Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

BACKGROUND & AIMS: 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 pa...

Descripción completa

Detalles Bibliográficos
Autores principales: Amaddeo, Giuliana, Brustia, Raffaele, Allaire, Manon, Lequoy, Marie, Hollande, Clémence, Regnault, Hélène, Blaise, Lorraine, Ganne-Carrié, Nathalie, Séror, Olivier, Larrey, Edouard, Lim, Chetana, Scatton, Olivier, El Mouhadi, Sanaa, Ozenne, Violaine, Paye, François, Balladur, Pierre, Dohan, Anthony, Massault, Pierre-Philippe, Pol, Stanislas, Dioguardi Burgio, Marco, Vilgrain, Valérie, Sepulveda, Ailton, Cauchy, Francois, Luciani, Alain, Sommacale, Daniele, Leroy, Vincent, Roudot-Thoraval, Francoise, Bouattour, Mohamed, Nault, Jean-Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Research Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604130/
https://www.ncbi.nlm.nih.gov/pubmed/33163949
http://dx.doi.org/10.1016/j.jhepr.2020.100199
Descripción
Sumario:BACKGROUND & AIMS: 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: 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: 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 (p = 0.034) and fewer had a first diagnosis of HCC (n = 104 exposed to COVID, n = 143 unexposed to COVID, p = 0.083). Treatment strategy was modified in 13.1% of patients, with no differences between the 2 periods. Nevertheless, 21.5% vs. 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared with 2019 (p <0.001). In 2020, 7.1% (21/293) of patients had a diagnosis of an active COVID-19 infection: 11 (52.4%) patients were hospitalised and 4 (19.1%) patients died. 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 vs. 2019. LAY SUMMARY: 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.

Ejemplares similares