Department of Dermatology, Kırşehir Ahi Evran University, Kırşehir, Turkey.
Department of Dermatology, Konya Numune Hospital, Konya, Turkey.
Dermatol Ther. 2020 Nov;33(6):e14101. doi: 10.1111/dth.14101. Epub 2020 Aug 25.
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.
黑色素瘤是最严重的皮肤癌形式,其发病率在过去几十年中有所增加。COVID-19 大流行影响了许多疾病的诊断和管理,包括黑色素瘤。在这项研究中,我们旨在提供一篇综述,重点介绍 COVID-19 时代黑色素瘤的诊断和管理。我们在 PubMed、Web of Science 和 Google Scholar 数据库中使用了“黑色素瘤”、“冠状病毒”、“COVID-19”和“SARS-CoV-2”等关键词进行了全面搜索。还包括欧洲肿瘤内科学会和美国国家综合癌症网络发布的相关指南。目前的指南建议优先考虑新诊断的侵袭性原发性黑色素瘤、术后并发症患者、新诊断的 T3-T4 黑色素瘤的广泛切除和前哨淋巴结活检,以及新辅助试验中计划进行手术的患者。除非可见大的临床残留病灶,否则 T3/T4 黑色素瘤的手术治疗应优先于 T1/T2 黑色素瘤。辅助治疗可根据当地中心情况推迟最多 12 周。对于开始免疫治疗的患者,建议使用 PD-1 抑制剂单药治疗。对于高危疾病患者,仍考虑联合免疫治疗。由于出现 COVID-19 感染症状的可能性较低,对于需要 BRAF 靶向治疗的患者,应优先考虑encorafenib 和 binimetinib。