Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area.
2019-nCoV
BCLC, Barcelona Clinic Liver Cancer
COVID-19
Cirrhosis
EASL, European Association for the Study of Liver
HCC, hepatocellular carcinoma
Hepatocellular carcinoma
ICU, intensive care unit
IQR, inter-quartile range
IR, interventional radiology
ITT, intention to treat
LR, liver resection
LT, liver transplantation
MELD, model for end-stage liver disease
MTB, multidisciplinary tumour board
Management
NASH, non-alcoholic steatohepatitis
OR, odds ratio
SIRT, selective internal radiation therapy
TACE, transarterial chemoembolisation
aOR, adjusted OR
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
20
07
2020
revised:
29
09
2020
accepted:
13
10
2020
pubmed:
10
11
2020
medline:
10
11
2020
entrez:
9
11
2020
Statut:
ppublish
Résumé
Patients affected by hepatocellular carcinoma (HCC) represent a vulnerable population during the COVID-19 pandemic and may suffer from altered allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of patients with HCC within 6 referral centres in the metropolitan area of Paris, France. We performed a multicentre, retrospective, cross-sectional study on the management of patients with HCC during the first 6 weeks of the COVID-19 pandemic (exposed group), compared with the same period in 2019 (unexposed group). We included all patients discussed in multidisciplinary tumour board (MTB) meetings and/or patients undergoing a radiological or surgical programmed procedure during the study period, with curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treat. After screening, n = 670 patients were included (n = 293 exposed to COVID, n = 377 unexposed to COVID). Fewer patients with HCC presented to the MTB in 2020 ( In a metropolitan area highly impacted by the COVID-19 pandemic, we observed fewer patients with HCC, and similar rates of treatment modification, but with a significantly longer treatment delay in 2020 During the coronavirus disease 2019 (COVID-19) pandemic era, fewer patients with hepatocellular carcinoma (HCC) presented to the multidisciplinary tumour board, especially with a first diagnosis of HCC. Patients with HCC had a treatment delay that was longer in the COVID-19 period than in 2019.
Sections du résumé
BACKGROUND & AIMS
OBJECTIVE
Patients affected by hepatocellular carcinoma (HCC) represent a vulnerable population during the COVID-19 pandemic and may suffer from altered allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of patients with HCC within 6 referral centres in the metropolitan area of Paris, France.
METHODS
METHODS
We performed a multicentre, retrospective, cross-sectional study on the management of patients with HCC during the first 6 weeks of the COVID-19 pandemic (exposed group), compared with the same period in 2019 (unexposed group). We included all patients discussed in multidisciplinary tumour board (MTB) meetings and/or patients undergoing a radiological or surgical programmed procedure during the study period, with curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treat.
RESULTS
RESULTS
After screening, n = 670 patients were included (n = 293 exposed to COVID, n = 377 unexposed to COVID). Fewer patients with HCC presented to the MTB in 2020 (
CONCLUSIONS
CONCLUSIONS
In a metropolitan area highly impacted by the COVID-19 pandemic, we observed fewer patients with HCC, and similar rates of treatment modification, but with a significantly longer treatment delay in 2020
LAY SUMMARY
BACKGROUND
During the coronavirus disease 2019 (COVID-19) pandemic era, fewer patients with hepatocellular carcinoma (HCC) presented to the multidisciplinary tumour board, especially with a first diagnosis of HCC. Patients with HCC had a treatment delay that was longer in the COVID-19 period than in 2019.
Identifiants
pubmed: 33163949
doi: 10.1016/j.jhepr.2020.100199
pii: S2589-5559(20)30133-6
pmc: PMC7604130
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100199Informations de copyright
© 2020 The Author(s).
Déclaration de conflit d'intérêts
JCN received a research grant from Bayer for INSERM UMR1138. The other authors declare no conflicts of interest that pertain to this study. Please refer to the accompanying ICMJE disclosure forms for further details.
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