Estimated effect of COVID-19 lockdown on skin tumor size and survival: an exponential growth model☆

Autor: Javier Cañueto, Antonio Tejera-Vaquerizo, Agustí Toll, E. Nagore, M.J. Fuente, Onofre Sanmartín, Fernando Almazán, David Moreno-Ramírez, C. Ferrandiz-Pulido, Simone Ribero, Ane Jaka, Sebastian Podlipnik, J. Santos-Juanes
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Oncology
Delayed Diagnosis
Time Factors
Skin Neoplasms
Review
Health Services Accessibility
COVID-19 virus disease
Cutaneous squamous cell carcinoma
Early diagnosis
Lockdown
Melanoma
Prognosis
Communicable Disease Control
Humans
Multicenter Studies as Topic
Observational Studies as Topic
Retrospective Studies
SARS-CoV-2
Spain
COVID-19
COVID-19 coronavirus
030207 dermatology & venereal diseases
0302 clinical medicine
Public Health Surveillance
Tumor size
Age Factors
Pronóstico
General Medicine
Tumor Burden
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Quarantine
Carcinoma
Squamous Cell
Female
Coronavirus Infections
Algorithms
Cohort study
medicine.medical_specialty
Histology
Coronavirus disease 2019 (COVID-19)
Pneumonia
Viral
Skin tumor
Dermatology
Article
Time-to-Treatment
Pathology and Forensic Medicine
Betacoronavirus
03 medical and health sciences
Sex Factors
Diagnóstico precoz
Exponential growth
Internal medicine
medicine
Pandemics
ComputingMethodologies_COMPUTERGRAPHICS
business.industry
Retrospective cohort study
medicine.disease
Carcinoma de células Escamosas cutáneo
Confinamiento
Cutaneous melanoma
business
Zdroj: Actas Dermo-Sifiliograficas
Actas Dermo-Sifiliográficas
ISSN: 1578-2190
0001-7310
Popis: Graphical abstract
Background and objectives Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. Material and methods Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. Results Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five- and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. Conclusions In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect to see to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays.
Databáze: OpenAIRE
Externí odkaz: