Sophie H. Chung MD, Jacob L. Leung BA, Kelsey S. Romatoski MD, Gordana Rasic MD, MS, Anna J. Kobzeva-Herzog MD, Jennifer F. Tseng MD, MPH, FACS, Kelly Kenzik MS, PhD, Teviah E. Sachs MD, MPH, FACS
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引用次数: 0
Abstract
Introduction
Timely treatment for patients with melanoma is critical. This study evaluated associations between the COVID-19 pandemic and time to treatment for patients with melanoma and delineated factors associated with delayed treatment.
Methods
Using the National Cancer Database, patients with cutaneous melanoma were categorized using year of diagnosis: COVID era (2020) versus pre-COVID era (2018-2019). Multivariable logistic regression was used to estimate the odds of delayed time to surgery (DTS) and/or chemoimmunotherapy (DTC), defined as >30 d.
Results
Among 72,590 patients with melanoma, 71.2% were diagnosed in the pre-COVID era (25,210 in 2018; 26,471 in 2019) compared to 28.8% diagnosed in the 2020 COVID era. Of the COVID era patients, 40.4% received COVID-19 testing, with 5.7% having a positive result. COVID era patients were diagnosed at a later stage (3 and 4), 7.4% versus 6.6%. While overall DTS decreased for COVID era patients, a higher proportion of patients tested for COVID experienced longer DTS. In multivariable logistic analysis, male sex, Black race, Hispanic ethnicity, uninsured or underinsured status, less education, stage > 1, and treatment locations in the Northeast, West, and South were associated with DTS. COVID era diagnosis was not associated with DTC; however, uninsured or underinsured status and treatment in the South were associated with DTC.
Conclusions
The pandemic was not associated with overall delays in treatment for melanoma; however, vulnerable populations and certain geographic areas experienced disproportionate differences in treatment timing. The potential long-term associations between delayed treatment and outcomes warrant further investigation, especially for marginalized populations.
期刊介绍:
The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories.
The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.