indicators. The trends reported inform on potential bottlenecks of the cancer care pathway. Monitoring this information closely could contribute to identifying moments for intervention during crises.
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Affiliation(s)
- Ana Sofia Carvalho
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands. .,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Óscar Brito Fernandes
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Mats de Lange
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niek Klazinga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Dionne Kringos
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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13
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Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown. Cancers (Basel) 2022; 14:cancers14102360. [PMID: 35625961 PMCID: PMC9139530 DOI: 10.3390/cancers14102360] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 01/09/2023] Open
Abstract
At the early stages of the COVID-19 outbreak in 2020, Switzerland was among the countries with the highest number of SARS-CoV2-infections per capita in the world. Lockdowns had a remarkable impact on primary care access and resulted in postponed cancer screenings. The aim of this study was to investigate the effects of the COVID-19 lockdown on the diagnosis of melanomas and stage of melanomas at diagnosis. In this retrospective, exploratory cohort study, 1240 patients with a new diagnosis of melanoma were analyzed at five tertiary care hospitals in German-speaking Switzerland over a period of two years and three months. We compared the pre-lockdown (01/FEB/19-15/MAR/20, n = 655) with the lockdown (16/MAR/20-22/JUN/20, n = 148) and post-lockdown period (23/JUN/20-30/APR/21, n = 437) by evaluating patients' demographics and prognostic features using Breslow thickness, ulceration, subtype, and stages. We observed a short-term, two-week rise in melanoma diagnoses after the major lift of social lockdown restrictions. The difference of mean Breslow thicknesses was significantly greater in older females during the lockdown compared to the pre-lockdown (1.9 ± 1.3 mm, p = 0.03) and post-lockdown period (1.9 ± 1.3 mm, p = 0.048). Thickness increase was driven by nodular melanomas (2.9 ± 1.3 mm, p = 0.0021; resp. 2.6 ± 1.3 mm, p = 0.008). A proportional rise of advanced melanomas was observed during lockdown (p = 0.047). The findings provide clinically relevant insights into lockdown-related gender- and age-dependent effects on melanoma diagnosis. Our data highlight a stable course in new melanomas with a lower-than-expected increase in the post-lockdown period. The lockdown period led to a greater thickness in elderly women driven by nodular melanomas and a proportional shift towards stage IV melanoma. We intend to raise awareness for individual cancer care in future pandemic management strategies.
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14
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Molinier R, Roger A, Genet B, Blom A, Longvert C, Chaplain L, Fort M, Saiag P, Funck‐Brentano E. Impact of the French COVID-19 pandemic lockdown on newly diagnosed melanoma delay and severity. J Eur Acad Dermatol Venereol 2022; 36:e164-e166. [PMID: 34753221 PMCID: PMC8657330 DOI: 10.1111/jdv.17802] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/03/2021] [Indexed: 01/19/2023]
Affiliation(s)
- R. Molinier
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance
| | - A. Roger
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance,Research unit EA4340 “Biomarkers and clinical trials in oncology and onco‐hematology”Versailles‐Saint‐Quentin‐en‐Yvelines UniversityParis‐Saclay UniversityVersaillesFrance
| | - B. Genet
- Department of Statistics and Methodology on Biomedical ResearchKremlin‐Bicêtre UniversityParis‐Saclay UniversityLe Kremlin‐BicêtreFrance
| | - A. Blom
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance,Research unit EA4340 “Biomarkers and clinical trials in oncology and onco‐hematology”Versailles‐Saint‐Quentin‐en‐Yvelines UniversityParis‐Saclay UniversityVersaillesFrance
| | - C. Longvert
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance,Research unit EA4340 “Biomarkers and clinical trials in oncology and onco‐hematology”Versailles‐Saint‐Quentin‐en‐Yvelines UniversityParis‐Saclay UniversityVersaillesFrance
| | - L. Chaplain
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance
| | - M. Fort
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance
| | - P. Saiag
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance,Research unit EA4340 “Biomarkers and clinical trials in oncology and onco‐hematology”Versailles‐Saint‐Quentin‐en‐Yvelines UniversityParis‐Saclay UniversityVersaillesFrance
| | - E. Funck‐Brentano
- Department of General and Oncologic DermatologyAmbroise‐Paré hospitalAP‐HPBoulogne‐BillancourtFrance,Research unit EA4340 “Biomarkers and clinical trials in oncology and onco‐hematology”Versailles‐Saint‐Quentin‐en‐Yvelines UniversityParis‐Saclay UniversityVersaillesFrance
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15
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Seretis K, Boptsi E, Boptsi A, Lykoudis EG. The impact of treatment delay on skin cancer in COVID-19 era: a case-control study. World J Surg Oncol 2021; 19:350. [PMID: 34949189 PMCID: PMC8702374 DOI: 10.1186/s12957-021-02468-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period. Methods A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019. Results Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap. Conclusion These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided. Trial registration The study adhered to the STROBE statement for case-control studies.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece.
