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Apostu AP, Vesa ȘC, Frățilă S, Iancu G, Bejinariu N, Muntean M, Șenilă SC, Baba OA, Secășan CP, Ungureanu L. The effects of the COVID-19 pandemic on the diagnosis and prognosis of melanoma 2 years after the pandemic in two Romanian counties. Front Med (Lausanne) 2024; 11:1328488. [PMID: 38323030 PMCID: PMC10844525 DOI: 10.3389/fmed.2024.1328488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/09/2024] [Indexed: 02/08/2024] Open
Abstract
Background The COVID-19 pandemic disrupted the healthcare system and negatively affected the diagnosis and management of melanoma worldwide. The purpose of this study is to investigate the long-term effects of the COVID-19 pandemic on the diagnosis and prognosis of melanoma. Materials and methods This retrospective cohort study included histopathologically confirmed melanoma cases from March 2019 to February 2023 in Cluj and Bihor counties. Data from the post-COVID-19 period (March 2021 to February 2023) were compared to the pre-COVID-19 period (March 2019 to February 2020) and the COVID-19 period (March 2020 to February 2021). Patient characteristics, monthly diagnostics, histological subtypes, and key histological features were analyzed using statistical tests. Results The number of melanoma cases diagnosed annually decreased by 31.37 and 23.75% in the first and second post-pandemic years, respectively, compared to pre-pandemic numbers. Diagnostic rates also decreased by 14.9 and 5.4% in the first and second post-pandemic years, respectively, compared to the pandemic period. Prognostic factors worsened in the post-pandemic period, with higher Breslow index and mitotic rate, and increased ulceration and thick melanomas compared to the pre-pandemic period. Conclusion The COVID-19 pandemic had a long-lasting impact on the diagnosis of melanoma in Romania, resulting in advanced stages and unfavorable prognostic factors. Larger global studies are needed to comprehensively understand the pandemic's long-term effects on the diagnosis of melanoma.
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Affiliation(s)
- Adina Patricia Apostu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases, Cluj Napoca, Romania
| | - Ștefan Cristian Vesa
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Simona Frățilă
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
- Clinical Emergency County Hospital, Oradea, Romania
| | - Gabriela Iancu
- Department of Dermatology, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Sibiu, Romania
- Clinic of Dermatology, County Emergency Hospital Sibiu, Sibiu, Romania
| | - Nona Bejinariu
- Santomar Oncodiagnostic Laboratory, Cluj-Napoca, Romania
| | - Maximilian Muntean
- Department of Plastic and Reconstructive Surgery, “Prof Dr. I. Chiricuță” Institute of Oncology, Cluj-Napoca, Romania
| | - Simona C. Șenilă
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, Cluj-Napoca, Romania
| | | | | | - Loredana Ungureanu
- Department of Dermatology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Dermatology, Emergency County Hospital, Cluj-Napoca, Romania
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2
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Kim U, Koroukian S, Rose J, Hoehn RS, Carroll BT. US Cancer Detection Decreased Nearly 9 Percent During The First Year Of The COVID-19 Pandemic. Health Aff (Millwood) 2024; 43:125-130. [PMID: 38190599 DOI: 10.1377/hlthaff.2023.00767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
We investigated the impact of the COVID-19 pandemic on cancer detection, using data from the Surveillance, Epidemiology, and End Results Program, which recently released data through the first year of the pandemic (2020). Across all cancer sites, cancer incidence fell by 8.7 percent. The most common cancers that experienced the largest disruptions were lung and bronchus, melanoma of the skin, and thyroid cancer.
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Affiliation(s)
- Uriel Kim
- Uriel Kim , Case Western Reserve University, Cleveland, Ohio
| | | | - Johnie Rose
- Johnie Rose, Case Western Reserve University
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3
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Hewitt DB, Beane JD, Grignol VP, Contreras CM. Association between surgical delay and outcomes among patients with invasive cutaneous melanoma. Am J Surg 2023; 226:631-639. [PMID: 37142517 DOI: 10.1016/j.amjsurg.2023.04.019] [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: 03/05/2023] [Revised: 04/11/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The relationship between surgical delay and outcomes for patients with cutaneous melanoma is understudied. The objectives of this study were to determine the impact of surgical delay on regional nodal involvement and mortality in patients with cutaneous melanoma. METHODS Retrospective study of patients diagnosed with clinically node-negative invasive cutaneous melanoma from 2004 to 2018. Outcomes included regional lymph node disease and overall survival. Multivariable logistic regression and Cox proportional-hazards models were constructed to adjust for pertinent clinical factors. RESULTS Of 423,001 patients, 21.8% experienced a surgical delay (≥45 days). These patients were more likely to have nodal involvement (OR1.09; P = 0.01). Surgical delay (HR1.14; P < 0.001), Black race (HR1.34; P = 0.002), and Medicaid (HR1.92; P < 0.001) were associated with lower survival. Patients treated at academic/research (HR0.87; P < 0.001) or integrated network cancer programs (HR0.89; P = 0.001) had improve survival. CONCLUSIONS Surgical delay was frequent and resulted in higher rates of lymph node involvement and decreased overall survival.
