Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Giuliana Amaddeo; Raffaele Brustia; Manon Allaire; Marie Lequoy; Clémence Hollande; Hélène Regnault; Lorraine Blaise; Nathalie Ganne-Carrié; Olivier Séror; Edouard Larrey; Chetana Lim; Olivier Scatton; Sanaa El Mouhadi; Violaine Ozenne; François Paye; Pierre Balladur; Anthony Dohan; Pierre-Philippe Massault; Stanislas Pol; Marco Dioguardi Burgio; Valérie Vilgrain; Ailton Sepulveda; Francois Cauchy; Alain Luciani; Daniele Sommacale; Vincent Leroy; Francoise Roudot-Thoraval; Mohamed Bouattour; Jean-Charles Nault

JHEP Reports (Feb 2021)

Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Giuliana Amaddeo,
Raffaele Brustia,
Manon Allaire,
Marie Lequoy,
Clémence Hollande,
Hélène Regnault,
Lorraine Blaise,
Nathalie Ganne-Carrié,
Olivier Séror,
Edouard Larrey,
Chetana Lim,
Olivier Scatton,
Sanaa El Mouhadi,
Violaine Ozenne,
François Paye,
Pierre Balladur,
Anthony Dohan,
Pierre-Philippe Massault,
Stanislas Pol,
Marco Dioguardi Burgio,
Valérie Vilgrain,
Ailton Sepulveda,
Francois Cauchy,
Alain Luciani,
Daniele Sommacale,
Vincent Leroy,
Francoise Roudot-Thoraval,
Mohamed Bouattour,
Jean-Charles Nault

Affiliations

Giuliana Amaddeo: Department of Hepatology, AP-HP, Hôpital Henri-Mondor, Créteil, France; Paris Est Créteil University, UPEC, Créteil, France; INSERM U955, Team “Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers”, Assistance Publique-Hôpitaux de Paris, Créteil, France; Corresponding authors. Addresses: Hepatology Department, Hôpitaux Universitaires Henri-Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, France. Tel.: +33 649875673; fax: +3149812352.
Raffaele Brustia: Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, Créteil, France
Manon Allaire: Hepatology and Liver Transplantation Department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France; Sorbonne Université, Paris, France
Marie Lequoy: Department of Hepatology, AP-HP, Hôpital Saint Antoine, Paris, France
Clémence Hollande: Department of Hepatology, AP-HP, Hôpital Cochin, Paris, France
Hélène Regnault: Department of Hepatology, AP-HP, Hôpital Henri-Mondor, Créteil, France
Lorraine Blaise: Service d'Hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France
Nathalie Ganne-Carrié: Service d'Hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France
Olivier Séror: Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France; Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France; INSERM U1149 “Centre de Recherche sur l'Inflammation”, CRI, Paris, France
Edouard Larrey: Hepatology and Liver Transplantation Department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France; Sorbonne Université, Paris, France
Chetana Lim: Digestive and Liver Transplantation Department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
Olivier Scatton: Sorbonne Université, Paris, France; Digestive and Liver Transplantation Department, Hôpital Pitié Salpêtrière, Sorbonne Université, AP-HP, Paris, France
Sanaa El Mouhadi: Department of Radiology, AP-HP, Hôpital Saint Antoine, Paris, France
Violaine Ozenne: Department of Hepatology, AP-HP, Hôpital Saint Antoine, Paris, France
François Paye: Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Paris, France
Pierre Balladur: Department of Digestive Surgery, AP-HP, Hôpital Saint Antoine, Paris, France
Anthony Dohan: Department of Radiology, AP-HP, Hôpital Cochin, Université de Paris, Paris, France
Pierre-Philippe Massault: Department of Digestive Surgery, AP-HP, Hôpital Cochin, Université de Paris, Paris, France
Stanislas Pol: Department of Hepatology, AP-HP, Hôpital Cochin, Paris, France
Marco Dioguardi Burgio: Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France; INSERM U1149 “Centre de Recherche sur l'Inflammation”, CRI, Paris, France
Valérie Vilgrain: Department of Radiology, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France; INSERM U1149 “Centre de Recherche sur l'Inflammation”, CRI, Paris, France
Ailton Sepulveda: Digestive and Liver Transplantation Department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
Francois Cauchy: Digestive and Liver Transplantation Department, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val de Seine, Assistance-Publique Hôpitaux de Paris, Clichy, France
Alain Luciani: Paris Est Créteil University, UPEC, Créteil, France; Department of Radiology, AP-HP, Hôpital Henri-Mondor, Créteil, France
Daniele Sommacale: Paris Est Créteil University, UPEC, Créteil, France; INSERM U955, Team “Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers”, Assistance Publique-Hôpitaux de Paris, Créteil, France; Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, Créteil, France
Vincent Leroy: Department of Hepatology, AP-HP, Hôpital Henri-Mondor, Créteil, France; Paris Est Créteil University, UPEC, Créteil, France; INSERM U955, Team “Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers”, Assistance Publique-Hôpitaux de Paris, Créteil, France
Francoise Roudot-Thoraval: Department of Hepatology, AP-HP, Hôpital Henri-Mondor, Créteil, France
Mohamed Bouattour: Département d'Oncologie Digestive, AP-HP, Hôpital Beaujon, Clichy, France
Jean-Charles Nault: Service d'Hépatologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bondy, France; Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France; Hepatology Department, Hôpital Jean Verdier, Avenue du 14 juillet, 93140 Bondy, France. Tel.: +33 6 10 67 94 61; fax: +33 1 53 72 51 92.

Journal volume & issue: Vol. 3, no. 1
p. 100199

Abstract

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Background & Aims: Patients affected by hepatocellular carcinoma (HCC) represent a vulnerable population during the COVID-19 pandemic and may suffer from altered allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of patients with HCC within 6 referral centres in the metropolitan area of Paris, France. Methods: We performed a multicentre, retrospective, cross-sectional study on the management of patients with HCC during the first 6 weeks of the COVID-19 pandemic (exposed group), compared with the same period in 2019 (unexposed group). We included all patients discussed in multidisciplinary tumour board (MTB) meetings and/or patients undergoing a radiological or surgical programmed procedure during the study period, with curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treat. Results: After screening, n = 670 patients were included (n = 293 exposed to COVID, n = 377 unexposed to COVID). Fewer patients with HCC presented to the MTB in 2020 (p = 0.034) and fewer had a first diagnosis of HCC (n = 104 exposed to COVID, n = 143 unexposed to COVID, p = 0.083). Treatment strategy was modified in 13.1% of patients, with no differences between the 2 periods. Nevertheless, 21.5% vs. 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared with 2019 (p <0.001). In 2020, 7.1% (21/293) of patients had a diagnosis of an active COVID-19 infection: 11 (52.4%) patients were hospitalised and 4 (19.1%) patients died. Conclusions: In a metropolitan area highly impacted by the COVID-19 pandemic, we observed fewer patients with HCC, and similar rates of treatment modification, but with a significantly longer treatment delay in 2020 vs. 2019. Lay summary: During the coronavirus disease 2019 (COVID-19) pandemic era, fewer patients with hepatocellular carcinoma (HCC) presented to the multidisciplinary tumour board, especially with a first diagnosis of HCC. Patients with HCC had a treatment delay that was longer in the COVID-19 period than in 2019.

Published in JHEP Reports

ISSN: 2589-5559 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the digestive system. Gastroenterology
Website: https://www.journals.elsevier.com/jhep-reports

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