Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2022; 10(15): 4785-4798
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4785
Impact of COVID-19 pandemic on clinicopathological features of transplant recipients with hepatocellular carcinoma: A case-control study
Sami Akbulut, Tevfik Tolga Sahin, Volkan Ince, Sezai Yilmaz
Sami Akbulut, Tevfik Tolga Sahin, Volkan Ince, Sezai Yilmaz, Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
Author contributions: Akbulut S and Ince V collected the data; Akbulut S performed the statistical analysis; Akbulut S and Sahin TT wrote the manuscript; Akbulut S, Sahin TT and Yilmaz S developed the study and reviewed the final version.
Institutional review board statement: This study was reviewed and approved by the Inonu University institutional review board for non-interventional studies, No. 2021/2538.
Informed consent statement: Verbal and written consents were obtained from all HCC patients before the liver transplantation procedure.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest regarding this study.
Data sharing statement: There are no additional data available for this study.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sami Akbulut, FACS, MD, PhD, Professor, Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Elazig Yolu 10.Km, Malatya 44280, Turkey. akbulutsami@gmail.com
Received: December 14, 2021
Peer-review started: December 14, 2021
First decision: March 12, 2022
Revised: March 17, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: May 26, 2022
Processing time: 160 Days and 18.8 Hours
Abstract
BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic had a significant impact on the management of all diseases. Various diseases such as cancer have a higher risk of COVID-19-related death. Despite this fact, any delay or alteration in treatment of cancer may have fatal consequences. Hepatocellular carcinoma (HCC) is an aggressive liver cancer that requires multimodality treatment to improve survival.

AIM

To evaluate the impact of COVID-19 on the management of patients with HCC by determining changes in demographic, clinical and histopathological variables.

METHODS

Demographic, clinical and pathological variables of patients with HCC who had undergone liver transplantation between March 2020 and June 2021 (Pandemic group, n = 48) were retrospectively compared with that of the patients with HCC transplanted between November 2018 and March 2020 (Pre-pandemic group, n = 61).

RESULTS

The median age of the patients in the study was 56 (interquartile range = 15). Ninety-seven patients (89%) were male and 12 were female (11%). The most common etiology of liver disease was hepatitis B virus (n = 52, 47.7%). According to our results, there was a 21.3% drop in the number of patients transplanted for HCC. There was no difference in the demographic, clinical and pathological characteristics of the patients except blood alkaline phosphatase levels (P = 0.029), lymphovascular invasion (P = 0.019) and type of the liver graft that was transplanted (P = 0.017).

CONCLUSION

It is important to develop a surveillance strategy for liver transplant centers. The liver transplantation for HCC is justified and safe provided that strict surveillance protocols are applied.

Keywords: COVID-19 pandemic; Liver transplantation; Hepatocellular carcinoma; Biological behavior

Core Tip: The coronavirus disease 2019 pandemic had a significant impact on the management of all diseases including hepatocellular carcinoma and related chronic liver disease. In this case control study, we aimed to investigate any change in the tumor behavior or change in the management of these patients during the pandemic. This study showed that there was a 21.3% drop in the number of patients transplanted for hepatocellular carcinoma. This study also showed that there were no differences in the demographic, clinical and pathological characteristics of the patients except blood alkaline phosphatase levels, lymphovascular invasion and type of the liver graft that was transplanted.