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Affiliation(s)
- D Brock Hewitt
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Joal D Beane
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Valerie P Grignol
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Carlo M Contreras
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Karamani L, McLean AL, Kamp MA, Mayer TE, Müller W, Dinc N, Senft C. Tumor size, treatment patterns, and survival in neuro-oncology patients before and during the COVID-19 pandemic. Neurosurg Rev 2023; 46:226. [PMID: 37670022 PMCID: PMC10480251 DOI: 10.1007/s10143-023-02132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/11/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023]
Abstract
The COVID-19 pandemic has disrupted healthcare delivery worldwide, leading to significant delays in cancer diagnosis and treatment. This study aimed to investigate the impact of the pandemic on the diagnosis and treatment of malignant brain tumors, specifically glioblastoma (GBM) and cerebral metastasis (CM), in a specialized neuro-oncology center. We analyzed data from 236 patients diagnosed with previously unknown malignant brain tumors between January 2018 and December 2021. Patients were classified into two groups: pre-COVID (January 2018 to December 2019) and COVID (January 2020 to December 2021). Tumor volumes were compared between the two groups and factors affecting tumor volumes were studied. Of 236 patients diagnosed with previously unknown malignant brain tumors, 114 were in the pre-COVID group and 122 were in the COVID group. Median tumor volumes at first diagnosis were significantly larger in the COVID group compared to the pre-COVID group (21.7 vs 15.7 cm3; p < 0.05). The survival times for the overall cohort and the GBM and CM subgroups did not differ significantly between the pre-COVID and COVID periods. Delays in diagnosis and treatment during the COVID-19 pandemic led to larger tumor volumes at diagnosis for patients with malignant brain tumors. However, these larger tumors did not result in worse survival outcomes. This counterintuitive finding highlights the crucial role of specialized neuro-oncological centers in mitigating the potential negative impact of delayed treatment and emphasizes the need for continued access to specialized care during times of crisis.
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Affiliation(s)
- Lydia Karamani
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany.
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany.
- Comprehensive Cancer Center Central Germany, Leipzig, Germany.
| | - Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
| | - Marcel A Kamp
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
| | - Thomas E Mayer
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
- Institute of Diagnostic and Interventional Radiology, Neuroradiology Section, Jena University Hospital, FriedrichSchillerUniversity, Jena, Germany
| | - Wolf Müller
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
- Paul Flechsig Institute of Neuropathology, University Medicine Leipzig, Leipzig, Germany
| | - Nazife Dinc
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
| | - Christian Senft
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
- Center for Neuro-Oncology, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany, Leipzig, Germany
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5
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Gil-Pallares P, Figueroa-Silva O, Gil-Pallares ME, Vázquez-Bueno JÁ, Piñeyro-Molina F, Monteagudo B, Heras-Sotos CDL. Did COVID-19 lockdown delay actually worsen melanoma prognosis? An Bras Dermatol 2023; 98:176-180. [PMID: 36567164 PMCID: PMC9729652 DOI: 10.1016/j.abd.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/17/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology. OBJECTIVES To evaluate the immediate and mid-term impact of diagnosis delay on melanoma. METHODS A retrospective observational study of melanoma diagnosed between March 14th 2019 and March 13th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively. RESULTS A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p>0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9mm, p<0.05) resulting in a significant upstaging according to the AJCC 8th ed. (p<0.05). STUDY LIMITATIONS The main limitation is that this is a single-center study. CONCLUSIONS The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.
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Affiliation(s)
- Pedro Gil-Pallares
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain.
| | - Olalla Figueroa-Silva
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
| | | | | | | | - Benigno Monteagudo
- Department of Dermatology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain
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6
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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: 16] [Impact Index Per Article: 8.0] [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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7
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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: 6] [Impact Index Per Article: 3.0] [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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9
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Trinh P, Yekrang K, Phung M, Pugliese S, Chang ALS, Bailey EE, Ko JM, Sarin KY. Partnering with a senior living community to optimise teledermatology via full body skin screening during the COVID-19 pandemic: A pilot programme. SKIN HEALTH AND DISEASE 2022; 2:e141. [PMID: 35941936 PMCID: PMC9349994 DOI: 10.1002/ski2.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/15/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Elderly patients in senior communities faced high barriers to care during the COVID-19 pandemic, including increased vulnerability to COVID-19, long quarantines for clinic visits, and difficulties with telemedicine adoption. OBJECTIVE To pilot a new model of dermatologic care to overcome barriers for senior living communities during the COVID-19 pandemic and assess patient satisfaction. METHODS From 16 November 2020 to 9 July 2021, this quality improvement programme combined in-residence full body imaging with real-time outlier lesion identification and virtual teledermatology. Residents from the Sequoias Portola Valley Senior Living Retirement Community (Portola Valley, California) voluntarily enroled in the Stanford Skin Scan Programme. Non-physician clinical staff with a recent negative COVID-19 test travelled on-site to obtain in-residence full body photographs using a mobile app-based system on an iPad called SkinIO that leverages deep learning to analyse patient images and suggest suspicious, outlier lesions for dermoscopic photos. A single dermatologist reviewed photographs with the patient and provided recommendations via a video visit. Objective measures included follow-up course and number of skin cancers detected. Subjective findings were obtained through patient experience surveys. RESULTS Twenty-seven individuals participated, three skin cancers were identified, with 11 individuals scheduled for a follow up in-person visit and four individuals starting home treatment. Overall, 88% of patients were satisfied with the Skin Scan programme, with 77% likely to recommend the programme to others. 92% of patients agreed that the Skin Scan photographs were representative of their skin. In the context of the COVID-19 pandemic, 100% of patients felt the process was safer or comparable to an in-person visit. Despite overall appreciation for the programme, 31% of patients reported that they would prefer to see dermatologist in-person after the pandemic. CONCLUSIONS This programme offers a framework for how a hybrid skin scan programme may provide high utility for individuals with barriers to accessing in-person clinics.
