Purpose: The COVID-19 pandemic has altered healthcare priorities which may adversely impact cancer management. We aimed to evaluate the impact of the pandemic on the diagnosis, treatment, and consultation methods for patients with hepatocellular carcinoma (HCC).
Patients and Methods: We conducted a survey among 27 hospitals from 14 Asia-Pacific countries, collecting hospital-level information on the number of newly diagnosed HCC cases during a pre-pandemic period (February to May 2019) and for the same period during the pandemic (February to May 2020). Information was also collected on delays in diagnosis and treatment, changes in treatment modalities and complication rates, changes in patient enrollment in clinical trials, and modes of patient consultation. The information was stratified by the Barcelona Clinic Liver Cancer (BCLC) stage.
Results: The survey included cohorts of 2789 and 2045 patients newly diagnosed with HCC during the pre- and pandemic period, respectively. A decline of 26.7% in new HCC cases was reported during the pandemic compared to the pre-pandemic. A sizable proportion of institutions reported delays in diagnosis (48.2% in BCLC 0/A/B and 51.9% in BCLC C), delays in treatment (66.7% in BCLC 0/A/B and 63.0% in BCLC C), changes in treatment modality (33.3% in BCLC 0/A/B and 18.5% in BCLC C), an increase in treatment complications (about 15% across all BCLC stages), and no growth in clinical trial enrollments during the pandemic. Furthermore, there was a decline of 27.3% in face-to-face patient consultations and an increase of 18.3% in video/telephonic consultations during the pandemic. A considerable variation in changes in HCC management was observed among countries.
Conclusion: The COVID-19 pandemic has significantly impacted the management of HCC among Asia-Pacific countries. The impact varies according to the disease stage and country. Well thought-through long-term strategies are required to ameliorate the negative impact of the pandemic on HCC patients.

Keywords: hepatocellular carcinoma, liver cancer, COVID-19, Asia-Pacific


中文翻译：

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COVID-19 对肝细胞癌管理的影响：一项多国和地区研究

目的： COVID-19 大流行改变了医疗保健的优先事项，这可能对癌症管理产生不利影响。我们旨在评估大流行对肝细胞癌 (HCC) 患者诊断、治疗和会诊方法的影响。
患者和方法：我们对来自 14 个亚太国家/地区的 27 家医院进行了一项调查，收集了关于大流行前时期（2019 年 2 月至 5 月）和大流行期间同期（2 月至2020 年 5 月）。还收集了有关诊断和治疗延误、治疗方式和并发症发生率变化、临床试验患者登记变化以及患者咨询方式的信息。这些信息按巴塞罗那临床肝癌 (BCLC) 分期进行分层。
结果：该调查分别包括 2789 名和 2045 名在大流行前和大流行期间新诊断为 HCC 的患者队列。与大流行前相比，大流行期间报告的新 HCC 病例下降了 26.7%。相当一部分机构报告了诊断延误（BCLC 0/A/B 为 48.2%，BCLC C 为 51.9%）、治疗延误（BCLC 0/A/B 为 66.7%，BCLC C 为 63.0%）、治疗方式（BCLC 0/A/B 为 33.3%，BCLC C 为 18.5%），治疗并发症增加（所有 BCLC 阶段约 15%），并且在大流行期间临床试验注册人数没有增长。此外，在大流行期间，面对面的患者咨询减少了 27.3%，视频/电话咨询增加了 18.3%。各国观察到 HCC 管理的变化存在相当大的差异。
结论： COVID-19 大流行对亚太国家 HCC 的管理产生了重大影响。影响因疾病阶段和国家而异。需要经过深思熟虑的长期战略来改善大流行对 HCC 患者的负面影响。

关键词：肝细胞癌，肝癌，COVID-19，亚太地区