Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
Can J Gastroenterol Hepatol. 2023 Apr 14;2023:8114732. doi: 10.1155/2023/8114732. eCollection 2023.
COVID-19 has led to potential delays in liver cancer treatment, which may have undesirable effects on the prognosis of patients. We aimed to quantify the COVID-19 pandemic impact on the survival of patients with hepatocellular carcinoma (HCC) who underwent transarterial chemoembolization (TACE).
A retrospective study was conducted in patients with HCC who underwent TACE at a tertiary care center during the prelockdown (March to July 2019) and lockdown (March to July 2020) periods. Demographic data, tumor characteristics, functional status, and vital status were collected from the hospital medical records. The endpoints were TACE interval, treatment response, and survival after TACE. Cox proportional hazards regression determined the significant preoperative factors influencing survival.
Compared to prelockdown, a significant delay occurred during the lockdown in repeated TACE treatments (76.7 vs. 63.5 days, =0.007). The trend suggested a significant decrease in patients with HCC in the repeated TACE group (-33.3%). After screening, 145 patients were included (prelockdown ( = 87), lockdown ( = 58)). There was no significant difference in the 1-month objective response rate between the prelockdown and lockdown groups (65.5% vs. 64.4%, =1.00). During follow-up, 56 (64.4%) and 34 (58.6%) deaths occurred in the prelockdown and lockdown groups, respectively (=0.600). Multivariate analysis revealed no association between the lockdown group and decreased survival (HR 0.88, 95% CI 0.57-1.35, =0.555).
The impact of the COVID-19 pandemic on liver cancer care resulted in significant decreases and delays in repeated TACE treatments in 2020 compared to 2019. However, treatment delays did not seem to significantly impact survival.
COVID-19 可能导致肝癌治疗的潜在延迟，这可能对患者的预后产生不良影响。我们旨在量化 COVID-19 大流行对接受经动脉化疗栓塞（TACE）治疗的肝细胞癌（HCC）患者生存的影响。
对一家三级护理中心在封锁前（2019 年 3 月至 7 月）和封锁期间（2020 年 3 月至 7 月）接受 TACE 的 HCC 患者进行了回顾性研究。从医院病历中收集了人口统计学数据、肿瘤特征、功能状态和生存状况。终点是 TACE 间隔、治疗反应和 TACE 后生存。Cox 比例风险回归确定了影响生存的术前显著因素。
与封锁前相比，封锁期间重复 TACE 治疗的时间显著延迟（76.7 天 vs. 63.5 天，=0.007）。趋势表明，重复 TACE 组的 HCC 患者数量显著减少（-33.3%）。筛选后，共纳入 145 例患者（封锁前（ = 87），封锁后（ = 58））。封锁前和封锁后组的 1 个月客观缓解率无显著差异（65.5% vs. 64.4%，=1.00）。随访期间，封锁前和封锁后组分别有 56（64.4%）和 34（58.6%）例死亡（=0.600）。多变量分析显示，封锁组与生存时间缩短无关（HR 0.88，95% CI 0.57-1.35，=0.555）。
COVID-19 大流行对肝癌治疗的影响导致 2020 年与 2019 年相比，重复 TACE 治疗的次数减少和延迟。然而，治疗延迟似乎并未显著影响生存。
