Uvid u lečenje obolelih od melanoma za vreme pandemije COVID-19 – iskustvo jednog centra

  • Jelena Nikolić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Marija Marinković Engleski
  • Mladen Jovanović Engleski
  • Ivana Mijatov University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Dragana Leković-Stojanov University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery, Novi Sad, Serbia
  • Stefan Kecman University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery, Novi Sad, Serbia
Ključne reči: biopsija;, hirurgija, dermatološka, procedure;, dijagnoza;, melanom;, covid-19;, hirurgija, rekonstruktivna, procedure.

Sažetak


Uvod/Cilj. Uprkos svim inovacijama u medicini, za melanom se i dalje beleže porast incidence i visoka smrtnost, zbog čega predstavlja značajan izazov za zdravstveni sistem. Pandemija koronavirusne bolesti 2019 (COVID-19), koja je trajala tri godine, preusmerila je resurse zdravstvene zaštite, obustavila preventivne programe i opteretila zdravstveni sistem, što je uticalo na lečenje obolelih od melanoma. Cilj rada bio je da se proceni uticaj pandemije COVID-19 na lečenje obolelih od melanoma. Metode. Retrospektivnom studijom su obuhvaćeni oboleli od melanoma koji su lečeni u jednom tercijarnom zdravstvenom centru tokom dva trogodišnja perioda: pre-COVID-19 perioda (2017–2019) i perioda pandemije COVID-19 (2020–2022). Prikupljeni su i upoređeni sledeći podaci: demografske karakteristike bolesnika, karakteristike melanoma, vremenski interval od biopsije do radikalne hirurške intervencije i udeo tankih i debelih melanoma. Rezultati. Tokom perioda pandemije COVID-19, u odnosu na period pre pandemije, zastupljenost obolelih od melanoma je smanjena 30%. Najveći pad registrovan je tokom 2020. godine, u vreme uvedenog vanrednog stanja u zemlji. Procenat tankog melanoma, kao mera uspešnih programa skrininga, značajno se smanjio tokom pandemije COVID-19 (11,57% naspram 24,01%), dok se srednja debljina melanoma, prema skali Breslow, nije značajno promenila. Distribucija različitih histoloških tipova melanoma bila je nepromenjena u oba perioda. Prosečno vreme od biopsije do hirurškog zahvata ostalo je slično između dva perioda, oko 40 dana. Zaključak. Uprkos izazovima koje je donela pandemija COVID-19, melanom ostaje kritično pitanje zdravstvene zaštite. Ovo istraživanje je istaklo značaj davanja prioriteta lečenju obolelih od melanoma u urgentnim okolnostima, kako bi se obezbedila rana identifikacija bolesnika i njihovo pravovremeno lečenje, u cilju njihovog boljeg preživljavanja i manjih troškova lečenja.

Reference

Conic RZ, Cabrera CI, Khorana AA, Gastman BR. Determina-tion of the impact of melanoma surgical timing on survival us-ing the National Cancer Database. J Am Acad Dermatol 2018; 78(1): 40–6.e7.

Hajdarevic S, Hörnsten Å, Sundbom E, Isaksson U, Schmitt-Egenolf M. Health-care delay in malignant melanoma: Various path-ways to diagnosis and treatment. Dermatol Res Pract 2014; 2014: 294287.

Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Bastholt L, et al. Diagnosis and treatment of melanoma. European con-sensus-based interdisciplinary guideline - Update 2016. Eur J Cancer 2016; 63: 201–17.

Chevalier J, Bonastre J, Avril MF. The economic burden of mel-anoma in France: assessing healthcare use in a hospital setting. Melanoma Res 2008; 18(1): 40–6.

Buja A, Sartor G, Scioni M, Vecchiato A, Bolzan M, Rebba V, et al. Estimation of direct melanoma-related costs by disease stage and by phase of diagnosis and treatment according to clinical guidelines. Acta Derm Venereol 2018; 98(2): 218–24.

Maringe C, Spicer J, Morris M, Purushotham A, Nolte E, Sullivan R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol 2020; 21(8): 1023–34. Erratum in: Lancet Oncol 2021; 22(1): e5.

Lallas A, Kyrgidis A, Manoli SM, Papageorgiou C, Lallas K, Soti-riou E, et al. Delayed skin cancer diagnosis in 2020 because of the COVID-19-related restrictions: Data from an institutional registry. J Am Acad Dermatol 2021; 85(3): 721–3.

Slotman E, Schreuder K, Nijsten TEC, Wakkee M, Hollestein L, Mooyaart A, et al. The impact of the COVID-19 pandemic on keratinocyte carcinoma in the Netherlands: Trends in diagno-ses and magnitude of diagnostic delays. J Eur Acad Dermatol-ogy Venereol 2022; 36(5): 680–7.

Marson JW, Maner BS, Harding TP, Meisenheimer J VII, Solomon JA, Leavitt M, et al. The magnitude of COVID-19’s effect on the timely management of melanoma and nonmelanoma skin cancers. J Am Acad Dermatol 2021; 84(4): 1100–3.

Ricci F, Fania L, Paradisi A, Di Lella G, Pallotta S, Sobrino L, et al. Delayed melanoma diagnosis in the COVID-19 era: in-creased breslow thickness in primary melanomas seen after the COVID-19 lockdown. J Eur Acad Dermatol Venereol 2020; 34(12): e778–9.

Shannon AB, Sharon CE, Straker RJ 3rd, Miura JT, Ming ME, Chu EY, et al. The impact of the COVID-19 pandemic on the presentation status of newly diagnosed melanoma: A single in-stitution experience. J Am Acad Dermatol 2021; 84(4): 1096–8.

Ungureanu L, Apostu AP, Vesa ȘC, Cășeriu AE, Frățilă S, Iancu G, et al. Impact of the COVID-19 Pandemic on Melanoma Diagnosis in Romania-Data from Two University Centers. Int J Environ Res Public Health 2022; 19(22): 15129.

Fanning JE, Kalsi S, Krag DN. Impact of the COVID-19 pan-demic on melanoma diagnosis and presentation: a `review. Int J Dermatol 2023; 62(7): 850–6.

Troesch A, Hoellwerth M, Forchhammer S, Del Regno L, Lodde G, Turko P, et al. The impact of the COVID-19 pandemic on the diagnosis of cutaneous melanomas: A retrospective cohort study from five European skin cancer reference centres. J Eur Acad Dermatol Venereol 2023; 37(5): 922–31.

Whiteman DC, Green AC, Olsen CM. The Growing Burden of Invasive Melanoma: Projections of Incidence Rates and Numbers of New Cases in Six Susceptible Populations through 2031. J Invest Dermatol 2016; 136(6): 1161–71.

Saginala K, Barsouk A, Aluru JS, Rawla P, Barsouk A. Epidemiology of Melanoma. Med Sci (Basel) 2021; 9(4): 63.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemi-ological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507–13.

Gomolin T, Cline A, Handler MZ. The danger of neglecting melanoma during the COVID-19 pandemic. J Dermatolog Treat 2020; 31(5): 444–5.

Objavljeno
2024/04/26
Rubrika
Originalni članak