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2020年新型冠状病毒肺炎大流行对侵袭性皮肤黑色素瘤的诊断、治疗及预后的影响:一项全国性回顾性队列研究。

The impact of the COVID-19 pandemic in 2020 on the diagnosis, treatment, and outcomes of invasive cutaneous melanoma: A retrospective national cohort study.

作者信息

Xiong David D, Bordeaux Jeremy

机构信息

Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.

Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.

出版信息

J Am Acad Dermatol. 2023 Dec;89(6):1167-1176. doi: 10.1016/j.jaad.2023.08.040. Epub 2023 Aug 23.

Abstract

BACKGROUND

Prior multiinstitutional studies demonstrate that patients diagnosed with melanoma during the Coronavirus Disease 2019 (COVID-19) pandemic presented with more advanced melanomas.

OBJECTIVES

To further characterize patients diagnosed with melanoma during the COVID-19 pandemic.

METHODS

Retrospective population-based cohort study of the Surveillance, Epidemiology, and End-Results (SEER) registry of patients diagnosed with cutaneous melanoma from 2018-2020.

RESULTS

Patients diagnosed with melanoma in 2020 were more likely to have increased Breslow depth, more ulceration, nodular tumors, and more advanced stage at diagnosis despite less treatment delays. Patients tended to be from wealthier, more urban areas. Primary surgical treatment was more likely to be with Mohs surgery. Diagnosis in the year 2020 was not correlated with overall or disease specific survival.

LIMITATIONS

This is a retrospective cohort review and limited by short follow-up times, which could affect survival outcomes. There was a 15.5% drop in melanoma diagnosis in 2020 compared to prior years, which could relate to delayed presentation.

CONCLUSIONS AND RELEVANCE

Patients diagnosed with melanoma in 2020 tended to have thicker, more ulcerated, and more advanced tumors, but this was not associated with survival. Further studies are needed to characterize outcomes for patients diagnosed with melanoma during the COVID-19 pandemic.

摘要

背景

先前的多机构研究表明,在2019年冠状病毒病(COVID-19)大流行期间被诊断为黑色素瘤的患者,其黑色素瘤病情更严重。

目的

进一步描述在COVID-19大流行期间被诊断为黑色素瘤的患者特征。

方法

对2018年至2020年诊断为皮肤黑色素瘤的患者进行基于监测、流行病学和最终结果(SEER)登记处的回顾性人群队列研究。

结果

2020年被诊断为黑色素瘤的患者,尽管治疗延迟较少,但更有可能出现Breslow深度增加、溃疡更多、结节状肿瘤以及诊断时分期更晚的情况。患者往往来自更富裕、城市化程度更高的地区。初次手术治疗更有可能采用莫氏手术。2020年的诊断与总生存率或疾病特异性生存率无关。

局限性

这是一项回顾性队列研究,受随访时间短的限制,这可能会影响生存结果。与前几年相比,2020年黑色素瘤诊断下降了15.5%,这可能与就诊延迟有关。

结论及意义

2020年被诊断为黑色素瘤的患者往往有更厚、溃疡更多且病情更严重的肿瘤,但这与生存率无关。需要进一步研究来描述在COVID-19大流行期间被诊断为黑色素瘤的患者的结局。

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