| | - Eleni Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Anastasia Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
| | - Efstathios G Lykoudis
- Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece
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16
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Li AR, Valdebran M, Reuben DY. Emerging Developments in Management of Melanoma During the COVID-19 Era. Front Med (Lausanne) 2021; 8:769368. [PMID: 34820401 PMCID: PMC8606631 DOI: 10.3389/fmed.2021.769368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022] Open
Abstract
In March 2020, the designation of the COVID-19 outbreak as a worldwide pandemic marked the beginning of an unprecedented era in modern medicine. Facing the possibility of resource precincts and healthcare rationing, leading dermatological and cancer societies acted expeditiously to adapt their guidelines to these contingencies. Melanoma is a lethal and aggressive skin cancer necessitating a multidisciplinary approach to management and is associated with significant healthcare and economic cost in later stages of disease. In revisiting how the pandemic transformed guidelines from diagnosis and surveillance to surgical and systemic management of melanoma, we appraise the evidence behind these decisions and their enduring implications.
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Affiliation(s)
- Andraia R Li
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Manuel Valdebran
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, SC, United States.,Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Daniel Y Reuben
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
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17
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Conde-Taboada A, Iglesias-Puzas Á, Sirgado A, Campos L, Serrano I, López-Bran E. Influence of COVID-19 confinement on the size of malignant skin tumours surgically removed at a Spanish hospital. Clin Exp Dermatol 2021; 47:578-580. [PMID: 34610172 PMCID: PMC8653350 DOI: 10.1111/ced.14957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
The COVID‐19 pandemic required people to confine themselves to their homes where possible, and disrupted normal hospital activities. We examine whether this lockdown generated changes in the size of the tumours. We compared the dimensions of the surgically removed malignant skin tumours from the first 150 patients treated after the confinement ended in Spain (22 May 2020) with those of the last 150 patients to receive such treatment before the confinement began (13 March 2020). Data on tumour surface area were collected from pathology reports. Overall, no significant difference was seen in the tumour sizes. However, among men, the tumours removed after confinement were significantly larger (P < 0.05). Controversy exists over how the reduction in the number of tumours diagnosed during lockdowns might have influenced the characteristics of tumours. In this study, no overall difference was seen in the size of the tumours removed, although those removed from men after confinement were larger.
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Affiliation(s)
- A Conde-Taboada
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - Á Iglesias-Puzas
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - A Sirgado
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - L Campos
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
| | - I Serrano
- Methodological Support Unit for Research, Hospital Clínico San Carlos, Madrid, Spain
| | - E López-Bran
- Department of Dermatology, Hospital Clínico San Carlos, Madrid, Spain
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18
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Lallas A, Kyrgidis A, Manoli SM, Papageorgiou C, Lallas K, Sotiriou E, Vakirlis E, Sidiropoulos T, Ioannides D, Apalla Z. Delayed skin cancer diagnosis in 2020 because of the COVID-19-related restrictions: Data from an institutional registry. J Am Acad Dermatol 2021; 85:721-723. [PMID: 34052332 PMCID: PMC8156834 DOI: 10.1016/j.jaad.2021.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/01/2021] [Accepted: 05/17/2021] [Indexed: 01/07/2023]
Affiliation(s)
- Aimilios Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece; DERMOMEDICA Dermatology Unit, Thessaloniki, Greece.
| | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Sofia-Magdalini Manoli
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece; DERMOMEDICA Dermatology Unit, Thessaloniki, Greece
| | - Chryssoula Papageorgiou
- DERMOMEDICA Dermatology Unit, Thessaloniki, Greece; Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Konstantinos Lallas
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Elena Sotiriou
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Theodoros Sidiropoulos
- State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
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19
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McFeely O, Hollywood A, Stanciu M, O'Connell M, Paul L. Comment on "The impact of the COVID-19 pandemic on the presentation status of newly diagnosed melanoma: A single institution experience". J Am Acad Dermatol 2021; 85:e419-e420. [PMID: 34464625 PMCID: PMC8403003 DOI: 10.1016/j.jaad.2021.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Orla McFeely
- Dermatology Department, University Hospital Waterford, Waterford, Ireland.
