TY - JOUR
AU - McLaren, Alistair Stewart
AU - Spoor, Johannes A.
AU - Cartwright, Douglas
AU - Naylor, Gregory
AU - Barclay, Stephen
AU - Priest, Matthew
AU - Puttagunta, Srikanth
AU - Armstrong, Kirsty
AU - Ballantyne, Stuart
AU - Stanley, Adrian J.
AU - Evans, Thomas R. Jeffry
AU - West of Scotland HCC MDT
PY - 2023
DA - November
TI - Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study
JO - BMJ Open Gastroenterology
VL - 10
IS - 1
DO - http://dx.doi.org/10.1136/bmjgast-2023-001231
AB - Objective: The COVID-19 pandemic had an undoubted impact on the provision of elective and emergency cancer care, including the diagnosis and management of patients with hepatocellular carcinoma (HCC). Our aim was to determine the effects of the COVID-19 pandemic on patients with HCC in the West of Scotland. Design: This was a retrospective audit of a prospectively collated database of patients presented to the West of Scotland Multidisciplinary Team (MDT) between April and October 2020 (during the pandemic), comparing baseline demographics, characteristics of disease at presentation, diagnostic workup, treatment and outcomes with patients from April to October 2019 (pre pandemic). Results: There was a 36.5% reduction in new cases referred to the MDT during the pandemic. Patients presented at a significantly later Barcelona Cancer Liver Clinic stage (24% stage D during the pandemic, 9.5% pre pandemic, p&lt;0.001) and with a significantly higher Child-Pugh Score (46% Child-Pugh B/C during the pandemic vs 27% pre pandemic, p&lt;0.001). We observed a reduction in overall survival (OS) among all patients with a median OS during the pandemic of 6 months versus 17 months pre pandemic (p=0.048). Conclusion: The impact of the COVID-19 pandemic is likely to have contributed to a reduction in the presentation of new cases and survival among patients with HCC in the West of Scotland. The reason for this is likely multifactorial, but disruption of standard care is likely to have played a significant role. Resources should be provided to address the backlog and ensure there are robust investigation and management pathways going forward.
PB - BMJ Publishing Group
UR - https://eprints.gla.ac.uk/309027/
KW - Coronavirus (COVID-19)
KW - Hospital care
ER