tetano
Editor, Senior Moderator
Liver Int
. 2022 May 24.
doi: 10.1111/liv.15320. Online ahead of print.
Outcome of liver cancer patients with SARS-CoV-2 infection
Sergio Muñoz-Martínez[SUP] 1 [/SUP], Victor Sapena[SUP] 1 2 [/SUP], Alejandro Forner[SUP] 1 [/SUP], Jordi Bruix[SUP] 1 [/SUP], Marco Sanduzzi-Zamparelli[SUP] 1 [/SUP], José Ríos[SUP] 3 4 [/SUP], Mohamed Bouattour[SUP] 5 [/SUP], Mohamed El Kassas[SUP] 6 [/SUP], Cassia Regina Guedes Leal[SUP] 7 8 [/SUP], Tudor Mocan[SUP] 9 [/SUP], Jean-Charles Nault[SUP] 10 11 12 [/SUP], Rogerio Camargo Pinheiro Alves[SUP] 13 14 [/SUP], Helen L Reeves[SUP] 15 16 [/SUP], Leonardo da Fonseca[SUP] 17 [/SUP], Ignacio García-Juárez[SUP] 18 [/SUP], David J Pinato[SUP] 19 [/SUP], María Varela[SUP] 20 [/SUP], Saleh A Alqahtani[SUP] 21 [/SUP], Mario Reis Alvares-da-Silva[SUP] 22 [/SUP], Juan C Bandi[SUP] 23 [/SUP], Lorenza Rimassa[SUP] 24 25 [/SUP], Mar Lozano[SUP] 26 [/SUP], Jesús Manuel González Santiago[SUP] 27 [/SUP], Frank Tacke[SUP] 28 [/SUP], Margarita Sala[SUP] 29 [/SUP], María Anders[SUP] 30 [/SUP], Anja Lachenmayer[SUP] 31 [/SUP], Federico Piñero[SUP] 32 [/SUP], Alex França[SUP] 33 [/SUP], Maria Guarino[SUP] 34 [/SUP], Alessandra Elvevi[SUP] 35 [/SUP], Giuseppe Cabibbo[SUP] 36 [/SUP], Markus Peck-Radosavljevic[SUP] 37 [/SUP], Ángela Rojas[SUP] 38 [/SUP], Mercedes Vergara[SUP] 39 [/SUP], Chiara Braconi[SUP] 40 [/SUP], Sonia Pascual[SUP] 41 [/SUP], Christie Perelló[SUP] 42 [/SUP], Vivianne Mello[SUP] 43 [/SUP], Carlos Rodríguez-Lope[SUP] 44 [/SUP], Juan Acevedo[SUP] 45 [/SUP], Rosanna Villani[SUP] 46 [/SUP], Clemence Hollande[SUP] 47 [/SUP], Valérie Vilgrain[SUP] 48 49 [/SUP], Ahmed Tawheed[SUP] 6 [/SUP], Carmem Ferguson Theodoro[SUP] 50 [/SUP], Zeno Sparchez[SUP] 51 [/SUP], Lorraine Blaise[SUP] 10 11 12 [/SUP], Daniele Evaristo Viera-Alves[SUP] 13 14 [/SUP], Robyn Watson[SUP] 16 [/SUP], Flair José Carrilho[SUP] 52 [/SUP], Carlos Moctezuma-Velázquez[SUP] 18 [/SUP], Antonio D'Alessio[SUP] 19 53 [/SUP], Massimo Iavarone[SUP] 54 [/SUP], Maria Reig[SUP] 1 [/SUP]
Affiliations
Abstract
Background & aims: Information about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with liver cancer is lacking. This study characterizes the outcomes and mortality risk in this population.
Methods: Multicenter retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February-December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered.
Results: Two-hundred-fifty patients from 38 centers were included, 218 with hepatocellular carcinoma (HCC), 32 with intrahepatic cholangiocarcinoma (iCCA). Median age was 66.5 and 64.5 years, and 84.9% and 21.9% had cirrhosis in the HCC and iCCA cohorts, respectively. Patients had advanced cancer stage at SARS-CoV-2 diagnosis in 39.0% of the HCC and 71.9% of the iCCA patients. After a median follow-up of 7.20 [IQR:1.84-11.24] months, 100 (40%) patients have died,48% of the deaths were SARS-CoV-2-related. Forty (18.4%) HCC patients died within 30-days. The death rate increase was significantly different according to the BCLC stage [6.10%(95%CI 2.24-12.74), 11.76%(95%CI 4.73-22.30), 20.69%(95%CI 11.35-31.96), and 34.52%(95%CI 17.03-52.78) for BCLC 0/A, B, C and D respectively; p=0.0017]. The Hazard Ratio was 1.45 (95%CI 0.49-4.31; p=0.5032) in BCLC-B vs 0/A, and 3.13 (95%CI 1.29-7.62; p=0.0118) in BCLC-C vs 0/A in the Competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, 12 deaths related to SARS-CoV-2 infection.
Conclusions: This is the largest cohort of liver cancer patients infected with SARS-CoV-2. It characterizes the 30-day mortality risk of SARS-CoV-2 infected patients with HCC during this period.
Keywords: COVID-19; Hepatocellular carcinoma; Liver cancer; mortality.
