McLaren, A. S. et al. (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10(1), e001231. (doi: 10.1136/bmjgast-2023-001231) (PMID:37989352) (PMCID:PMC10660158)
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Abstract
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<0.001) and with a significantly higher Child-Pugh Score (46% Child-Pugh B/C during the pandemic vs 27% pre pandemic, p<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.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Spoor, Dr Johannes and Stanley, Dr Adrian and Ballantyne, Dr Stuart and Puttagunta, Dr Srikanth and Evans, Professor Jeff and McLaren, Dr Alistair |
| Authors: | McLaren, A. S., Spoor, J. A., Cartwright, D., Naylor, G., Barclay, S., Priest, M., Puttagunta, S., Armstrong, K., Ballantyne, S., Stanley, A., Evans, T. R. J., and West of Scotland HCC MDT, |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | BMJ Open Gastroenterology |
| Publisher: | BMJ Publishing Group |
| ISSN: | 2054-4774 |
| Published Online: | 20 November 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in BMJ Open Gastroenterology 10(1):e001231 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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