Impact of COVID-19 on uveal melanoma in France

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. 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. 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). 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. Les retards de traitement dus au COVID-19 chez les patients atteints de mélanome uvéal (MU) ont entraîné une augmentation du taux d’énucléations en Europe. L’impact des multiples confinements liés au COVID-19 sur la prise en charge du MU n’a pas été évalué en France. Le but de cette étude était d’évaluer si des diagnostics tardifs ont pu conduire à des stades plus avancés et donc à un taux d’énucléations plus élevé. Deux ensembles de données ont été analysés : les patients de deux centres d’oncologie oculaire (données-1), avec la collecte des tailles, de stades pronostiques (TNM) et des traitements, et une ba