评估2019冠状病毒病对肝癌管理的影响（CERO-19）。
Assessing the impact of COVID-19 on liver cancer management (CERO-19).
作者信息
Muñoz-Martínez Sergio, Sapena Victor, Forner Alejandro, Nault Jean-Charles, Sapisochin Gonzalo, Rimassa Lorenza, Sangro Bruno, Bruix Jordi, Sanduzzi-Zamparelli Marco, Hołówko Wacław, El Kassas Mohamed, Mocan Tudor, Bouattour Mohamed, Merle Philippe, Hoogwater Frederik J H, Alqahtani Saleh A, Reeves Helen L, Pinato David J, Giorgakis Emmanouil, Meyer Tim, Villadsen Gerda Elisabeth, Wege Henning, Salati Massimiliano, Mínguez Beatriz, Di Costanzo Giovan Giuseppe, Roderburg Christoph, Tacke Frank, Varela María, Galle Peter R, Alvares-da-Silva Mario Reis, Trojan Jörg, Bridgewater John, Cabibbo Giuseppe, Toso Christian, Lachenmayer Anja, Casadei-Gardini Andrea, Toyoda Hidenori, Lüdde Tom, Villani Rosanna, Matilla Peña Ana María, Guedes Leal Cassia Regina, Ronzoni Monica, Delgado Manuel, Perelló Christie, Pascual Sonia, Lledó José Luis, Argemi Josepmaria, Basu Bristi, da Fonseca Leonardo, Acevedo Juan, Siebenhüner Alexander R, Braconi Chiara, Meyers Brandon M, Granito Alessandro, Sala Margarita, Rodríguez-Lope Carlos, Blaise Lorraine, Romero-Gómez Manuel, Piñero Federico, Gomez Dhanny, Mello Vivianne, Pinheiro Alves Rogerio Camargo, França Alex, Branco Fernanda, Brandi Giovanni, Pereira Gustavo, Coll Susanna, Guarino Maria, Benítez Carlos, Anders Maria Margarita, Bandi Juan C, Vergara Mercedes, Calvo Mariona, Peck-Radosavljevic Markus, García-Juárez Ignacio, Cardinale Vincenzo, Lozano Mar, Gambato Martina, Okolicsanyi Stefano, Morales-Arraez Dalia, Elvevi Alessandra, Muñoz Alberto E, Lué Alberto, Iavarone Massimo, Reig Maria
机构信息
BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.
Service d'hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France.
出版信息
JHEP Rep. 2021 Jun;3(3):100260. doi: 10.1016/j.jhepr.2021.100260. Epub 2021 Feb 23.
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.
背景与目的
2019年冠状病毒病（COVID-19）大流行给医疗系统带来了前所未有的挑战，可能对肝癌（LC）患者产生了重大影响。在此，我们评估了LC筛查或治疗计划是否因COVID-19大流行而中断或延迟。
方法
作为一个多中心、国际性观察项目的第一阶段，一项国际调查评估了2020年3月至2020年6月期间COVID-19大流行对临床实践和临床试验的影响。重点关注在COVID-19大流行第一波期间全球范围内接受治疗的肝细胞癌或肝内胆管癌患者。
结果
91个中心表示有兴趣参与，76个中心纳入分析，分别来自欧洲、南美洲、北美洲、亚洲和非洲（各洲占比分别为73.7%、17.1%、5.3%、2.6%和1.3%）。87%的中心改变了临床实践：40.8%改变了诊断程序，80.9%改变了筛查计划，50%取消了LC的根治性和/或姑息性治疗，41.7%改变了肝移植计划。69个正在进行临床试验的中心中有45个（65.2%）在该情况下改变了治疗方法，但58.1%的中心能够招募新患者。在COVID-19大流行之前提供电话服务的中心中，51.4%（n = 19/37）对电话服务进行了更改。
结论
COVID-19大流行的第一波对肝癌患者的常规护理产生了巨大影响。筛查、诊断和治疗算法的改变可能严重损害患者的治疗结果。正在进行的数据收集和未来分析将报告所实施策略的利弊，有助于未来的决策制定。
简要概述
2019年冠状病毒病（COVID-19）大流行给全球医疗系统带来了前所未有的挑战。在此，我们评估了第一波大流行对肝癌患者的影响，发现这些患者的常规护理受到了严重干扰，这可能对治疗结果产生重大影响。
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