Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 27;15(13):3378.
doi: 10.3390/cancers15133378.

Impact of COVID-19 on 1-Year Survival Outcomes in Hepatocellular Carcinoma: A Multicenter Cohort Study

Shuell De Souza  1 , Jeffrey Kahol de Jong  1 , Ylenia Perone  1 , Shishir Shetty  2 , Maria Qurashi  2 , Mathew Vithayathil  1 , Tahir Shah  2 , Paul Ross  3 , Laura Temperley  3 , Vincent S Yip  4 , Abhirup Banerjee  4 , Dominik Bettinger  5 , Lukas Sturm  5 , Helen L Reeves  6 , Daniel Geh  6 , James Orr  7 , Benjamin Allen  7 , Robert P Jones  8 , Rohini Sharma  1
Affiliations

Impact of COVID-19 on 1-Year Survival Outcomes in Hepatocellular Carcinoma: A Multicenter Cohort Study

Shuell De Souza et al. Cancers (Basel). .

Abstract

Introduction: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients' access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term indirect impact of COVID-19 health services utilisation on hepatocellular cancer (HCC) outcomes.

Methods: A prospective cohort study was conducted from 1 March 2020 until 30 June 2020, correlating to the first wave of the COVID-19 pandemic. Patients were enrolled from tertiary hospitals in the UK and Germany with dedicated HCC management services. All patients with current or past HCC who were discussed at a multidisciplinary meeting (MDM) were identified. Any delay to treatment (DTT) and the effect on survival at one year were reported.

Results: The median time to receipt of therapy following MDM discussion was 49 days. Patients with Barcelona Clinic Liver Cancer (BCLC) stages-A/B disease were more likely to experience DTT. Significant delays across all treatments for HCC were observed, but delay was most marked for those undergoing curative therapies. Even though severe delays were observed in curative HCC treatments, this did not translate into reduced survival in patients.

Conclusion: Interruption of routine healthcare services because of the COVID-19 pandemic caused severe delays in HCC treatment. However, DTT did not translate to reduced survival. Longer follow is important given the delay in therapy in those receiving curative therapy.

Keywords: COVID-19; hepatocellular carcinoma; pandemic; survival; time-to-treatment; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Effect of the 3-month COVID-19 complete lockdown on treatment waiting times across all HCC treatments. Bar graphs illustrate the effect on COVID-19 lockdown on time between decision to treat (DTT) MDM date and start date of treatment across treatments. In panels (A–D), the bars represent the mean time between MDM DTT and start of treatment, and the error bars represent the standard error of the mean (SEM). Statistically significant data comparisons with p < 0.01 are denoted with ** and p < 0.001 are denoted with ***. Delay in treatment was defined according to the 31 days NHS target.
Figure 2
Figure 2
Kaplan–Meier curves illustrating the impact of delayed treatment on (A) progression-free survival (PFS) and (B) overall survival (OS) in HCC with patients diagnosed during COVID-19 complete lockdown period.
Figure 2
Figure 2
Kaplan–Meier curves illustrating the impact of delayed treatment on (A) progression-free survival (PFS) and (B) overall survival (OS) in HCC with patients diagnosed during COVID-19 complete lockdown period.
See this image and copyright information in PMC

References

    1. Richards M., Anderson M., Carter P., Ebert B.L., Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nat. Cancer. 2020;1:565–567. doi: 10.1038/s43018-020-0074-y. - DOI - PMC - PubMed
    1. Lai A.G., Pasea L., Banerjee A., Hall G., Denaxas S., Chang W.H., Katsoulis M., Williams B., Pillay D., Noursadeghi M., et al. Estimated impact of the COVID-19 pandemic on cancer services and excess 1-year mortality in people with cancer and multimorbidity: Near real-time data on cancer care, cancer deaths and a population-based cohort study. BMJ Open. 2020;10:e043828. doi: 10.1136/bmjopen-2020-043828. - DOI - PMC - PubMed
    1. Ferlay J., Colombet M., Soerjomataram I., Mathers C., Parkin D.M., Pineros M., Znaor A., Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int. J. Cancer. 2019;144:1941–1953. doi: 10.1002/ijc.31937. - DOI - PubMed
    1. European Association for the Study of the Liver EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J. Hepatol. 2018;69:182–236. doi: 10.1016/j.jhep.2018.03.019. - DOI - PubMed
    1. Hanna T.P., King W.D., Thibodeau S., Jalink M., Paulin G.A., Harvey-Jones E., O’Sullivan D.E., Booth C.M., Sullivan R., Aggarwal A. Mortality due to cancer treatment delay: Systematic review and meta-analysis. BMJ. 2020;371:m4087. doi: 10.1136/bmj.m4087. - DOI - PMC - PubMed

LinkOut - more resources