Department of Plastic Surgery, Medical School, University of Ioannina, Leoforos St. Niarchou, 45110, Ioannina, Greece.
World J Surg Oncol. 2021 Dec 24;19(1):350. doi: 10.1186/s12957-021-02468-z.
The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period.
A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019.
Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap.
These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided.
The study adhered to the STROBE statement for case-control studies.
COVID-19 大流行导致欧洲实施了为期 2 个月的封锁。包括皮肤癌切除术在内的择期手术被推迟。本前瞻性病例对照研究的目的是评估在封锁后第一阶段治疗延迟对非黑素瘤皮肤癌（NMSC）或黑色素瘤患者的影响。
对 2020 年和 2019 年在 4 个月内进行的皮肤癌手术进行了比较研究。所有数据均从一个前瞻性维护的诊所数据库和病理报告中收集。根据分布情况，连续变量用 t 检验或 Mann-Whitney U 检验进行比较。分类变量用 Fisher 确切检验进行比较。用比值比（OR）及其 95%置信区间（95%CI）评估 2020 年与 2019 年相比切除高危 NMSC 的风险。
2020 年共进行了 158 例皮肤癌切除术，而 2019 年为 125 例（增加了 26.4%）。2020 年切除的 SCC 明显增多（p=0.024）。BCC、SCC 和黑色素瘤的几个临床参数无显著差异。然而，切除 NMSC 后应用的重建方法存在显著差异，通常需要皮肤移植或皮瓣。
这些结果表明，COVID-19 大流行导致的皮肤癌治疗延迟与 SCC 发病率增加以及重建方法复杂化有关。考虑到 COVID-19 反复出现的浪潮，应避免出现严重的皮肤癌治疗延迟。
本研究符合病例对照研究的 STROBE 声明。
