Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience

Cariti, Caterina; Merli, Martina; Avallone, Gianluca; Rubatto, Marco; Marra, Elena; Fava, Paolo; Caliendo, Virginia; Picciotto, Franco; Gualdi, Giulio; Stanganelli, Ignazio; Fierro, Maria Teresa; Ribero, Simone; Quaglino, Pietro

doi:10.3390/cancers13236071

Cited by 16 publications

(12 citation statements)

References 42 publications

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“…A study developed in four provinces of the Veneto region in Italy documented a 12% decrease in melanoma cases during the COVID-19 period [ 17 ], while, in Turin, Italy Cariti et al found a 32% reduction in melanoma excisions in 2020 compared to the previous years (2017–2019), with the most frequently excised type being superficial spreading melanoma (SSM), whereas, in the previous years it was melanoma in situ. Regarding the Breslow thickness, it was higher than in the previous years (the average thickness was 1.56 mm), but the difference was not statistically significant [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, Lallas et al found that the patients with melanoma were significantly younger than those before the lockdown, which might mean that the elderly might feel a greater fear of COVID-19 [ 14 ]. Cariti et al also reported that the average age of melanoma patients during the COVID-19 lockdown was much lower than the one before the lockdown (55 vs. 60 years) [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania—Data from Two University Centers

Ungureanu

Apostu

Vesa

et al. 2022

IJERPH

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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 1st March 2019 and 29th February 2020 (pre-COVID-19) and between 1st March 2020 and 28th 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania—Data from Two University Centers

Ungureanu

Apostu

Vesa

et al. 2022

IJERPH

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“…The study selection process is summarized in Figure 1 . From a total of 466 records, 25 studies were incorporated in our data analysis models [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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

Seretis

Bounas

Gaitanis

et al. 2022

Cancers

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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.

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“…Most of the authors recommend continuing immunotherapy without interruption if possible. They argue that almost no patients have developed Covid-19, and there is increased risk for tumor progression in patients discontinuing their melanoma therapy [ 9 , 10 , 15 ]. However, those studies analyzed all melanoma patients undergoing therapy, including those without Sars-CoV-2 infection, in a very short time period of one to two months.…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on the management of patients with metastatic melanoma

et al. 2022

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The Covid-19 pandemic created new uncertainties in the management of metastatic melanoma patients. In particular, the impact of immunotherapy, targeted therapy, or chemotherapy on the risk of Sars-CoV-2 infection and severity was debated. In this study, we analyzed all patients with metastatic melanoma receiving therapy who developed Covid-19 between February 2020 and February 2022. We retrospectively collected demographic data, cancer-specific parameters, melanoma treatment regimen, comorbidities and Covid-19-specific parameters in these patients. Of the 350 patients with metastatic melanoma, 25 had Covid-19. The median age at the time of Covid-19 diagnosis was 66 years (range 36–86), 10 patients were female, and 15 patients were male. The treatment regimen during infection was immunotherapy in 12 cases, followed by targeted therapy ( n = 8), chemotherapy ( n = 2), and TVEC injections, follow-up and palliative therapy in 1 case each. The severity was mild in 17 patients and 8 had a moderate to critical course. Patients with a severe Covid-19 course were often older and had more comorbidities than patients with a mild infection. Many of the patients had a mild Covid-19 course despite having metastatic melanoma and systemic therapy. We therefore recommend continuing systemic therapy whenever possible, even in such exceptional situations as the Covid-19 pandemic.

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Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience

Cited by 16 publications

References 42 publications

Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania—Data from Two University Centers

Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania—Data from Two University Centers

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

Impact of Covid-19 on the management of patients with metastatic melanoma

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