A Tejera-Vaquerizo1, J Cañueto2, A Toll3, J Santos-Juanes4, A Jaka5, C Ferrandiz6, O Sanmartín7, S Ribero8, D Moreno-Ramírez9, F Almazán10, M J Fuente5, S Podlipnik3, E Nagore7. 1. Servicio de Dermatología, Instituto Dermatológico GlobalDerm, Palma del Río Córdoba, Spain. 2. Servicio de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain. 3. Servicio de Dermatología, Hospital Clìnic de Barcelona, Barcelona, Spain. 4. Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. 5. Servicio de Dermatología, Hospital Germans Trial i Pujol, Badalona, Barcelona, Spain. 6. Servicio de Dermatología, Hospital de la Vall d'Hebron, Barcelona, Spain. 7. Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain. 8. Departamento de Dermatología, Hospital Universitario de Turín, Turín, Italy. 9. Unidad de Melanoma, Servicio de Dermatología Médico-Quirúrgica, Hospital Universitario Virgen Macarena, Sevilla, Spain. 10. Unidad de Gestión Clínica de Dermatología, Hospital Universitario San Cecilio, Granada, Spain.
Abstract
Background and objectives: Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. Material and methods: Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. Results: Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five- and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. Conclusions: In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect to see to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays.
Background and objectives: Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. Material and methods: Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. Results: Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five- and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. Conclusions: In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect to see to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays.
Authors: A Boada; A Tejera-Vaquerizo; S Ribero; S Puig; D Moreno-Ramírez; S Osella-Abate; P Cassoni; J Malvehy; S Podlipnik; C Requena; E Manrique-Silva; J J Rios-Martin; C Ferrándiz; E Nagore Journal: J Eur Acad Dermatol Venereol Date: 2020-05-22 Impact factor: 6.166
Authors: David L Bartlett; James R Howe; George Chang; Aimee Crago; Melissa Hogg; Giorgos Karakousis; Edward Levine; Ajay Maker; Eleftherios Mamounas; Kandace McGuire; Nipun Merchant; David Shibata; Vance Sohn; Carmen Solorzano; Kiran Turaga; Richard White; Anthony Yang; Sam Yoon Journal: Ann Surg Oncol Date: 2020-04-08 Impact factor: 5.344
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