Did COVID-19 lockdown delay actually worsen melanoma prognosis?

Abstract

Background: The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology.

Objectives: To evaluate the immediate and mid-term impact of diagnosis delay on melanoma.

Methods: A retrospective observational study of melanoma diagnosed between March 14^th 2019 and March 13^th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively.

Results: A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p>0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9mm, p<0.05) resulting in a significant upstaging according to the AJCC 8^th ed. (p<0.05).

Study limitations: The main limitation is that this is a single-center study.

Conclusions: The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.

Keywords: COVID-19; Melanoma; Prognosis; Quarantine; SARS-CoV-2.