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Affiliation(s)
- Pavin Trinh
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Kiana Yekrang
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Michelle Phung
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Silvina Pugliese
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Anne Lynn S. Chang
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Elizabeth E. Bailey
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Justin M. Ko
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
| | - Kavita Y. Sarin
- Department of DermatologyStanford University School of MedicineStanfordCaliforniaUSA
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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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11
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Barcaui CB, Machado CJ, Piñeiro-Maceira J. Impact of the SARS-CoV-2 pandemic on the diagnosis of primary cutaneous melanoma at a University Hospital in Rio de Janeiro. An Bras Dermatol 2022; 97:801-803. [PMID: 36089548 PMCID: PMC9411134 DOI: 10.1016/j.abd.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/07/2022] [Accepted: 04/16/2022] [Indexed: 11/26/2022] Open
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12
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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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13
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Ramiscal JAB, Stern SL, Wilson AK, Lorimer PD, Lee NA, Goldfarb MR, Foshag LJ, Fischer TD. Does Residual Invasive Disease in Wide Local Excision after Diagnosis with Partial Biopsy Technique Influence Survival in Melanoma? Matched-Pair Analysis of Multicenter Selective Lymphadenectomy Trial I and II. J Am Coll Surg 2022; 235:49-59. [PMID: 35703962 DOI: 10.1097/xcs.0000000000000263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Current guidelines recommend excisional/complete biopsy for melanoma diagnosis, owing to high rates of residual disease found at wide local excision (WLE) after partial biopsy techniques. We sought to determine any survival disadvantage associated with the presence of residual invasive melanoma in the WLE after diagnosis with a partial biopsy technique. STUDY DESIGN Data were examined from Multicenter Selective Lymphadenectomy Trials I and II (MSLT-I and -II), 2 large melanoma trials. Patients diagnosed with excisional/complete biopsy were excluded. Clinicopathologic characteristics, melanoma-specific survival (MSS), distant disease-free survival (DDFS), and disease-free survival (DFS) of those with residual invasive melanoma in the definitive WLE and those with no residual melanoma were compared. Matched pairing was used to reduce variability between groups. RESULTS From 1994 through 2014, 3,939 patients were enrolled in these trials and 874 (22%) were diagnosed using partial biopsy techniques. Of these, 399 (46%) had residual tumor in the WLE. Only 6 patients had residual tumor in their WLE resulting in T-upstaging of their tumor. Match-pairing formed two cohorts (1:1) of patients with and without residual invasive tumor after WLE. A total of 514 patients were paired; 288 (56%) males, 148 (28.8%) aged 60 or older, 192 (37.4%) with truncal melanomas, 214 (41.6%) had Breslow thickness 2 mm or greater, and 376 (73.2%) had positive sentinel nodes. Kaplan-Meier analysis showed no statistical difference in 10-year MSS (73.6% ± 3.3% vs 73.9% ± 3.7%, p = 0.891), DDFS (68.7% ± 3.4% vs 65.3% ± 4.0%, p = 0.548), or DFS (59.6% ± 3.7% vs 59.4% ± 3.9%, p = 0.783). CONCLUSIONS Survival in patients with primary melanoma does not appear to be worse in patients who undergo a partial biopsy technique and are later found to have residual invasive tumor in the WLE specimen.
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Affiliation(s)
- Judi Anne B Ramiscal
- From Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA
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14
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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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15
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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: 18] [Impact Index Per Article: 9.0] [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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16
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[Translated article] Cuentos Lunares: Poems and Flash Fiction That Save Lives — A Euromelanoma Project During the COVID-19 Pandemic. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Cariti C, Merli M, Avallone G, Rubatto M, Marra E, Fava P, Caliendo V, Picciotto F, Gualdi G, Stanganelli I, Fierro MT, Ribero S, Quaglino P. Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience. Cancers (Basel) 2021; 13:cancers13236071. [PMID: 34885180 PMCID: PMC8656565 DOI: 10.3390/cancers13236071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary COVID-19 is a highly contagious infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In March 2020, the World Health Organization (WHO) declared that COVID-19 had become a pandemic; since then, several elective clinical and surgical activities have been postponed to reduce the risk of nosocomial infection. This has influenced the diagnosis and management of many diseases, including melanoma. The aim of our literature review was to evaluate whether the management of melanoma has been changed by the outbreak of COVID-19, and if so, what the consequences of these changes are. The main topics in this literature review are the screening of suspicious lesions, diagnosis of primary melanoma, and the management of early-stage and advanced melanomas in the COVID-19 era. We also reported the experience of our dermatological clinic in Turin, one of the most affected areas in Italy. Abstract Background: The current COVID-19 pandemic has influenced the modus operandi of all fields of medicine, significantly impacting patients with oncological diseases and multiple comorbidities. Thus, in recent months, the establishment of melanoma management during the emergency has become a major area of interest. In addition to original articles, case reports and specific guidelines for the period have been developed. Purpose: This article aims to evaluate whether melanoma management has been changed by the outbreak of COVID-19, and if so, what the consequences are. We summarized the main issues concerning the screening of suspicious lesions, the diagnosis of primary melanoma, and the management of early-stage and advanced melanomas during the pandemic. Additionally, we report on the experience of our dermatological clinic in northern Italy. Methods: We performed a literature review evaluating articles on melanomas and COVID-19 published in the last two years on PubMed, as well as considering publications by major healthcare organizations. Concerning oncological practice in our center, we collected data on surgical and therapeutic procedures in patients with a melanoma performed during the first months of the pandemic. Conclusions: During the emergency period, the evaluation of suspicious skin lesions was ensured as much as possible. However, the reduced level of access to medical care led to a documented delay in the diagnosis of new melanomas. When detected, the management of early-stage and advanced melanomas was fully guaranteed, whereas the follow-up visits of disease-free patients have been postponed or replaced with a teleconsultation when possible.
