Impact of COVID-19 on uveal melanoma in France

A Hamerstehl; É Gadiollet; A Martel; A Groulier; D Aloi; A M Nguyen; S Lassalle; C Bertolotto; J-P Caujolle; C Maschi; A Ducoulombier; T Mathis; S Baillif; S Nahon-Estève

doi:10.1016/j.jfo.2024.104351

Impact of COVID-19 on uveal melanoma in France

J Fr Ophtalmol. 2024 Nov 7;48(1):104351. doi: 10.1016/j.jfo.2024.104351. Online ahead of print.

Authors

A Hamerstehl¹, É Gadiollet², A Martel¹, A Groulier³, D Aloi³, A M Nguyen², S Lassalle⁴, C Bertolotto⁵, J-P Caujolle¹, C Maschi¹, A Ducoulombier⁶, T Mathis⁷, S Baillif¹, S Nahon-Estève⁸

Affiliations

¹ Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
² Ophthalmology Department, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
³ Department of Radiation Oncology, Antoine-Lacassagne Cancer Center, Université Côte d'Azur, Nice, France.
⁴ Laboratory of Clinical and Experimental Pathology, FHU OncoAge, BB-0033-00025, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Department of Biology and Pathologies of Melanocytes, Team1, Équipe Labellisée Ligue 2020 and Équipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, Inserm, Nice, France.
⁵ Department of Biology and Pathologies of Melanocytes, Team1, Équipe Labellisée Ligue 2020 and Équipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, Inserm, Nice, France.
⁶ Department of Medical Oncology, Antoine-Lacassagne Cancer Center, Université Côte d'Azur, Nice, France.
⁷ Ophthalmology Department, Hôpital Universitaire de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; UMR-CNRS 5510 Matéis, Université Lyon 1, Villeurbanne, France.
⁸ Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Department of Biology and Pathologies of Melanocytes, Team1, Équipe Labellisée Ligue 2020 and Équipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, Inserm, Nice, France. Electronic address: nahon-esteve.s@chu-nice.fr.

PMID: 39515034
DOI: 10.1016/j.jfo.2024.104351

Abstract

Purpose: Treatment delays due to the COVID-19 pandemic in uveal melanoma (UM) patients have led to an increased rate of enucleations in Europe. The impact of multiple COVID-19 lockdowns on UM management has not been assessed in France. The goal of this study was to assess whether delayed diagnosis could have led to more advanced stages and thus a higher rate of enucleations.

Methods: Two datasets were analyzed: patients from two ocular oncology centers (dataset-1), with recording of sizes, prognostic stages (TNM) and treatments, and a national database (dataset-2), obtained by ICD-10 codes and medical procedures for clip placement. After year-by-year comparison, the pre-COVID-19 (2018-2019) and post-COVID-19 (2021-2022) periods were compared for each dataset. Five hundred and thirty-seven patients were diagnosed with UM (dataset-1), including 213 patients in the pre-COVID-19 period and 212 patients in the post-COVID-19 period. Similarly, 2187 patients were diagnosed with UM (dataset-2), of whom 914 patients and 864 patients were diagnosed in the pre-COVID-19 and post-COVID-19 periods, respectively.

Results: A higher number of patients had locally advanced tumors during the post-COVID-19 period compared to the pre-COVID-19 period (cT1=66, cT2=64, cT3=66 and cT4=21 vs. cT1=59, cT2=82, cT3=65 and cT4=7, P=0.03), but without difference in ciliary body involvement, extraocular extension or AJCC stage (dataset-1). Treatments were similar between the pre-COVID-19 and post-COVID-19 periods in dataset-1 (P=0.36) and dataset-2 (P=0.47), with a higher ratio of proton beam therapy to primary enucleation in 2020 than in the pre-COVID-19 and post-COVID-19 periods (21.4 vs. 8.6 and 6.3, P=0.02).

Conclusion: The COVID-19 pandemic did not impact the ophthalmological management of UM patients in France, but more locally advanced stages were observed upon initial presentation during the post-COVID-19 period.

Keywords: Enucleation; Mélanome uvéal; Pandemic; Pandémie; Proton beam therapy; Protonthérapie; Uveal melanoma; Énucléation.