| | - Aoife Hollywood
- Dermatology Department, University Hospital Waterford, Waterford, Ireland
| | - Maria Stanciu
- Dermatology Department, University Hospital Waterford, Waterford, Ireland
| | - Michael O'Connell
- Dermatology Department, University Hospital Waterford, Waterford, Ireland
| | - Lyndsey Paul
- Dermatology Department, University Hospital Waterford, Waterford, Ireland
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20
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Pikkel YY, Duek OS, Ben Naftali Y, Link Y, Khayr M, Ullmann Y. Hidden in plain sight: the (other) danger of COVID-19. Melanoma Res 2021; 31:389-392. [PMID: 33965975 PMCID: PMC8253375 DOI: 10.1097/cmr.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 03/27/2021] [Indexed: 11/25/2022]
Abstract
The Novel Coronavirus disease (COVID-19) first emerged in Wuhan province, China, in late November 2019 and changed public healthcare perception. It has caused a significant decline in attendance to outpatient clinics. However, other diseases have not stopped, including malignant melanoma. Survey of the number of visits to plastic surgery outpatient clinic during the first lockdown in Israel concerning malignant melanoma was compared to the same months in the previous years. We assessed the number of visits to the oncology department during 2020 compared to the number of visits and treatment protocols for malignant melanoma. During the first lockdown, the attendance at the plastic surgery outpatient clinic and ambulatory surgery decreased significantly (P = 0.002), both in excisions of suspected malignant melanoma and malignant melanoma follow-ups (P = 0.019 and P = 0.035, respectively). The last third of 2020 (from September to December) had shown a significant rise in new protocols commenced (P < 0.001). This rise in the final third of the year was not noted in 2018 or 2019. These data clearly show the rise in advanced and metastatic malignant melanoma cases due to refraining from medical follow-ups and treatments during the COVID-19 pandemic. Diseases other than COVID-19 have not vanished, and continue to treat those diseases. Ignoring malignant melanoma treatment because of COVID-19 and vice-versa will not benefit our patients.
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Affiliation(s)
| | - Ori Samuel Duek
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa
- Bruce and Ruth Rappaport Faculty of Medicine, Technion
| | - Yeela Ben Naftali
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa
| | - Yuval Link
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Majd Khayr
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa
| | - Yehuda Ullmann
- Department of Plastic and Reconstructive Surgery, Rambam Health Care Campus, Haifa
- Bruce and Ruth Rappaport Faculty of Medicine, Technion
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21
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22
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Dessinioti C, Garbe C, Stratigos AJ. The impact of the COVID-19 pandemic on diagnostic delay of skin cancer: a call to restart screening activities. J Eur Acad Dermatol Venereol 2021; 35:e836-e837. [PMID: 34309963 PMCID: PMC8447214 DOI: 10.1111/jdv.17552] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Dessinioti
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, University of Athens, Athens, Greece
| | - C Garbe
- Center for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - A J Stratigos
- 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, University of Athens, Athens, Greece
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23
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Lo Bello G, Pini GM, Ferguglia G, Regazzini R, Locatelli A, Patriarca C. Effects of COVID-19 restriction measures and clinical resetting on delayed melanoma diagnosis: a single Institution experience. Ital J Dermatol Venerol 2021; 156:497-498. [PMID: 34282862 DOI: 10.23736/s2784-8671.21.07052-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Giacomo M Pini
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Guido Ferguglia
- Dermatology Unit, St. Anna Hospital (ASST Lariana), Como, Italy
| | | | | | - Carlo Patriarca
- Pathology Unit, St. Anna Hospital (ASST Lariana), Como, Italy
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24
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Switzer B, Haanen J, Lorigan PC, Puzanov I, Turajlic S. Clinical and immunologic implications of COVID-19 in patients with melanoma and renal cell carcinoma receiving immune checkpoint inhibitors. J Immunother Cancer 2021; 9:e002835. [PMID: 34272309 PMCID: PMC8288220 DOI: 10.1136/jitc-2021-002835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/13/2022] Open
Abstract
The clinical and immunologic implications of the SARS-CoV-2 pandemic for patients with cancer receiving systemic anticancer therapy have introduced a multitude of clinical challenges and academic controversies. This review summarizes the current evidence, discussion points, and recommendations regarding the use of immune checkpoint inhibitors (ICIs) in patients with cancer during the SARS-CoV-2 pandemic, with a focus on patients with melanoma and renal cell carcinoma (RCC). More specifically, we summarize the theoretical concepts and available objective data regarding the relationships between ICIs and the antiviral immune response, along with recommended clinical approaches to the management of melanoma and RCC patient cohorts receiving ICIs throughout the course of the COVID-19 pandemic. Additional insights regarding the use of ICIs in the setting of current and upcoming COVID-19 vaccines and broader implications toward future pandemics are also discussed.
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Affiliation(s)
- Benjamin Switzer
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - John Haanen
- Division of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Paul C Lorigan
- Division of Cancer Sciences, The University of Manchester, Manchester, UK
- Division of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Igor Puzanov
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Samra Turajlic
- Renal and Skin Units, Royal Marsden NHS Foundation Trust, London, UK
- Cancer Dynamics Laboratory, The Francis Crick Institute, London, UK
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25
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Krumeich LN, Kelz RR. Editorial: Time to Surgery and Thyroid Cancer Survival in the United States. Ann Surg Oncol 2021; 28:3459-3460. [PMID: 33948772 PMCID: PMC8095222 DOI: 10.1245/s10434-021-10101-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/19/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Lauren N Krumeich
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel R Kelz
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. .,Division of Endocrine and Oncologic Surgery, Department of Surgery, Perelman School of Medicine, Philadelphia, PA, USA.
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