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Affiliation(s)
- Caterina Cariti
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Martina Merli
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
- Correspondence: ; Tel.: +39-011-633-5843
| | - Gianluca Avallone
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Marco Rubatto
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Elena Marra
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Paolo Fava
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Virginia Caliendo
- Dermatologic Surgery Department, Surgery Department, University Hospital, 10126 Turin, Italy; (V.C.); (F.P.)
| | - Franco Picciotto
- Dermatologic Surgery Department, Surgery Department, University Hospital, 10126 Turin, Italy; (V.C.); (F.P.)
| | - Giulio Gualdi
- Department of Medicine and Ageing Science, Dermatologic Clinic, “G. D’Annunzio” University, 66100 Chieti, Italy;
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS-IRST Scientific Institute of Romagna for the Study and Treatment of Cancer, Meldola and University of Parma, 43121 Parma, Italy;
| | - Maria Teresa Fierro
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Simone Ribero
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatology Clinic, University of Turin, 10126 Turin, Italy; (C.C.); (G.A.); (M.R.); (E.M.); (P.F.); (M.T.F.); (S.R.); (P.Q.)
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18
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Davis CH, Ho J, Greco SH, Koshenkov VP, Vidri RJ, Farma JM, Berger AC. COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States. Ann Surg Oncol 2021; 29:1629-1635. [PMID: 34797482 PMCID: PMC8603898 DOI: 10.1245/s10434-021-11086-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Abstract
Background Covid-19 significantly affected healthcare delivery over the past year, with a shift in focus away from nonurgent care. Emerging data are showing that screening for breast and colon cancer has dramatically decreased. It is unknown whether the same trend has affected patients with melanoma. Methods This is a retrospective cohort study of melanoma patients at two large-volume cancer centers. Patients were compared for 8 months before and after the lockdown. Outcomes focused on delay in treatment and possible resultant upstaging of melanoma. Results A total of 375 patients were treated pre-lockdown and 313 patients were treated post-lockdown (17% decrease). Fewer patients presented with in situ disease post-lockdown (15.3% vs. 17.9%), and a higher proportion presented with stage III-IV melanoma (11.2% vs. 9.9%). Comparing patients presenting 2 months before versus 2 months after the lockdown, there was an even more significant increase in Stage III-IV melanoma from 7.1% to 27.5% (p < 0.0001). Finally, in Stage IIIB-IIID patients, there was a decrease in patients receiving adjuvant therapy in the post lockdown period (20.0% vs. 15.2%). Conclusions As a result of the recent pandemic, it appears there has been a shift away from melanoma in situ and toward more advanced disease, which may have significant downstream effects on prognosis and could be due to a delay in screening. Significantly patients have presented after the lockdown, and fewer patients are undergoing the recommended adjuvant therapies. Patient outreach efforts are essential to ensure that patients continue to receive preventative medical care and screening as the pandemic continues.
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Affiliation(s)
- Catherine H Davis
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA
| | - Jason Ho
- Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA
| | - Stephanie H Greco
- Division of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Vadim P Koshenkov
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA
| | - Roberto J Vidri
- Division of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jeffrey M Farma
- Division of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Adam C Berger
- Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. .,Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ, USA.
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19
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Gualdi G, Porreca A, Amoruso GF, Atzori L, Calzavara-Pinton P, De Tursi M, Buduo AD, Marino PD, Fabroncini G, Fantini F, Fargnoli MC, Giannotta G, Lacarruba F, Lotesoriere A, Merli M, Micali G, Paradisi A, Puviani M, Quaglino P, Rongioletti F, Rubatto M, Sbano P, Scalvenzi M, Soglia S, Sollima L, Villani A, Nicola MD, Amerio P. The Effect of the COVID-19 Lockdown on Melanoma Diagnosis in Italy. Clin Dermatol 2021; 39:911-919. [PMID: 34785022 PMCID: PMC8156913 DOI: 10.1016/j.clindermatol.2021.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to lockdowns for much of the world. In Italy, all health procedures not directly related to COVID-19 were reduced or suspended, thus limiting patient access to hospitals. Any delay in cancer treatment presents the additional risk of tumors progressing from being curable to incurable. Specifically, melanoma survival rate strictly depends on tumor thickness, which, in turn, is a function of time. To estimate the impact on melanoma progression caused by the reduction in dermatologic services during the COVID-19 lockdown, a retrospective observational cohort study was conducted. This study was designed to compare the clinical and histologic characteristics of the primary melanomas removed in the first 2 months after the end of the lockdown (May-July 2020) in 12 Italian centers characterized by different COVID-19 case frequencies. The control group was represented by the melanomas removed during the same period in the previous 3 years. Overall, 1,124 melanomas were considered: 237 as part of the study group and 887 from the control group (average, 295), with a 20% reduction. Breslow thickness, as well as high-risk histotypes and melanomas with vertical growth, increased for all melanomas. Ulcerated and high mitotic index melanomas increased, particularly in northern Italy. In Italy, the lockdown led to a significant worsening of melanoma severity, causing a staging jump, with a consequent worsening of outcomes.
