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2019冠状病毒病大流行对肝细胞癌移植受者临床病理特征的影响:一项病例对照研究。

Impact of COVID-19 pandemic on clinicopathological features of transplant recipients with hepatocellular carcinoma: A case-control study.

作者信息

Akbulut Sami, Sahin Tevfik Tolga, Ince Volkan, Yilmaz Sezai

机构信息

Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey.

出版信息

World J Clin Cases. 2022 May 26;10(15):4785-4798. doi: 10.12998/wjcc.v10.i15.4785.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the management of all diseases. Various diseases such as cancer have a higher risk of COVID-19-related death. Despite this fact, any delay or alteration in treatment of cancer may have fatal consequences. Hepatocellular carcinoma (HCC) is an aggressive liver cancer that requires multimodality treatment to improve survival.

AIM

To evaluate the impact of COVID-19 on the management of patients with HCC by determining changes in demographic, clinical and histopathological variables.

METHODS

Demographic, clinical and pathological variables of patients with HCC who had undergone liver transplantation between March 2020 and June 2021 (Pandemic group, = 48) were retrospectively compared with that of the patients with HCC transplanted between November 2018 and March 2020 (Pre-pandemic group, = 61).

RESULTS

The median age of the patients in the study was 56 (interquartile range = 15). Ninety-seven patients (89%) were male and 12 were female (11%). The most common etiology of liver disease was hepatitis B virus ( = 52, 47.7%). According to our results, there was a 21.3% drop in the number of patients transplanted for HCC. There was no difference in the demographic, clinical and pathological characteristics of the patients except blood alkaline phosphatase levels ( = 0.029), lymphovascular invasion ( = 0.019) and type of the liver graft that was transplanted ( = 0.017).

CONCLUSION

It is important to develop a surveillance strategy for liver transplant centers. The liver transplantation for HCC is justified and safe provided that strict surveillance protocols are applied.

摘要

背景

2019年冠状病毒病(COVID-19)大流行对所有疾病的管理产生了重大影响。各种疾病,如癌症,与COVID-19相关的死亡风险更高。尽管如此,癌症治疗的任何延迟或改变都可能产生致命后果。肝细胞癌(HCC)是一种侵袭性肝癌,需要多模式治疗以提高生存率。

目的

通过确定人口统计学、临床和组织病理学变量的变化,评估COVID-19对HCC患者管理的影响。

方法

回顾性比较2020年3月至2021年6月期间接受肝移植的HCC患者(大流行组,n = 48)与2018年11月至2020年3月期间接受肝移植的HCC患者(大流行前组,n = 61)的人口统计学、临床和病理变量。

结果

研究中患者的中位年龄为56岁(四分位间距 = 15)。97名患者(89%)为男性,12名患者(11%)为女性。肝病最常见的病因是乙型肝炎病毒(n = 52,47.7%)。根据我们的结果,因HCC接受移植的患者数量下降了21.3%。除血碱性磷酸酶水平(P = 0.029)、淋巴管侵犯(P = 0.019)和移植肝移植物类型(P = 0.017)外,患者的人口统计学、临床和病理特征没有差异。

结论

为肝移植中心制定监测策略很重要。只要应用严格的监测方案,HCC的肝移植是合理且安全的。

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