Estimated effect of COVID-19 lockdown on skin tumor size and survival: an exponential growth model
Date
2020Author
Tejera-Vaquerizo, A.
Canueto, J.
Toll, A.
Santos-Juanes, J.
Jaka, A.
Ferrandiz, C.
Sanmartín, O.
Ribero, S.
Moreno-Ramírez, D.
Almazan, F.
Fuente, M.J.
Podlipnik, S.
Nagore, E.
Metadata
Show full item recordAbstract
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.
Link to resource
https://doi.org/10.1016/j.adengl.2020.09.008Collections
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