. 2022 May 24.
doi: 10.1111/liv.15320. Online ahead of print.
Outcome of liver cancer patients with SARS-CoV-2 infection
Sergio Muñoz-Martínez[SUP] 1 [/SUP], Victor Sapena[SUP] 1 2 [/SUP], Alejandro Forner[SUP] 1 [/SUP], Jordi Bruix[SUP] 1 [/SUP], Marco Sanduzzi-Zamparelli[SUP] 1 [/SUP], José Ríos[SUP] 3 4 [/SUP], Mohamed Bouattour[SUP] 5 [/SUP], Mohamed El Kassas[SUP] 6 [/SUP], Cassia Regina Guedes Leal[SUP] 7 8 [/SUP], Tudor Mocan[SUP] 9 [/SUP], Jean-Charles Nault[SUP] 10 11 12 [/SUP], Rogerio Camargo Pinheiro Alves[SUP] 13 14 [/SUP], Helen L Reeves[SUP] 15 16 [/SUP], Leonardo da Fonseca[SUP] 17 [/SUP], Ignacio García-Juárez[SUP] 18 [/SUP], David J Pinato[SUP] 19 [/SUP], María Varela[SUP] 20 [/SUP], Saleh A Alqahtani[SUP] 21 [/SUP], Mario Reis Alvares-da-Silva[SUP] 22 [/SUP], Juan C Bandi[SUP] 23 [/SUP], Lorenza Rimassa[SUP] 24 25 [/SUP], Mar Lozano[SUP] 26 [/SUP], Jesús Manuel González Santiago[SUP] 27 [/SUP], Frank Tacke[SUP] 28 [/SUP], Margarita Sala[SUP] 29 [/SUP], María Anders[SUP] 30 [/SUP], Anja Lachenmayer[SUP] 31 [/SUP], Federico Piñero[SUP] 32 [/SUP], Alex França[SUP] 33 [/SUP], Maria Guarino[SUP] 34 [/SUP], Alessandra Elvevi[SUP] 35 [/SUP], Giuseppe Cabibbo[SUP] 36 [/SUP], Markus Peck-Radosavljevic[SUP] 37 [/SUP], Ángela Rojas[SUP] 38 [/SUP], Mercedes Vergara[SUP] 39 [/SUP], Chiara Braconi[SUP] 40 [/SUP], Sonia Pascual[SUP] 41 [/SUP], Christie Perelló[SUP] 42 [/SUP], Vivianne Mello[SUP] 43 [/SUP], Carlos Rodríguez-Lope[SUP] 44 [/SUP], Juan Acevedo[SUP] 45 [/SUP], Rosanna Villani[SUP] 46 [/SUP], Clemence Hollande[SUP] 47 [/SUP], Valérie Vilgrain[SUP] 48 49 [/SUP], Ahmed Tawheed[SUP] 6 [/SUP], Carmem Ferguson Theodoro[SUP] 50 [/SUP], Zeno Sparchez[SUP] 51 [/SUP], Lorraine Blaise[SUP] 10 11 12 [/SUP], Daniele Evaristo Viera-Alves[SUP] 13 14 [/SUP], Robyn Watson[SUP] 16 [/SUP], Flair José Carrilho[SUP] 52 [/SUP], Carlos Moctezuma-Velázquez[SUP] 18 [/SUP], Antonio D'Alessio[SUP] 19 53 [/SUP], Massimo Iavarone[SUP] 54 [/SUP], Maria Reig[SUP] 1 [/SUP]
Affiliations
- PMID: 35608939
- DOI: 10.1111/liv.15320
Abstract
Background & aims: Information about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with liver cancer is lacking. This study characterizes the outcomes and mortality risk in this population.
Methods: Multicenter retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February-December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered.
Results: Two-hundred-fifty patients from 38 centers were included, 218 with hepatocellular carcinoma (HCC), 32 with intrahepatic cholangiocarcinoma (iCCA). Median age was 66.5 and 64.5 years, and 84.9% and 21.9% had cirrhosis in the HCC and iCCA cohorts, respectively. Patients had advanced cancer stage at SARS-CoV-2 diagnosis in 39.0% of the HCC and 71.9% of the iCCA patients. After a median follow-up of 7.20 [IQR:1.84-11.24] months, 100 (40%) patients have died,48% of the deaths were SARS-CoV-2-related. Forty (18.4%) HCC patients died within 30-days. The death rate increase was significantly different according to the BCLC stage [6.10%(95%CI 2.24-12.74), 11.76%(95%CI 4.73-22.30), 20.69%(95%CI 11.35-31.96), and 34.52%(95%CI 17.03-52.78) for BCLC 0/A, B, C and D respectively; p=0.0017]. The Hazard Ratio was 1.45 (95%CI 0.49-4.31; p=0.5032) in BCLC-B vs 0/A, and 3.13 (95%CI 1.29-7.62; p=0.0118) in BCLC-C vs 0/A in the Competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, 12 deaths related to SARS-CoV-2 infection.
Conclusions: This is the largest cohort of liver cancer patients infected with SARS-CoV-2. It characterizes the 30-day mortality risk of SARS-CoV-2 infected patients with HCC during this period.
Keywords: COVID-19; Hepatocellular carcinoma; Liver cancer; mortality.