Burciu Calin, Miutescu Bogdan, Bende Renata, Burciu Deiana, Moga Tudor Voicu, Popescu Alina, Popa Alexandru, Bende Felix, Gadour Eyad, Burdan Adrian, Iovanescu Dana, Danila Mirela, Sirli Roxana
Department of Gastroenterology, Faculty of Medicine, Pharmacy and Dental Medicine, "Vasile Goldis" West University of Arad, 310414 Arad, Romania.
Center for Advanced Research in Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Cancers (Basel). 2025 May 14;17(10):1660. doi: 10.3390/cancers17101660.
BACKGROUND/OBJECTIVES: Access to healthcare services was significantly restricted during the COVID-19 pandemic, leading to changes in the management of hepatocellular carcinoma (HCC). However, limited research has examined how these changes evolved post-pandemic. This study evaluated the impact of the pandemic at a tertiary center in Romania, focusing on diagnosis rates, treatments, and survival outcomes.
A retrospective study conducted at Timișoara County Hospital divided patients into three equal cohorts of 23 months each: the pre-pandemic period (PreP: 1 May 2018-31 March 2020), the pandemic period (PandP: 1 April 2020-28 February 2022), and the post-pandemic period (PostP: 1 March 2022-31 January 2024). Newly diagnosed HCC cases were evaluated for the tumor stage, biological markers, and treatment received during each period. A survival census was conducted nine months after the diagnosis.
During the PandP and PostP periods, the numbers of newly diagnosed HCC cases decreased to 58 cases ( < 0.001) and 64 cases ( < 0.005), respectively, representing reductions of 38.3% and 31.9% compared to the PreP period, which had 94 cases. The proportion of patients in the BCLC-B stage increased from 31.9% in the PreP period to 50% during the PandP period ( = 0.0401), with fewer BCLC-A-0 cases (17% vs 5.1%; = 0.059) during PandP. The tumor characteristics, BCLC classification, and TNM staging showed no significant differences between the PreP and PostP periods. Systemic therapy was the most commonly used treatment (39.7-50%). No significant differences were observed across treatment types when comparing all three periods ( > 0.05). The median follow-up times in the PreP, PandP, and PostP periods were 157.5, 159.5, and 183.5 days, respectively, with no statistically significant differences. The survival curve showed no statistically significant differences in survival between the groups at the nine-month follow-up ( > 0.05).
The COVID-19 pandemic decreased HCC diagnoses, with only a partial rebound in the PostP period that did not reach PreP levels. While the PandP period showed worsening BCLC staging and an increase in tumor numbers, the tumor stage and treatment in the PostP period were similar to those in the PreP period. Similarly, the nine-month survival rates remained similar across all three periods.
背景/目的：在新冠疫情期间，获得医疗服务受到显著限制，这导致肝细胞癌（HCC）的管理发生了变化。然而，关于这些变化在疫情后如何演变的研究有限。本研究评估了疫情对罗马尼亚一家三级中心的影响，重点关注诊断率、治疗情况和生存结果。
在蒂米什瓦拉县医院进行的一项回顾性研究将患者分为三个相等的队列，每个队列23个月：疫情前时期（PreP：2018年5月1日至2020年3月31日）、疫情时期（PandP：2020年4月1日至2022年2月28日）和疫情后时期（PostP：2022年3月1日至2024年1月31日）。对新诊断的HCC病例评估每个时期的肿瘤分期、生物标志物和接受的治疗。在诊断后九个月进行生存普查。
在PandP期和PostP期，新诊断的HCC病例数分别降至58例（<0.001）和64例（<0.005），与PreP期的94例相比，分别减少了38.3%和31.9%。BCLC-B期患者的比例从PreP期的31.9%增加到PandP期的50%（=0.0401），PandP期BCLC-A-0病例较少（17%对5.1%；=0.059）。PreP期和PostP期之间的肿瘤特征、BCLC分类和TNM分期无显著差异。全身治疗是最常用的治疗方法（39.7 - 50%）。比较所有三个时期时，各治疗类型之间未观察到显著差异（>0.05）。PreP期、PandP期和PostP期的中位随访时间分别为157.5天、159.5天和183.5天，无统计学显著差异。生存曲线显示，在九个月随访时，各组之间的生存率无统计学显著差异（>0.05）。
新冠疫情导致HCC诊断减少，PostP期仅有部分反弹，未达到PreP期水平。虽然PandP期显示BCLC分期恶化且肿瘤数量增加，但PostP期的肿瘤分期和治疗与PreP期相似。同样，所有三个时期的九个月生存率保持相似。
