Surgical treatment of hepatocellular carcinoma in the era of COVID-19 pandemic: A comprehensive review of current recommendations

Table 1 Resume of scientific societies and institutions releasing recommendations addressing the surgical treatment of hepatocellular carcinoma during the coronavirus disease 2019 pandemic

Society/Institution	Date of release	Items addressed
AASLD (American Association for the Study of Liver Diseases)[20]	November 2020	Clinical best practice advice for hepatology and liver transplant providers during the COVID-19
APASL (Asian Pacific Association for the Study of the Liver)[46]	May 2020	Clinical practice guidance for hepatology and liver transplant providers during the COVID-19 pandemic
APASL (Asian Pacific Association for the Study of the Liver)[10]	November 2020	Practical recommendations for the management of hepatocellular carcinoma in the era of COVID-19
E-AHPBA (European-African Hepato Pancreato-Biliary Association)[13]	June 2020	Delivery of hepato-pancreato-biliary surgery during the COVID-19 pandemic
EASL (European Association for theStudy of the Liver)[48]	April 2020	Care of patients with liver disease during the COVID-19 pandemic
ESMO (European Society of Medical Oncology)[40]	April 2020	Management and treatment adapted recommendations in the COVID-19 era: hepatocellular carcinoma
ILCA (International Liver Cancer Association)[35]	April 2020	Management of HCC during COVID-19 pandemic
JAMMT (Working Group for Japan Association of Molecular Targeted Therapy for HCC)[23]	September 2020	Treatment of hepatocellular carcinoma during the COVID-19 outbreak
SAGES-AHPBA (Society of American Gastrointestinal and Endoscopic Surgeons- Americas Hepato-Pancreato-Biliary Association)[41]	April 2020	Recommendations regarding surgical management of HPB cancer patients during the response to the COVID-19 crisis
Saudi Association for the Study of Liver Disease and Transplantation[27]	June 2020	Principles of care for patients with liver disease during the COVID-19 pandemic
SSO (Society of Surgical Oncology)[43]	April 2020	Resource for management options of GI and HPB cancers during COVID-19

COVID-19: Coronavirus disease 2019; HCC: Hepatocellular carcinoma; GI: Gastrointestinal; HPB: Hepato-pancreato-biliary.

Table 2 Studies reporting on the surgical treatment of hepatocellular carcinoma in the pre-coronavirus disease and coronavirus disease era

Ref.	Treatment of HCC
Aghemo et al[18]	Surgical and nonsurgical locoregional procedures for management of HCC had been reduced (44% and 34%, respectively) or suspended (44% and 8%, respectively) in the centers involved in the study
Amaddeo et al[4]	Delay was longer than one month in the treatment of HCC in 2020, compared to 2019 (pre-COVID era)
Balakrishnan et al[13]	Only 10% of respondents in a cross-sectional survey reported that cancer surgery for HBP proceeded unaffected in the pandemic
Iavarone et al[63]	In a 4-wk period in 2020 compared with a 4-wk period in 2019, a lower number of patients submitted to surgical resection and liver transplant was observed
Siniscalchi et al[64]	Transplantation activities were reduced from February June 30, 2020, compared with the corresponding period in 2019
Soin et al[65]	In the period March-June 2020 the authors performed less living-donor liver transplantation than 2019 (39 vs 23)

HCC: Hepatocellular carcinoma; COVID-19: Coronavirus disease 2019; HPB: Hepato-pancreato-biliary.