Toggle Main Menu Toggle Search

Open Access padlockePrints

Assessing the impact of COVID-19 on liver cancer management (CERO-19)

Lookup NU author(s): Professor Helen ReevesORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2021 The AuthorsBackground & Aims: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. Methods: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. Results: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). Conclusions: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. Lay summary: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

Publication metadata

Author(s): Munoz-Martinez S, Sapena V, Forner A, Nault J-C, Sapisochin G, Rimassa L, Sangro B, Bruix J, Sanduzzi-Zamparelli M, Holowko W, El Kassas M, Mocan T, Bouattour M, Merle P, Hoogwater FJH, Alqahtani SA, Reeves HL, Pinato DJ, Giorgakis E, Meyer T, Villadsen GE, Wege H, Salati M, Minguez B, Di Costanzo GG, Roderburg C, Tacke F, Varela M, Galle PR, Alvares-da-Silva MR, Trojan J, Bridgewater J, Cabibbo G, Toso C, Lachenmayer A, Casadei-Gardini A, Toyoda H, Ludde T, Villani R, Matilla Pena AM, Guedes Leal CR, Ronzoni M, Delgado M, Perello C, Pascual S, Lledo JL, Argemi J, Basu B, da Fonseca L, Acevedo J, Siebenhuner AR, Braconi C, Meyers BM, Granito A, Sala M, Rodriguez-Lope C, Blaise L, Romero-Gomez M, Pinero F, Gomez D, Mello V, Pinheiro Alves RC, Franca A, Branco F, Brandi G, Pereira G, Coll S, Guarino M, Benitez C, Anders MM, Bandi JC, Vergara M, Calvo M, Peck-Radosavljevic M, Garcia-Juarez I, Cardinale V, Lozano M, Gambato M, Okolicsanyi S, Morales-Arraez D, Elvevi A, Munoz AE, Lue A, Iavarone M, Reig M

Publication type: Article

Publication status: Published

Journal: JHEP Reports

Year: 2021

Volume: 3

Issue: 3

Print publication date: 01/06/2021

Online publication date: 23/02/2021

Acceptance date: 09/02/2021

Date deposited: 10/06/2021

ISSN (electronic): 2589-5559

Publisher: Elsevier B.V.


DOI: 10.1016/j.jhepr.2021.100260


Altmetrics provided by Altmetric