Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab
Abstract
1. Introduction
2. Materials and Methods
2.1. Ethical Statement
2.2. Study Design and Patients
2.3. Treatments and Outcome Evaluation
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics and COVID-19 Severity
3.2. Inflammatory Markers According to COVID-19 Severity
3.3. Organ Dysfunction and Complications after COVID-19
3.4. Treatment Delay and Treatment Strategy Changes after COVID-19
3.5. Survival Outcomes after COVID-19
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | All n = 241 100.0% | Non-Infected n = 206 (85.5%) | * Low-Severity Group n = 26 (10.8%) | * High-Severity Group n = 9 (3.7%) | * p-Value |
---|---|---|---|---|---|
Age, median (IQR) | 62 (55–68) | 62 (55–69) | 57.5 (54–63) | 62 (60–65) | 0.398 |
Male sex | 208 (86.3%) | 176 (85.4%) | 23 (88.5%) | 9 (100.0%) | 0.287 |
ECOG status | 0.147 | ||||
0 | 99 (41.1%) | 84 (40.8%) | 13 (50.0%) | 2 (22.2%) | |
1, 2 | 142 (58.9%) | 122 (59.2%) | 13 (50.0%) | 7 (77.8%) | |
Child–Pugh class | 0.038 | ||||
A | 181 (75.1%) | 155 (75.2%) | 21 (80.8%) | 4 (44.4%) | |
B | 60 (24.9%) | 51 (24.8%) | 5 (19.2%) | 5 (55.6%) | |
BCLC stage | 0.439 | ||||
B | 37 (15.4%) | 30 (14.6%) | 6 (23.1%) | 1 (11.1%) | |
C | 204 (84.6%) | 176 (85.4%) | 20 (76.9%) | 8 (88.9%) | |
Etiology of HCC | |||||
Hepatitis B | 162 (67.2%) | 137 (66.5%) | 19 (73.1%) | 6 (66.7%) | 0.714 |
Hepatitis C | 17 (7.1%) | 15 (7.3%) | 1 (3.8%) | 1 (11.1%) | 0.418 |
Alcohol | 34 (14.1%) | 29 (14.1%) | 4 (15.4%) | 1 (11.1%) | 0.752 |
Other unknown | 28 (11.6%) | 25 (12.1%) | 2 (7.7%) | 1 (11.1%) | 0.752 |
MVI | 106 (44.0%) | 88 (42.7%) | 11 (42.3%) | 7 (77.8%) | 0.067 |
Extrahepatic spread | 149 (61.8%) | 132 (64.1%) | 13 (50.0%) | 4 (44.4%) | 0.774 |
Age | Sex | Etiology of HCC | BCLC Stage | COVID-19 Severity | * Deterioration of LFT | * CP Score Change | * Event within 60 DPI (Days) | Infection Time from Ate/Bev Start (Days) | Delay of Ate/Bev (Days) |
---|---|---|---|---|---|---|---|---|---|
56 | M | HBV | C | Asym | - | 5 | PD (30) | 90 | 0 |
71 | M | Other unknown | B | Asym | - | 6 | f/u loss (52) | 81 | 0 |
44 | M | HBV | C | Mild | - | 5 | PD (49) | 87 | 0 |
61 | M | HBV | B | Mild | Bil (1.5→2.4) | 5→6 | - | 285 | 14 |
57 | M | HBV | C | Mild | Bil (1.1→2.1) | 6→7 | f/u loss (18) | 27 | 0 |
41 | M | HBV | C | Mild | Bil (2.4→4.3) AST (G0→G1) r-GT (G0→G1) | 7→8 | ECOG 3 (12) | 330 | D/C |
63 | M | Other unknown | C | Mild | Bil (1.4→3.3) | 7→9 | HEP (56) Death (56) | 102 | 21 |
46 | M | HBV | C | Moderate | Alb (3.5→2.3) | 5→6 | Esophageal varix bleeding (21) | 417 | 28 |
51 | M | HBV | C | Moderate | Bil (0.7→2.1) Alb (3.2→2.7) AST (G0→G1) | 6→8 | HCC rupture (30) PD (30) Death (32) | 309 | 14 |
60 | M | HBV | C | Moderate | Bil (1.8→3.9) Alb (2.9→2.4) AST (G2→G3) | 6→9 | PD (9) | 48 | 9 |
62 | M | HBV | C | Moderate | Bil (1.8→4.7) AST (G1→G2) ALT (G0→G1) | 7→9 | Gastric varix bleeding (39) | 216 | D/C |
65 | M | HBV | C | Moderate | Bil (2.3→4.9) AST (G0→G1) | 7→9 | ECOG decline (9) | 126 | D/C |
69 | F | Other unknown | C | Severe | Alb (3.3→1.3) INR (1.2→2.2) AST (G1→G3) ALT (G0→G3) | 7→8 | Esophageal varix bleeding (30) | 471 | D/C |
62 | M | HCV | C | Critical | Bil (1.3→2.1) INR (2.9→2.4) AST (G1→G3) | 7→9 | Gastric perforation by PD (3) Death (3) | 45 | 0 |
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Sang, Y.B.; Lee, C.; Kim, S.-G.; Lee, B.; Kang, B.; Kim, C.; Chon, H.J. Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab. J. Clin. Med. 2024, 13, 1335. https://doi.org/10.3390/jcm13051335
Sang YB, Lee C, Kim S-G, Lee B, Kang B, Kim C, Chon HJ. Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab. Journal of Clinical Medicine. 2024; 13(5):1335. https://doi.org/10.3390/jcm13051335
Chicago/Turabian StyleSang, Yun Beom, Chaeryoung Lee, Seul-Gi Kim, Boyoung Lee, Beodeul Kang, Chan Kim, and Hong Jae Chon. 2024. "Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab" Journal of Clinical Medicine 13, no. 5: 1335. https://doi.org/10.3390/jcm13051335
APA StyleSang, Y. B., Lee, C., Kim, S.-G., Lee, B., Kang, B., Kim, C., & Chon, H. J. (2024). Impact of Coronavirus Disease 2019 on Unresectable Hepatocellular Carcinoma Treated with Atezolizumab/Bevacizumab. Journal of Clinical Medicine, 13(5), 1335. https://doi.org/10.3390/jcm13051335