Scharf Camila, Mongardini Federico M, Fisone Francesca, Briatico Giulia, Brancaccio Gabriella, Chirico Fabrizio, Tolone Salvatore, Docimo Ludovico, Gambardella Claudio, Lucido Francesco, Parisi Simona, Moscarella Elvira, Argenziano Giuseppe, Iovino Francesco
Dermatology Unit, University of Campania L. Vanvitelli, Naples, Italy.
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Int J Dermatol. 2025 Jan;64(1):37-43. doi: 10.1111/ijd.17401. Epub 2024 Aug 2.
The global healthcare sector faced immense challenges due to the COVID-19 pandemic. Oncologists noted reduced cancer screening, which impacted melanoma diagnosis and treatment, leading to concerns about delayed care and poorer outcomes. This review analyzes how the pandemic influenced melanoma ulceration risk and Breslow thickness index through a meta-analysis of published studies. Following PRISMA guidelines, we conducted a systematic review of literature from January 2021 to December 2022 on cutaneous melanoma before and during the COVID-19 pandemic. Upon screening 1854 manuscripts, the review led to 13 studies meeting inclusion standards. The quality assessment followed MINORS and Newcastle-Ottawa Scale criteria. Regarding ulceration, post-COVID ulceration surpassed pre-COVID levels significantly, with a risk ratio of 1.31 and an estimated odds ratio of 1.41, indicating a 44% rise post-COVID. As for Breslow thickness, studies show a rising trend in the Breslow index post-COVID, but less significantly, with an effect size of 0.08 regarding the meta-analysis model (P = 0.02) with a pre-COVID mean Breslow of 1.56 mm and post-COVID of 1.84 mm. This meta-analysis concluded that post-COVID ulceration rates significantly surpassed pre-COVID levels. Considering that ulcerated melanomas usually undergo sentinel lymph node biopsy and are more likely to benefit from adjuvant therapies, this indicates important implications, as many patients might have missed the opportunity to start therapy appropriately, regardless of their Breslow thickness status.
由于新冠疫情，全球医疗保健行业面临巨大挑战。肿瘤学家指出癌症筛查减少，这影响了黑色素瘤的诊断和治疗，引发了对护理延迟和预后较差的担忧。本综述通过对已发表研究的荟萃分析，分析了疫情如何影响黑色素瘤溃疡风险和 Breslow 厚度指数。遵循 PRISMA 指南，我们对 2021 年 1 月至 2022 年 12 月期间关于新冠疫情之前和期间皮肤黑色素瘤的文献进行了系统综述。在筛选了 1854 篇手稿后，该综述得出 13 项研究符合纳入标准。质量评估遵循 MINORS 和纽卡斯尔 - 渥太华量表标准。关于溃疡，新冠疫情后的溃疡发生率显著超过疫情前水平，风险比为 1.31，估计优势比为 1.41，表明新冠疫情后上升了 44%。至于 Breslow 厚度，研究表明新冠疫情后 Breslow 指数呈上升趋势，但不太显著，荟萃分析模型的效应大小为 0.08（P = 0.02），疫情前 Breslow 平均厚度为 1.56 毫米，疫情后为 1.84 毫米。该荟萃分析得出结论，新冠疫情后的溃疡发生率显著超过疫情前水平。鉴于溃疡型黑色素瘤通常会进行前哨淋巴结活检，并且更有可能从辅助治疗中获益，这表明具有重要意义，因为许多患者可能错过了适当开始治疗的机会，无论其 Breslow 厚度状况如何。
