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Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic
To compare liver cancer resectability rates before and during the COVID-19 pandemic. BACKGROUND: Liver cancers usually present with nonspecific symptoms or are diagnosed through screening programs for at-risk patients, and early detection can improve patient outcomes. In 2020, the COVID-19 pandemic...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health, Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782462/ https://www.ncbi.nlm.nih.gov/pubmed/36590894 http://dx.doi.org/10.1097/AS9.0000000000000207 |
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author | Li, Daniel Jia, Angela Y. Zorzi, Jane Griffith, Paige Kim, Amy K. Dao, Doan Anders, Robert A. Georgiades, Christos Liddell, Robert P. Hong, Kelvin Azad, Nilofer S. Ho, Won Jin Baretti, Marina Christenson, Eric Baghdadi, Azarakhsh Kamel, Ihab R. Meyer, Jeffrey Ghabi, Elie Burkhart, Richard A. Lafaro, Kelly He, Jin Shubert, Chris Yarchoan, Mark |
author_facet | Li, Daniel Jia, Angela Y. Zorzi, Jane Griffith, Paige Kim, Amy K. Dao, Doan Anders, Robert A. Georgiades, Christos Liddell, Robert P. Hong, Kelvin Azad, Nilofer S. Ho, Won Jin Baretti, Marina Christenson, Eric Baghdadi, Azarakhsh Kamel, Ihab R. Meyer, Jeffrey Ghabi, Elie Burkhart, Richard A. Lafaro, Kelly He, Jin Shubert, Chris Yarchoan, Mark |
author_sort | Li, Daniel |
collection | PubMed |
description | To compare liver cancer resectability rates before and during the COVID-19 pandemic. BACKGROUND: Liver cancers usually present with nonspecific symptoms or are diagnosed through screening programs for at-risk patients, and early detection can improve patient outcomes. In 2020, the COVID-19 pandemic upended medical care across all specialties, but whether the pandemic was associated with delays in liver cancer diagnosis is not known. METHODS: We performed a retrospective review of all patients evaluated at the Johns Hopkins Multidisciplinary Liver Cancer Clinic from January 2019 to June 2021 with a new diagnosis of suspected or confirmed hepatocellular carcinoma (HCC) or biliary tract cancer (BTC). RESULTS: There were 456 liver cancer patients (258 HCC and 198 BTC). From January 2019 to March 2020 (pre-pandemic), the surgical resectability rate was 20%. The subsequent 6 months (early pandemic), the resectability rate decreased to 11%. Afterward from October 2020 to June 2021 (late pandemic), the resectability rate increased to 27%. The resectability rate early pandemic was significantly lower than that for pre-pandemic and later pandemic combined (11% lower; 95% confidence interval [CI], 2%–20%). There was no significant difference in resectability rates pre-pandemic and later pandemic (7% difference; 95% CI, –3% to 16%). In subgroup analyses, the early pandemic was associated with a larger impact in BTC resectability rates than HCC resectability rates. Time from BTC symptom onset until Multidisciplinary Liver Clinic evaluation increased by over 6 weeks early pandemic versus pre-pandemic (Hazard Ratio, 0.63; 95% CI, 0.44–0.91). CONCLUSIONS: During the early COVID-19 pandemic, we observed a drop in the percentage of patients presenting with curable liver cancers. This may reflect delays in liver cancer diagnosis and contribute to excess mortality related to the COVID-19 pandemic. |
format | Online Article Text |
id | pubmed-9782462 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer Health, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97824622022-12-28 Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic Li, Daniel Jia, Angela Y. Zorzi, Jane Griffith, Paige Kim, Amy K. Dao, Doan Anders, Robert A. Georgiades, Christos Liddell, Robert P. Hong, Kelvin Azad, Nilofer S. Ho, Won Jin Baretti, Marina Christenson, Eric Baghdadi, Azarakhsh Kamel, Ihab R. Meyer, Jeffrey Ghabi, Elie Burkhart, Richard A. Lafaro, Kelly He, Jin Shubert, Chris Yarchoan, Mark Ann Surg Open Original Study To compare liver cancer resectability rates before and during the COVID-19 pandemic. BACKGROUND: Liver cancers usually present with nonspecific symptoms or are diagnosed through screening programs for at-risk patients, and early detection can improve patient outcomes. In 2020, the COVID-19 pandemic upended medical care across all specialties, but whether the pandemic was associated with delays in liver cancer diagnosis is not known. METHODS: We performed a retrospective review of all patients evaluated at the Johns Hopkins Multidisciplinary Liver Cancer Clinic from January 2019 to June 2021 with a new diagnosis of suspected or confirmed hepatocellular carcinoma (HCC) or biliary tract cancer (BTC). RESULTS: There were 456 liver cancer patients (258 HCC and 198 BTC). From January 2019 to March 2020 (pre-pandemic), the surgical resectability rate was 20%. The subsequent 6 months (early pandemic), the resectability rate decreased to 11%. Afterward from October 2020 to June 2021 (late pandemic), the resectability rate increased to 27%. The resectability rate early pandemic was significantly lower than that for pre-pandemic and later pandemic combined (11% lower; 95% confidence interval [CI], 2%–20%). There was no significant difference in resectability rates pre-pandemic and later pandemic (7% difference; 95% CI, –3% to 16%). In subgroup analyses, the early pandemic was associated with a larger impact in BTC resectability rates than HCC resectability rates. Time from BTC symptom onset until Multidisciplinary Liver Clinic evaluation increased by over 6 weeks early pandemic versus pre-pandemic (Hazard Ratio, 0.63; 95% CI, 0.44–0.91). CONCLUSIONS: During the early COVID-19 pandemic, we observed a drop in the percentage of patients presenting with curable liver cancers. This may reflect delays in liver cancer diagnosis and contribute to excess mortality related to the COVID-19 pandemic. Wolters Kluwer Health, Inc. 2022-10-03 /pmc/articles/PMC9782462/ /pubmed/36590894 http://dx.doi.org/10.1097/AS9.0000000000000207 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Study Li, Daniel Jia, Angela Y. Zorzi, Jane Griffith, Paige Kim, Amy K. Dao, Doan Anders, Robert A. Georgiades, Christos Liddell, Robert P. Hong, Kelvin Azad, Nilofer S. Ho, Won Jin Baretti, Marina Christenson, Eric Baghdadi, Azarakhsh Kamel, Ihab R. Meyer, Jeffrey Ghabi, Elie Burkhart, Richard A. Lafaro, Kelly He, Jin Shubert, Chris Yarchoan, Mark Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title | Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title_full | Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title_fullStr | Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title_full_unstemmed | Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title_short | Impact of the COVID-19 Pandemic on Liver Cancer Staging at a Multidisciplinary Liver Cancer Clinic |
title_sort | impact of the covid-19 pandemic on liver cancer staging at a multidisciplinary liver cancer clinic |
topic | Original Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782462/ https://www.ncbi.nlm.nih.gov/pubmed/36590894 http://dx.doi.org/10.1097/AS9.0000000000000207 |
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