Article Dans Une Revue JHEP Reports Innovation in Hepatology Année : 2021

Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Giuliana Amaddeo
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Raffaele Brustia
Manon Allaire
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Marie Lequoy
Clémence Hollande
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Hélène Regnault
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Lorraine Blaise
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Edouard Larrey
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Chetana Lim
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Olivier Scatton
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Sanaa El Mouhadi
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Violaine Ozenne
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François Paye
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Pierre Balladur
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Anthony Dohan
Pierre-Philippe Massault
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Stanislas Pol
Ailton Sepulveda
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Francois Cauchy
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Alain Luciani
Daniele Sommacale
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Vincent Leroy
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Francoise Roudot-Thoraval
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Mohamed Bouattour

Résumé

Background & Aims: Patients affected by hepatocellular carcinoma (HCC) represent a vulnerable population during the COVID-19 pandemic and may suffer from altered allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of patients with HCC within 6 referral centres in the metropolitan area of Paris, France. Methods: We performed a multicentre, retrospective, cross-sectional study on the management of patients with HCC during the first 6 weeks of the COVID-19 pandemic (exposed group), compared with the same period in 2019 (unexposed group). We included all patients discussed in multidisciplinary tumour board (MTB) meetings and/or patients undergoing a radiological or surgical programmed procedure during the study period, with curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treat. Results: After screening, n = 670 patients were included (n = 293 exposed to COVID, n = 377 unexposed to COVID). Fewer patients with HCC presented to the MTB in 2020 (p = 0.034) and fewer had a first diagnosis of HCC (n = 104 exposed to COVID, n = 143 unexposed to COVID, p = 0.083). Treatment strategy was modified in 13.1% of patients, with no differences between the 2 periods. Nevertheless, 21.5% vs. 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared with 2019 (p <0.001). In 2020, 7.1% (21/293) of patients had a diagnosis of an active COVID-19 infection: 11 (52.4%) patients were hospitalised and 4 (19.1%) patients died. Conclusions: In a metropolitan area highly impacted by the COVID-19 pandemic, we observed fewer patients with HCC, and similar rates of treatment modification, but with a significantly longer treatment delay in 2020 vs. 2019.

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hal-03240158 , version 1 (28-05-2021)

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Giuliana Amaddeo, Raffaele Brustia, Manon Allaire, Marie Lequoy, Clémence Hollande, et al.. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area. JHEP Reports Innovation in Hepatology, 2021, 3 (1), pp.100199. ⟨10.1016/j.jhepr.2020.100199⟩. ⟨hal-03240158⟩
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