Emerging Developments in Management of Melanoma During the COVID-19 Era

Li, Andraia R.; Valdebran, Manuel; Reuben, Daniel Y.

doi:10.3389/fmed.2021.769368

Cited by 5 publications

(4 citation statements)

References 40 publications

(43 reference statements)

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“…During the early phase of the pandemic, many dermatology practices were not open or only saw emergent cases [11]. To adjust for the limited access to care during the early pandemic, the National Comprehensive Cancer Network (NCCN) released specific guidelines for surgical management and follow-up for patients with known melanoma [13]. In many instances, however, the surveillance for new melanomas through routine screening was halted or significantly delayed during this period.…”

Section: Introductionmentioning

confidence: 99%

The number needed to biopsy for cutaneous melanoma in academic dermatology clinics

Kibbie,

Zita,

Dellavalle

et al. 2024

Melanoma Research

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A standard metric for melanoma detection is the number needed to biopsy (NNB). This metric has been used to evaluate practicing dermatologists, dermatology advanced practice professionals, and primary care providers. This metric, however, has rarely been applied to residency clinics. We aimed to determine the NNB at the University of Colorado residency clinics. Moreover, we sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on NNB. This study is a retrospective analysis of biopsies performed from 2016 to 2022 at the Denver Health Medical Center and the Rocky Mountain Regional Veteran Affairs dermatology clinics. Differential diagnosis at the time of biopsy was searched for keywords including melanoma, melanoma in situ, and lentigo maligna. Skin biopsies that included re-excisions were excluded. The NNB was subsequently generated by dividing the number of biopsied lesions with suspected melanoma by the number of histologically confirmed melanomas. The data was further separated by pre-COVID-19 (2016–February 2020), COVID-19 shutdown period (March 2020–July 2020), and post-COVID-19 (March 2020–present). Demographic data, including age, sex, race, and Fitzpatrick type, were collected. There were 2230 biopsies with suspected melanoma in the differential diagnosis at both clinic sites from 2016 to 2022. Of these, 362 were histologically confirmed melanoma. Total NNB was 6.16. The pre-COVID-19 NNB was 5.86, and the post-COVID-19 NNB was 6.91. Residency clinics have NNB similar to published values of practicing dermatologists. Furthermore, within these clinics, the impact of the COVID-19 pandemic was appreciated by a relative, although statistically insignificant, increase in NNB.

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Section: Introductionmentioning

confidence: 99%

The number needed to biopsy for cutaneous melanoma in academic dermatology clinics

Kibbie,

Zita,

Dellavalle

et al. 2024

Melanoma Research

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“… 9 The treatment of advanced skin cancers correlates with a poorer prognosis and significant healthcare burden. 10 For every 4‐week delay in treatment for head and neck cancers, there is a 6%–8% increase in the risk of death. 11 This highlights the importance of prompt treatment while balancing the risks of COVID‐19 infection.…”

Section: Introductionmentioning

confidence: 99%

“…From April 2020 to November 2020 there was a 28% decrease in the diagnosis of melanoma, and a 24% decrease in diagnoses of all skin cancers (excluding NMSC) 9 . The treatment of advanced skin cancers correlates with a poorer prognosis and significant healthcare burden 10 . For every 4‐week delay in treatment for head and neck cancers, there is a 6%–8% increase in the risk of death 11 .…”

Section: Introductionmentioning

confidence: 99%

The effect of COVID‐19 on surgical management of skin cancers of the head, face and neck in elderly patients

Borg

Eisold

Miyanjo

et al. 2023

Skin Health and Disease

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Background: The Corona Virus (COVID-19) has had a profound impact on healthcare systems worldwide, with interruptions to medical practices including the delivery of cancer treatment. Skin cancer is one of the leading causes of malignancy worldwide, with later stages of disease correlating to poorer prognosis. Immunocompromized and elderly patients represent populations that are at higher risk for adverse outcomes related to skin cancer, treatment delay and COVID-19 infection. Methodology: Patients aged 65 and above who underwent surgical management of skin cancers from 31 January 2020 to 31 January 2021 were included in this study then compared with samples pre-and post-pandemic. Retrospective analysis was performed regarding: date of referral to date of surgery, skin cancer type, location of cancer, surgery performed, anaesthesia used, sutures used and outcomes. Data was compared to national guidelines. Results: Five hundred and twenty skin cancers were included in this analysis, of which 340 were treated during the COVID-19 pandemic. Of the cohort treated during the pandemic, 44.2% (n = 111) received excision and direct closure, 13.1% (n = 33) underwent reconstruction by integra dermal substitute, 3.2% (n = 8) by split thickness skin graft, 6.4% (n = 16) by full thickness skin grafts and 33.1% (n = 83) by local flaps. Complete excision was achieved in 88.5% of cases (n = 301). The mean time from referral to surgery was 119 days. There were no deaths associated with COVID-19. Conclusion: Safe and prompt treatment of head and neck skin cancers is achievable despite the COVID-19 pandemic. Measures to minimize infection risk include the use of teledermatology, reliable COVID-19 testing, Green Pathways and a reduction in the mean referral to surgery time.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…In order to minimize the burden on the healthcare system and physical contact, many medical visits, such as skin cancer screenings were postponed. For this reason, newly detected tumors had significantly higher tumor thickness and mitotic rates and overall higher TNM stage at diagnosis [6,[10][11][12][13]. However, the pandemic also had implications for the treatment of patients with metastatic melanoma (AJCC 8th Edition Stage 3 and 4).…”

Section: Introductionmentioning

confidence: 99%

Impact of Covid-19 on the management of patients with metastatic melanoma

et al. 2022

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The Covid-19 pandemic created new uncertainties in the management of metastatic melanoma patients. In particular, the impact of immunotherapy, targeted therapy, or chemotherapy on the risk of Sars-CoV-2 infection and severity was debated. In this study, we analyzed all patients with metastatic melanoma receiving therapy who developed Covid-19 between February 2020 and February 2022. We retrospectively collected demographic data, cancer-specific parameters, melanoma treatment regimen, comorbidities and Covid-19-specific parameters in these patients. Of the 350 patients with metastatic melanoma, 25 had Covid-19. The median age at the time of Covid-19 diagnosis was 66 years (range 36–86), 10 patients were female, and 15 patients were male. The treatment regimen during infection was immunotherapy in 12 cases, followed by targeted therapy ( n = 8), chemotherapy ( n = 2), and TVEC injections, follow-up and palliative therapy in 1 case each. The severity was mild in 17 patients and 8 had a moderate to critical course. Patients with a severe Covid-19 course were often older and had more comorbidities than patients with a mild infection. Many of the patients had a mild Covid-19 course despite having metastatic melanoma and systemic therapy. We therefore recommend continuing systemic therapy whenever possible, even in such exceptional situations as the Covid-19 pandemic.

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Emerging Developments in Management of Melanoma During the COVID-19 Era

Cited by 5 publications

References 40 publications

The number needed to biopsy for cutaneous melanoma in academic dermatology clinics

The number needed to biopsy for cutaneous melanoma in academic dermatology clinics

The effect of COVID‐19 on surgical management of skin cancers of the head, face and neck in elderly patients

Impact of Covid-19 on the management of patients with metastatic melanoma

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