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Affiliation(s)
- Giulio Gualdi
- Department of Dermatology, Università G. D'Annunzio Chieti-Pescara, Chieti, Italy.
| | - Annamaria Porreca
- Biostatistic, Department of Medical, Oral and Biotechnological Sciences, Università G. D'Annunzio Chieti-Pescara, Italy
| | | | - Laura Atzori
- Dermatologic Clinic, Department of Public Health, Università di Cagliari, Cagliari, Italy
| | | | - Michele De Tursi
- Oncologic Clinic, Department of Medical, Oral Sciences and Biotechnologies, Università G. D'Annunzio Chieti-Pescara, Italy
| | - Andrea Di Buduo
- Dermatologic Clinic, Department of Public Health, Università di Cagliari, Cagliari, Italy
| | - Pietro Di Marino
- Oncologic Clinic, Department of Medical, Oral Sciences and Biotechnologies, Università G. D'Annunzio Chieti-Pescara, Italy
| | - Gabriella Fabroncini
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Napoli, Italy
| | | | - Maria Concetta Fargnoli
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, Università dell'Aquila, Italy
| | | | | | - Andrea Lotesoriere
- Department of Dermatology, Università G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Martina Merli
- Department of Dermatology, Università di Torino, Torino, Italy
| | | | - Andrea Paradisi
- Dermatology Unit, Ospedale Generale "Cristo Re," Rome, Italy
| | - Mario Puviani
- Department of Dermatology, Ospedale di Sassuolo, Sassuolo, Italy
| | - Pietro Quaglino
- Department of Dermatology, Università di Torino, Torino, Italy
| | - Franco Rongioletti
- Dermatologic Clinic, Department of Public Health, Università di Cagliari, Cagliari, Italy
| | - Marco Rubatto
- Department of Dermatology, Università di Torino, Torino, Italy
| | - Paolo Sbano
- Dermatology Unit, Ospedale Generale "Belcolle," Viterbo, Italy
| | - Massimiliano Scalvenzi
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Simone Soglia
- Department of Dermatology, Università di Brescia, Brescia, Italy
| | - Laura Sollima
- Pathology Unit, Ospedale San Salvatore, L'Aquila, Italy
| | - Alessia Villani
- Department of Clinical Medicine and Surgery, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Marta Di Nicola
- Biostatistic, Department of Medical, Oral and Biotechnological Sciences, Università G. D'Annunzio Chieti-Pescara, Italy
| | - Paolo Amerio
- Department of Dermatology, Università G. D'Annunzio Chieti-Pescara, Chieti, Italy
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20
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Flórez Menéndez A, Nagore E, Buendía Eisman A. Cuentos Lunares: Poems and Flash Fiction That Save Lives — A Euromelanoma Project During the COVID-19 Pandemic. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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21
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Effects of the COVID-19 pandemic on care of melanoma patients in Berlin, Germany: the Mela-COVID survey. Eur J Dermatol 2021; 31:521-529. [PMID: 36094385 PMCID: PMC8572687 DOI: 10.1684/ejd.2021.4098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The COVID-19 pandemic imposes major challenges for care of cancer patients. Objectives Our aim was to assess the effects of the pandemic on treatment and appointments of patients with malignant melanoma based on a large skin cancer centre in Berlin, Germany, and identify reasons for, and impact factors associated with these changes. Materials & Methods Patients with melanoma treated from January 1st 2019 received a postal survey with questions on impairment due to the pandemic, fear of COVID-19, fear of melanoma, changes in therapy and/or appointments, including reasons for the changes. Impact factors on postponed/missed appointments were examined using descriptive analyses and multivariate logistic regression. Results The response rate was 41.3% (n = 324; 57.4% males; mean age: 67.9 years). Among 104 participants currently receiving therapy, four (3.8%) reported treatment changes due to the pandemic. Postponements or cancellations of appointments occurred in 48 participants (14.8%), most frequently, at their own request (81.3%) due to fear of SARS-CoV-2 infection (68.8%). Current treatment was associated with a reduced chance of postponing/missing appointments (OR = 0.208, p = 0.003), whereas a high or very high level of concern for COVID-19 (OR = 6.806, p = 0.034; OR = 10.097, p = 0.038), SARS-CoV-2 infection among close acquaintances (OR = 4.251, p = 0.026), anxiety disorder (OR = 5.465, p = 0.016) and AJCC stage IV (OR = 3.108, p = 0.048) were associated with a higher likelihood of postponing/missing appointments. Conclusion Among our participants, treatment changes were rare and the proportion of missed/delayed appointments was rather small. The main reasons for delays/cancellations of appointments were anxiety and concern for COVID-19. Supplementary data Supplementary data associated with this article can be found, in the online version, at doi:10.1684/ejd.2021.4098. Table S1. Disease and treatment characteristics and their association with postponed/missed appointments. Table S2. Treatment changes or postponement due to the pandemic. Table S3. Comorbidities and their association with postponed/missed appointments. Fig. S1. Number of new SARS-CoV-2 infections per day in Germany and Berlin between February 1st 2020 and July 1st 2020.
