新冠肺炎大流行对苏格兰西部肝细胞癌患者的影响:一项队列研究

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Alistair Stewart McLaren, Johannes A Spoor, Douglas Cartwright, Gregory Naylor, Stephen Barclay, Matthew Priest, Srikanth Puttagunta, Kirsty Armstrong, Stuart Ballantyne, Adrian Stanley, Thomas R Jeffry Evans
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引用次数: 0

摘要

目的:2019冠状病毒病(COVID-19)大流行对选择性和紧急癌症护理的提供,包括肝癌(HCC)患者的诊断和管理,无疑产生了影响。我们的目的是确定COVID-19大流行对苏格兰西部HCC患者的影响。设计:这是对2020年4月至10月(大流行期间)提交给苏格兰西部多学科团队(MDT)的前瞻性整理数据库的回顾性审计,比较2019年4月至10月(大流行前)患者的基线人口统计学、疾病表现特征、诊断检查、治疗和结果。结果:大流行期间提交MDT的新病例减少了36.5%。患者出现在明显较晚的巴塞罗那肝癌临床阶段(大流行期间为24%,大流行前为9.5%)。结论:2019冠状病毒病大流行的影响可能导致苏格兰西部HCC患者出现新病例和生存率的减少。造成这种情况的原因可能是多方面的,但标准护理的中断可能起了重要作用。应提供资源以解决积压问题,并确保今后有强有力的调查和管理途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the West of Scotland: a cohort study.

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.

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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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