Background and Aims. 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). Methods. 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. Results. Compared to prelockdown, a significant delay occurred during the lockdown in repeated TACE treatments (76.7 vs. 63.5 days, ). The trend suggested a significant decrease in patients with HCC in the repeated TACE group (−33.3%). After screening, 145 patients were included (prelockdown (n = 87), lockdown (n = 58)). There was no significant difference in the 1-month objective response rate between the prelockdown and lockdown groups (65.5% vs. 64.4%, ). During follow-up, 56 (64.4%) and 34 (58.6%) deaths occurred in the prelockdown and lockdown groups, respectively (). Multivariate analysis revealed no association between the lockdown group and decreased survival (HR 0.88, 95% CI 0.57–1.35, ). Conclusions. 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.

中文翻译：

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COVID-19 大流行相关化疗栓塞延迟对肝细胞癌患者生存的影响

背景和目标。COVID-19 已导致肝癌治疗的潜在延误，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术 (TACE) 的肝细胞癌 (HCC) 患者生存的影响。方法. 对在封锁前（2019 年 3 月至 2019 年 7 月）和封锁（2020 年 3 月至 2020 年 7 月）期间在三级医疗中心接受 TACE 治疗的 HCC 患者进行了一项回顾性研究。从医院病历中收集人口统计学数据、肿瘤特征、功能状态和生命状态。终点是 TACE 间隔、治疗反应和 TACE 后的存活率。Cox 比例风险回归确定影响生存的重要术前因素。结果。与锁定前相比，锁定期间重复 TACE 治疗出现显着延迟（76.7 天与 63.5 天，). 该趋势表明重复 TACE 组中 HCC 患者显着减少 (-33.3%)。筛选后，包括 145 名患者（锁定前（ n  = 87），锁定（ n  = 58））。预锁定组和锁定组之间的 1 个月客观反应率没有显着差异（65.5% 对 64.4%，). 在随访期间，prelockdown 组和 lockdown 组分别有 56 例 (64.4%) 和 34 例 (58.6%) 死亡（). 多变量分析显示锁定组与生存率下降之间没有关联（HR 0.88，95% CI 0.57–1.35，). 结论。与 2019 年相比，COVID-19 大流行对肝癌护理的影响导致 2020 年重复 TACE 治疗显着减少和延迟。但是，治疗延迟似乎并未显着影响生存。