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. 2023 Apr 14:2023:8114732.
doi: 10.1155/2023/8114732. eCollection 2023.

Effect of COVID-19 Pandemic-Related Delays in Chemoembolization on the Survival of Patients with Hepatocellular Carcinoma

Kittipitch Bannangkoon  1 , Keerati Hongsakul  1 , Teeravut Tubtawee  1 , Phurich Janjindamai  1
Affiliations

Effect of COVID-19 Pandemic-Related Delays in Chemoembolization on the Survival of Patients with Hepatocellular Carcinoma

Kittipitch Bannangkoon et al. Can J Gastroenterol Hepatol. .

Abstract

Background and aims: COVID-19 has led to potential delays in liver cancer treatment, which may have undesirable effects on the prognosis of patients. We aimed to quantify the COVID-19 pandemic impact on the survival of patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization (TACE).

Methods: A retrospective study was conducted in patients with HCC who underwent TACE at a tertiary care center during the prelockdown (March to July 2019) and lockdown (March to July 2020) periods. Demographic data, tumor characteristics, functional status, and vital status were collected from the hospital medical records. The endpoints were TACE interval, treatment response, and survival after TACE. Cox proportional hazards regression determined the significant preoperative factors influencing survival.

Results: Compared to prelockdown, a significant delay occurred during the lockdown in repeated TACE treatments (76.7 vs. 63.5 days, P=0.007). The trend suggested a significant decrease in patients with HCC in the repeated TACE group (-33.3%). After screening, 145 patients were included (prelockdown (n = 87), lockdown (n = 58)). There was no significant difference in the 1-month objective response rate between the prelockdown and lockdown groups (65.5% vs. 64.4%, P=1.00). During follow-up, 56 (64.4%) and 34 (58.6%) deaths occurred in the prelockdown and lockdown groups, respectively (P=0.600). Multivariate analysis revealed no association between the lockdown group and decreased survival (HR 0.88, 95% CI 0.57-1.35, P=0.555).

Conclusions: The impact of the COVID-19 pandemic on liver cancer care resulted in significant decreases and delays in repeated TACE treatments in 2020 compared to 2019. However, treatment delays did not seem to significantly impact survival.

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Conflict of interest statement

All authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Numbers of patients with hepatocellular carcinoma during the prelockdown (March to July 2019) and lockdown (March to July 2020) periods who underwent first transarterial chemoembolization (TACE) (a) and repeated TACE (b).
Figure 2
Figure 2
Cumulative survival of HCC patients who underwent repeated transarterial chemoembolization (TACE) during the prelockdown and lockdown periods.
See this image and copyright information in PMC

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