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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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Koch E, Villanueva F, Marchetti MA, Abarzúa-Araya Á, Cárdenas C, Castro JC, Dominguez F, Droppelmann K, Droppelmann N, Galindo H, León A, Madrid J, Molgó M, Mondaca S, Montero PH, Uribe P, Villaseca MA, Vinés E, Navarrete-Dechent C. Reduction in the number of early melanomas diagnosed during the COVID-19 pandemic: a single-centre cohort study. J Eur Acad Dermatol Venereol 2021; 35:e735-e737. [PMID: 34260770 PMCID: PMC8447396 DOI: 10.1111/jdv.17522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Erica Koch
- Department of Hematology and Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Francisco Villanueva
- Department of Hematology and Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Michael A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Álvaro Abarzúa-Araya
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Consuelo Cárdenas
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Juan Camilo Castro
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Francisco Dominguez
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Surgical Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Katherine Droppelmann
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | | | - Héctor Galindo
- Department of Hematology and Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Augusto León
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Surgical Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jorge Madrid
- Department of Hematology and Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Montserrat Molgó
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Sebastián Mondaca
- Department of Hematology and Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Pablo H Montero
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Surgical Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Pablo Uribe
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Miguel A Villaseca
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Pathology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Pathology, Universidad de la Frontera, Temuco, Chile
| | - Eugenio Vinés
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Radiation Oncology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
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24
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Gisondi P, Cazzaniga S, Di Leo S, Piaserico S, Bellinato F, Pizzolato M, Gatti A, Eccher A, Brunelli M, Saraggi D, Girolomoni G, Naldi L. Impact of the COVID-19 pandemic on melanoma diagnosis. J Eur Acad Dermatol Venereol 2021; 35:e714-e715. [PMID: 34236721 PMCID: PMC8447457 DOI: 10.1111/jdv.17493] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- P Gisondi
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - S Cazzaniga
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - S Di Leo
- Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - S Piaserico
- Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy
| | - F Bellinato
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - M Pizzolato
- Division of Dermatology, Ospedale Santa Maria della Misericordia, Rovigo, Italy
| | - A Gatti
- Division of Dermatology, Ospedale Ca' Foncello di Treviso, Treviso, Italy
| | - A Eccher
- Department of Pathology and Diagnostics, Section of Pathology, University Hospital of Verona, Verona, Italy
| | - M Brunelli
- Department of Pathology and Diagnostics, Section of Pathology, University Hospital of Verona, Verona, Italy
| | - D Saraggi
- Division of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - G Girolomoni
- Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy
| | - L Naldi
- Centro Studi GISED, Bergamo, Italy.,Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
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25
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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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26
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Flórez Menéndez A, Nagore E, Buendía Eisman A. Cuentos Lunares: Poems and Flash Fiction That Save Lives - A Euromelanoma Project During the COVID-19 Pandemic. ACTAS DERMO-SIFILIOGRAFICAS 2021; 113:1-3. [PMID: 34052203 PMCID: PMC8197447 DOI: 10.1016/j.ad.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/16/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- A Flórez Menéndez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España; Grupo de Investigación DIPO, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Pontevedra, España.
| | - E Nagore
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - A Buendía Eisman
- Área de Dermatología, Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, España
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27
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de Souza Melo A, da Penha Sobral AIG, Marinho MLM, Duarte GB, Vieira AA, Sobral MFF. The impact of social distancing on COVID-19 infections and deaths. Trop Dis Travel Med Vaccines 2021; 7:12. [PMID: 33941286 PMCID: PMC8093001 DOI: 10.1186/s40794-021-00137-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/12/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To assess the impact of the social isolation index on the number of infections and deaths by COVID-19 in the state of São Paulo (Brazil). METHODS Daily isolation data, obtained through geolocation information by mobile phone, were evaluated together with the number of daily infections and deaths by COVID-19 in the state of São Paulo. The study was conducted from February 26 to May 19, 2020. The data were modeled through the vector autoregression (VAR) model. RESULTS The isolation index has an effect of approximately 5% in variation in the number of infections, and 7% in the number of deaths. The impulse response function (IRF) caused a drop of 0.15% in the number of new cases/day, and 0.17% in the number of deaths/day following a shock in the isolation index. For both cases, this effect occurred 1 day after the shock and stabilized after 10 periods. An increase of 1% in the isolation index led to a reduction of 6.91% in new cases and 6.90% in the number of deaths. The 30 cumulative day reduction reached 22.72% in terms of transmission and 35.39% for deaths. CONCLUSIONS The social isolation index is related to deaths and infections from SARS-CoV-2. Although distancing measures are accompanied with impacts on the economy and the emergence of other morbidities, the benefits caused by the reduction in the speed of contagion are significant. The adoption of distancing measures has a substantial impact on the number of infected individuals and deaths by COVID-19.
