Management of cutaneous malignancies impacted by COVID-19 delays

ABSTRACT

Introduction: Coronavirus disease 2019 affected the timing of management of patients with cutaneous malignancies, delaying their surgical care by several months. The study objective is to determine the impact of delays on patients' oncologic and reconstructive management in comparison to 2 standard years. Method: A retrospective review of all patients with surgical management for their cutaneous malignancies at a single institution in the departments of otolaryngology and plastic surgery was conducted from January 2018 to January 2021. The 2020 group was considered to have delayed care due to the health care restrictions. Demographics, malignancy characteristics, ablative and reconstructive surgery, and adjuvant management were all evaluated comparing the pre-2020 and 2020 groups. Univariate analysis was performed using a 2-sample t test for continuous variables and chi-squared test and Fisher exact test for categorical variables. Significance was determined if P < .05. Results: In total 80 patients underwent cutaneous malignancy management and reconstruction during the time period, in which the squamous cell carcinoma was the most common pathology (38.75%) and the nose was the most common subsite (38.75%). In 2020 there were no cutaneous cases that were managed surgically between February and June compared with cases occurring monthly during the prior standard years, suggesting a delay in care anywhere from 1 to 4 months during this time. Despite delays, there was no significant difference between the pre-2020 and 2020 groups in terms of staging, oncologic management, or reconstruction. There were no differences in the variables between the groups. Conclusion: There was no significant difference in presentation, oncologic management, or reconstruction required for patients requiring a several-month delay in care for the management of cutaneous malignancy compared with the 2 prior standard years. This suggests that this delay did not significantly affect management of cutaneous malignancy in this subset of patients, leading us to understand more about urgency of management in patients with cutaneous malignancies.