Jin Zhi-Cheng, Chen Li, Zhong Bin-Yan, Zhu Hai-Dong, Zeng Chu-Hui, Li Rui, Guo Jin-He, He Shi-Cheng, Deng Gang, Zhu Xiao-Li, Ni Cai-Fang, Teng Gao-Jun
Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Front Oncol. 2021 May 6;11:602700. doi: 10.3389/fonc.2021.602700. eCollection 2021.
Given that the novel coronavirus disease (COVID-19) pandemic has disrupted operations globally, an institution's ability to repeat transarterial chemoembolization (TACE) for patients with hepatocellular carcinoma (HCC) has also been affected. The aim of this study was to evaluate the impact of the COVID-19 on the intervals and outcomes of TACE in HCC patients.
This retrospective study included 154 HCC patients who underwent follow-up after TACE treatment from January 2020 to March 2020 (n = 71, study group) and January 2019 to March 2019 (n = 83, control group) at two institutions in China. The endpoints included the follow-up interval and overall response rate (ORR). Multivariate logistic regression analyses were performed to identify independent risk factors for a worse ORR. The cut-off point was determined to divide follow-up durations into long- and short-intervals.
The median follow-up interval was 82.0 days (IQR, 61-109) in the study group, which was significantly longer than 66.0 days (IQR, 51-94) in the control group ( = 0.004). The ORR was 23.9 and 39.8% in the study and control group, respectively ( = 0.037). The cut-off value was 95 days. The grouping (OR, 2.402; 95% CI, 1.040-5.546; = 0.040), long interval (OR, 2.573; 95% CI, 1.022-6.478; = 0.045), and China liver cancer staging system (OR, 2.500; 95% CI, 1.797-3.480; 0.001) were independent predictors for the efficacy of TACE treatment.
The COVID-19 pandemic causes a longer follow-up interval in general, which may further lead to a lower ORR in HCC patients. Those with a follow-up interval of >95 days tend to have a worse prognosis.
鉴于新型冠状病毒肺炎（COVID-19）大流行扰乱了全球医疗运作，某机构对肝细胞癌（HCC）患者重复进行经动脉化疗栓塞术（TACE）的能力也受到了影响。本研究旨在评估COVID-19对HCC患者TACE治疗间隔及治疗结果的影响。
本回顾性研究纳入了154例HCC患者，这些患者于2020年1月至2020年3月（n = 71，研究组）以及2019年1月至2019年3月（n = 83，对照组）在中国两家机构接受TACE治疗后进行随访。观察终点包括随访间隔和总缓解率（ORR）。进行多因素逻辑回归分析以确定ORR较差的独立危险因素。确定截断点以将随访持续时间分为长间隔和短间隔。
研究组的中位随访间隔为82.0天（IQR，61 - 109），显著长于对照组的66.0天（IQR，51 - 94）（P = 0.004）。研究组和对照组的ORR分别为23.9%和39.8%（P = 0.037）。截断值为95天。分组（OR，2.402；95%CI，1.040 - 5.546；P = 0.040）、长间隔（OR，2.573；95%CI，1.022 - 6.478；P = 0.045）以及中国肝癌分期系统（OR，2.500；95%CI, 1.797 - 3.480；P = 0.001）是TACE治疗疗效的独立预测因素。
COVID-19大流行总体上导致更长的随访间隔，这可能进一步导致HCC患者的ORR降低。随访间隔>95天的患者预后往往更差。