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Affiliation(s)
- André de Souza Melo
- Departamento de Economia, Federal Rural University of Pernambuco, Avenida Dom Manoel de Medeiros, s/n – Dois Irmãos, Recife, PE Brazil
| | - Ana Iza Gomes da Penha Sobral
- Departamento de Psicologia Cognitiva, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE 50670-901 Brazil
| | - Marcelo Luiz Monteiro Marinho
- Departamento de Economia, Federal Rural University of Pernambuco, Avenida Dom Manoel de Medeiros, s/n – Dois Irmãos, Recife, PE Brazil
| | - Gisleia Benini Duarte
- Departamento de Economia, Federal Rural University of Pernambuco, Avenida Dom Manoel de Medeiros, s/n – Dois Irmãos, Recife, PE Brazil
| | - Amanda Aires Vieira
- Faculdade Boa Viagem, R. Jean Emile Favre, 422 - Ipsep, Recife, PE 51190-450 Brazil
| | - Marcos Felipe Falcão Sobral
- Departamento de Economia, Federal Rural University of Pernambuco, Avenida Dom Manoel de Medeiros, s/n – Dois Irmãos, Recife, PE Brazil
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28
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Efecto del confinamiento por la pandemia de COVID-19 en el diagnóstico y el tratamiento del cáncer de piel. PIEL 2021. [PMCID: PMC7834446 DOI: 10.1016/j.piel.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Intergruppo Melanoma Italiano. The effect of COVID-19 emergency in the management of melanoma in Italy. Dermatol Reports 2021; 13:8972. [PMID: 33824708 PMCID: PMC8018261 DOI: 10.4081/dr.2021.8972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/28/2020] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic has severely hampered the functioning of any health system, absorbing a considerable amount of resources and with the threat of widespread infection in the health services. The present survey has been carried out in Italy to evaluate if and how COVID-19 also affected skin melanoma management. We enrolled 13 Italian centres highly qualified in the diagnosis and care of skin melanoma. We compared a set of information evaluating the amount of activity for melanoma performed during February-April 2020 with the same quarter in 2019. The number of new melanoma diagnosis, biopsies, wide local excisions, overall pathology reports decreased. However, the most severe cases seem promptly managed with sentinel lymph node biopsies, new systemic treatments (north) and the total number of (advanced) treated patients (centre-south). The COVID-19 experience has underlined the need to exploit the help which may come from telemedicine.
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Affiliation(s)
- Intergruppo Melanoma Italiano
- Andrea Anichini, Salvatore Asero, Melissa Bersanelli, Corrado Caracò, Vincenzo De Giorgi, Anna Maria Di Giacomo, Claudio Feliciani, Virginia Ferraresi, Paola Ghiorzo, Antonio M. Grimaldi, Michele Guida, Mario Mandalà, Daniela Massi, Simone Mocellin, Giuseppe Palmieri, Roberto Patuzzo, Maria Antonietta Pizzichetta, Roberto Ricci, Giulio Rossi, Pietro Quaglino, Paola Queirolo, Rebecca Senetta, Ignazio Stanganelli, Marco Tucci
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30
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Filoni A, Del Fiore P, Cappellesso R, Dall'Olmo L, Salimian N, Spina R, Tropea S, Rastrelli M, Russano F, D'Amico M, Collodetto A, Rossi CR, Buja A, Vecchiato A, Alaibac M, Mocellin S. Management of melanoma patients during COVID-19 pandemic in an Italian skin unit. Dermatol Ther 2021; 34:e14908. [PMID: 33619813 PMCID: PMC7995113 DOI: 10.1111/dth.14908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/18/2021] [Accepted: 02/04/2021] [Indexed: 12/19/2022]
Abstract
Due to the COVID‐19 crisis, many scheduled medical and surgical activities have been suspended. This interruption to the healthcare system can negatively affect the diagnosis and management of melanoma. Neglecting melanoma throughout the outbreak may be associated with increased rates of mortality, morbidity, and healthcare expenses. We performed a retrospective review of all dermatological and surgical activity performed in our Melanoma Skin Unit between 23 February 2020 and 21 May 2020 and compared these data with those from the same period in 2019. During the lockdown period, we observed a decrease in dermatologic follow‐up (DFU) (−30.2%) and in surgical follow‐up (SFU) (−37%), and no modification of melanoma diagnosis (−3%). Finally, surgical excisions (SE) (+ 31.7%) increased, but sentinel lymph node biopsy (SLNB) (−29%) and lymph node dissections(LND) (−64%) decreased compared to the same period in 2019. Our experience supports the continuation of surgical and diagnostic procedures in patients with melanoma during the COVID‐19 pandemic. Surgical and follow‐up procedures for the diagnosis and treatment of melanoma should not be postponed considering that the pandemic is lasting for an extended period.
