Scientific publications

Assessing the impact of COVID-19 on liver cancer management (CERO-19)

Jun 3, 2021 | Magazine: JHEP Report

Sergio Muñoz-Martínez  1 , Victor Sapena  1 , Alejandro Forner  1 , Jean-Charles Nault  2   3   4 , Gonzalo Sapisochin  5 , Lorenza Rimassa  6   7 , Bruno Sangro  8 , Jordi Bruix  1 , Marco Sanduzzi-Zamparelli  1 , Wacław Hołówko  9 , Mohamed El Kassas  10 , Tudor Mocan  11 , Mohamed Bouattour  12 , Philippe Merle  13 , Frederik J H Hoogwater  14 , Saleh A Alqahtani  15 , Helen L Reeves  16 , David J Pinato  17 , Emmanouil Giorgakis  18 , Tim Meyer  19 , Gerda Elisabeth Villadsen  20 , Henning Wege  21 , Massimiliano Salati  22 , Beatriz Mínguez  23 , Giovan Giuseppe Di Costanzo  24 , Christoph Roderburg  25 , Frank Tacke  25 , María Varela  26 , Peter R Galle  27 , Mario Reis Alvares-da-Silva  28 , Jörg Trojan  29 , John Bridgewater  30 , Giuseppe Cabibbo  31 , Christian Toso  32 , Anja Lachenmayer  33 , Andrea Casadei-Gardini  34 , Hidenori Toyoda  35 , Tom Lüdde  36 , Rosanna Villani  37 , Ana María Matilla Peña  38 , Cassia Regina Guedes Leal  39 , Monica Ronzoni  40 , Manuel Delgado  41 , Christie Perelló  42 , Sonia Pascual  43 , José Luis Lledó  44 , Josepmaria Argemi  45 , Bristi Basu  46   47 , Leonardo da Fonseca  48 , Juan Acevedo  49 , Alexander R Siebenhüner  50 , Chiara Braconi  51 , Brandon M Meyers  52 , Alessandro Granito  53 , Margarita Sala  54 , Carlos Rodríguez-Lope  55 , Lorraine Blaise  2   3   4 , Manuel Romero-Gómez  56 , Federico Piñero  57 , Dhanny Gomez  58 , Vivianne Mello  59 , Rogerio Camargo Pinheiro Alves  60 , Alex França  61 , Fernanda Branco  62 , Giovanni Brandi  63 , Gustavo Pereira  64 , Susanna Coll  65 , Maria Guarino  66 , Carlos Benítez  67 , Maria Margarita Anders  68 , Juan C Bandi  69 , Mercedes Vergara  70   71   72 , Mariona Calvo  73 , Markus Peck-Radosavljevic  74 , Ignacio García-Juárez  75 , Vincenzo Cardinale  76 , Mar Lozano  77 , Martina Gambato  78   79 , Stefano Okolicsanyi  80 , Dalia Morales-Arraez  81 , Alessandra Elvevi  82 , Alberto E Muñoz  83 , Alberto Lué  84 , Massimo Iavarone  85 , Maria Reig  1


Background & aims: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic.

Methods: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave.

Results: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme.

Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37).

Conclusions: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making.

Lay summary: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

CITATION  JHEP Rep. 2021 Jun;3(3):100260.  doi: 10.1016/j.jhepr.2021.100260.  Epub 2021 Feb 23

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