Estimated Effect of COVID-19 Lockdown on Skin Tumor Size and Survival : An Exponential Growth Model Estimación del efecto en el tamaño y la supervivencia de los tumores cutáneos debido al confinamiento por COVID-19: modelo basado en un crecimiento exponencial
Tejera-Vaquerizo, Antonio ![ORCID Identifier](/img/uab/orcid.ico)
(Servicio de Dermatología. Instituto Dermatológico GlobalDerm)
Cañueto, Javier (Hospital Universitario de Salamanca)
Toll Abelló, Agustí (Hospital Clínic i Provincial de Barcelona)
Santos-Juanes, Jorge ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitario Central de Asturias)
Jaka, Ane ![ORCID Identifier](/img/uab/orcid.ico)
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrandiz-Pulido, Carla ![ORCID Identifier](/img/uab/orcid.ico)
(Hospital Universitari Vall d'Hebron)
Sanmartín, Onofre (Fundació Institut Valencià d'Oncologia)
Ribero, Simone (Departamento de Dermatología. Hospital Universitario de Turín)
Moreno-Ramírez, David
(Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Almazán Castro, Francisco (Hospital Universitario San Cecilio (Granada))
Fuente González, María Josefa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Podlipnik, Sebastian
(Hospital Clínic i Provincial de Barcelona)
Nagore, Eduardo
(Fundació Institut Valencià d'Oncologia)
Universitat Autònoma de Barcelona
Date: |
2020 |
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 >4cm 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. |
Grants: |
Instituto de Salud Carlos III PI18-00587
|
Rights: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. ![Creative Commons](/img/licenses/by-nc-nd.ico) |
Language: |
Castellà |
Document: |
Article ; recerca ; Versió publicada |
Subject: |
COVID-19 virus disease ;
Cutaneous squamous cell carcinoma ;
Early diagnosis ;
Lockdown ;
Melanoma ;
Prognosis |
Published in: |
Actas Dermo-Sifiliograficas, 2020 , ISSN 1578-2190 |
DOI: 10.1016/j.ad.2020.05.001
PMID: 32513393
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Record created 2020-06-22, last modified 2024-07-24