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Affiliation(s)
- Angela Filoni
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Paolo Del Fiore
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Rocco Cappellesso
- Division of Surgical Pathology and Cytopathology, Department of Medicine, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Luigi Dall'Olmo
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Nick Salimian
- Faculty of Medicine and Surgery, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Romina Spina
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Saveria Tropea
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Marco Rastrelli
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy.,Faculty of Medicine and Surgery, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Francesco Russano
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Mattia D'Amico
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Alessandra Collodetto
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Carlo Riccardo Rossi
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy.,Faculty of Medicine and Surgery, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Alessandra Buja
- Department of Cardiac, Thoracic, and Vascular Sciences, School of Medicine and Surgery, University of Padua, Padua, Italy
| | - Antonella Vecchiato
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy
| | - Mauro Alaibac
- Division of Dermatology, Department of Medicine, University of Padua, Padua, Italy
| | - Simone Mocellin
- Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy.,Faculty of Medicine and Surgery, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
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31
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The magnitude of COVID-19's effect on the timely management of melanoma and nonmelanoma skin cancers. J Am Acad Dermatol 2021; 84:1100-1103. [PMID: 33482258 PMCID: PMC7817517 DOI: 10.1016/j.jaad.2020.12.065] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/18/2020] [Accepted: 12/25/2020] [Indexed: 11/22/2022]
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32
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33
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Porcar Saura S, Pons Benavent M, Guillén Climent S, García Vázquez A. Attitudes of Patients With Skin Tumors During the COVID-19 Pandemic. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:195-198. [PMID: 32905789 PMCID: PMC7474904 DOI: 10.1016/j.ad.2020.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/14/2020] [Accepted: 08/22/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- S Porcar Saura
- Servicio de Dermatología. Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España.
| | - M Pons Benavent
- Servicio de Dermatología. Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
| | - S Guillén Climent
- Servicio de Dermatología. Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
| | - A García Vázquez
- Servicio de Dermatología. Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
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34
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Elmas ÖF, Demirbaş A, Düzayak S, Atasoy M, Türsen Ü, Lotti T. Melanoma and COVID-19: A narrative review focused on treatment. Dermatol Ther 2020; 33:e14101. [PMID: 32734626 DOI: 10.1111/dth.14101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022]
Abstract
Melanoma is the most severe form of skin cancer and its incidence has increased over the past few decades. COVID-19 pandemic affected the diagnosis and management of many diseases including melanoma. In this study, we aimed to provide a review focused on the diagnosis and management of melanoma in the era of COVID-19. A comprehensive search was conducted on PubMed, Web of Science, and Google Scholar databases using the keywords "melanoma," "coronavirus," "COVID 19," and "SARS-CoV-2." The relevant guidelines published by the European Society for Medical Oncology and the National Comprehensive Cancer Network were also included. The current guidelines recommend that surgical interventions for new diagnosis of invasive primary melanoma, patients with postoperative complications, wide resection and sentinel lymph node biopsy for newly diagnosed T3-T4 melanoma, and planned surgical procedures for patients in neo-adjuvant trials should be prioritized. Surgical treatment of T3/T4 melanomas should be prioritized over T1/T2 melanomas except for any melanoma in which large clinical residual lesion is visible. Adjuvant therapies can be postponed for up to 12 weeks depending on the local center circumstances. PD-1 inhibitor monotherapy is recommended for patients starting immunologic therapy. Combination immunotherapy is still considered suitable for patients with higher-risk disease. Encorafenib and binimetinib should be prioritized for patients requiring BRAF-targeted therapy due to the lower chance of symptoms mimicking COVID-19 infection.
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Affiliation(s)
- Ömer Faruk Elmas
- Department of Dermatology, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | | | - Serkan Düzayak
- Department of Dermatology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Mustafa Atasoy
- Department of Dermatology, Health Science University, Kayseri City Hospital, Kayseri, Turkey
| | - Ümit Türsen
- Department of Dermatology, Mersin University, Mersin, Turkey
| | - Torello Lotti
- Department of Dermatology, Guglielmo Marconi University, Rome, Italy
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Brochez L, Baurain JF, Del Marmol V, Nikkels A, Kruse V, Sales F, Stas M, Van Laethem A, Garmyn M. Recommendations for skin cancer consultation and surgery during COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:1876-1878. [PMID: 32789960 PMCID: PMC7436227 DOI: 10.1111/jdv.16772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e433–e466.
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Affiliation(s)
- L Brochez
- Dermatology, University Hospital Gent, Ghent, Belgium
| | - J F Baurain
- Centre du Cancer, Cu Saint-Luc/UCL, Brussels, Belgium
| | - V Del Marmol
- Dermatology, Hôspital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A Nikkels
- Dermatology, CHU du Sart Tilman, University of Liège, Liège, Belgium
| | - V Kruse
- Oncology, University Hospital Gent, Ghent, Belgium
| | - F Sales
- Surgery, Bordet Institute, Brussels, Belgium
| | - M Stas
- Oncological Surgery, University Hospital Leuven, Leuven, Belgium
| | - A Van Laethem
- Dermatology, University Hospital Leuven, Leuven, Belgium
| | - M Garmyn
- Dermatology, University Hospital Leuven, Leuven, Belgium
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de Pelsemaeker MC, Guiot Y, Vanderveken J, Galant C, Van Bockstal MR. The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology. Pathobiology 2020; 88:46-55. [PMID: 32634799 PMCID: PMC7445376 DOI: 10.1159/000509546] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/19/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology. Methods Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system. Results The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to “functional” pathology, such as thyroidectomies and gastric biopsies. Conclusions Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for “deconfinement” health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.
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Affiliation(s)
| | - Yves Guiot
- Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - Christine Galant
- Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium
| | - Mieke Rosalie Van Bockstal
- Department of Pathology, Cliniques universitaires Saint-Luc, Brussels, Belgium, .,Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain, Brussels, Belgium,
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