A Meta-Analysis on the Impact of the COVID-19 Pandemic on Cutaneous Melanoma Diagnosis in Europe

Abstract

The COVID-19 pandemic has been the epicenter of healthcare attention globally for the past two years, and large-scale adaptations in healthcare provision have been required. This study aimed to investigate the impact of the pandemic and the resulting lockdowns on cutaneous melanoma diagnosis and tumor burdens in Europe. A relevant literature search in electronic databases was conducted from inception to September 2022. The inclusion criteria were: controlled studies published in a peer-reviewed journal evaluating cutaneous melanoma in Europe and reporting data on melanoma characteristics from diagnoses. The quality of studies was evaluated using the Cochrane ROBINS-I tool for assessing bias in non-randomized studies. Meta-analysis was conducted utilizing a random effects model to synthesize the data. A total of 25 studies involving 32,231 patients were included in the data analysis models. Statistically significant increases in mean Breslow thickness (0.29 mm (0.03–0.55 mm)), ulceration rates (OR = 1.66 (1.29–2.13)), and resultant tumor staging were observed in the PostCovid group, with subgroup analysis revealing that lockdown-derived data were responsible for this trend. This meta-analysis reported on the impact of COVID-19 restrictions on melanoma diagnosis in Europe, emphasizing the higher tumor burden and disease progression state provoked by healthcare adaptations in the pandemic period.

The Efficacy of Wide-Awake Local Anesthesia No Tourniquet (WALANT) in Common Plastic Surgery Operations Performed on the Upper Limbs: A Case–Control Study

“…It is also worth mentioning that the WALANT approach during the Coronavirus pandemic was recommended by the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand for hand injury management, so that medical resources are conserved [ 29 ]. Expecting a surge of surgical cases following the tremendous impact of the early pandemic phase on skin cancer, WALANT seems a viable, reliable and worthwhile procedure [ 30 , 31 ]. Although we have not performed a formal cost-analysis, we estimate lower total costs in the WALANT group due to the significantly shorter operation theater occupation time and the avoidance of the main operating room, the anesthesiologist and most of the non-medical personnel.…”

Intraoperative Flow Cytometry for the Rapid Diagnosis and Validation of Surgical Clearance of Non-Melanoma Skin Cancer: A Prospective Clinical Feasibility Study

“…Furthermore, the recent COVID-19 pandemic, and the subsequent restrictions to healthcare services, had a profound impact on skin cancer diagnosis and treatment [40,41]. Indeed, an increased incidence of SCC and more complicated methods of reconstruction following NMSC excision, as well as higher melanoma burden and disease progression were revealed [40,41].…”

“…Furthermore, the recent COVID-19 pandemic, and the subsequent restrictions to healthcare services, had a profound impact on skin cancer diagnosis and treatment [40,41]. Indeed, an increased incidence of SCC and more complicated methods of reconstruction following NMSC excision, as well as higher melanoma burden and disease progression were revealed [40,41]. Considering the association between delay of surgery and increased mortality recently revealed, and the heavy workload of NMSC cases anticipated in the postpandemic era, the timely and adequate treatment provided is of utmost importance [42].…”

Real-World Evaluation of the Management, Treatment Pathways and Outcome of Melanoma Patients with Target Therapies in Italy

“…This point deserves special attention, as the COVID-19 pandemic has been the central global emergency during the past 2 years, resulting in large-scale adaptations in healthcare provisions. A recent meta-analysis by Seretis et al [ 35 ] investigated the relationship of the pandemic outbreak and lockdowns with melanoma diagnoses and related burdens across Europe. Through an extensive literature search, the authors selected 25 studies involving 32,231 patients and found significantly increased mean Breslow thickness, ulceration rates, and resultant tumor staging in the post-COVID era, indicating that the pandemic caused a heavier tumor burden and faster disease progression state due to healthcare adaptations, especially during the earlier pandemic waves.…”