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