Background/Objectives: Access to healthcare services was significantly restricted during the COVID-19 pandemic, leading to changes in the management of hepatocellular carcinoma (HCC). However, limited research has examined how these changes evolved post-pandemic. This study evaluated the impact of the pandemic at a tertiary center in Romania, focusing on diagnosis rates, treatments, and survival outcomes. Methods: A retrospective study conducted at Timișoara County Hospital divided patients into three equal cohorts of 23 months each: the pre-pandemic period (PreP: 1 May 2018–31 March 2020), the pandemic period (PandP: 1 April 2020–28 February 2022), and the post-pandemic period (PostP: 1 March 2022–31 January 2024). Newly diagnosed HCC cases were evaluated for the tumor stage, biological markers, and treatment received during each period. A survival census was conducted nine months after the diagnosis. Results: During the PandP and PostP periods, the numbers of newly diagnosed HCC cases decreased to 58 cases (p< 0.001) and 64 cases (p< 0.005), respectively, representing reductions of 38.3% and 31.9% compared to the PreP period, which had 94 cases. The proportion of patients in the BCLC-B stage increased from 31.9% in the PreP period to 50% during the PandP period (p= 0.0401), with fewer BCLC-A-0 cases (17% vs 5.1%;p= 0.059) during PandP. The tumor characteristics, BCLC classification, and TNM staging showed no significant differences between the PreP and PostP periods. Systemic therapy was the most commonly used treatment (39.7–50%). No significant differences were observed across treatment types when comparing all three periods (p> 0.05). The median follow-up times in the PreP, PandP, and PostP periods were 157.5, 159.5, and 183.5 days, respectively, with no statistically significant differences. The survival curve showed no statistically significant differences in survival between the groups at the nine-month follow-up (p> 0.05). Conclusions: The COVID-19 pandemic decreased HCC diagnoses, with only a partial rebound in the PostP period that did not reach PreP levels. While the PandP period showed worsening BCLC staging and an increase in tumor numbers, the tumor stage and treatment in the PostP period were similar to those in the PreP period. Similarly, the nine-month survival rates remained similar across all three periods.
背景/目的：在COVID-19大流行期间，医疗服务的可及性受到显著限制，导致肝细胞癌（HCC）的管理方式发生变化。然而，关于这些变化在大流行后如何演变的研究有限。本研究评估了疫情对罗马尼亚一家三级医疗中心的影响，重点关注诊断率、治疗方式和生存结局。方法：在蒂米什瓦拉县医院进行的一项回顾性研究将患者分为三个时长均为23个月的队列：大流行前时期（PreP：2018年5月1日至2020年3月31日）、大流行时期（PandP：2020年4月1日至2022年2月28日）和大流行后时期（PostP：2022年3月1日至2024年1月31日）。评估了各时期新诊断HCC病例的肿瘤分期、生物学标志物及接受的治疗。在诊断后九个月进行了生存情况调查。结果：在PandP和PostP时期，新诊断HCC病例数分别降至58例（p<0.001）和64例（p<0.005），相较于PreP时期的94例，分别减少了38.3%和31.9。BCLC-B期患者的比例从PreP时期的31.9%增加至PandP时期的50%（p=0.0401），而PandP时期BCLC-A-0期病例较少（17% vs 5.1%；p=0.059）。肿瘤特征、BCLC分期和TNM分期在PreP与PostP时期之间无显著差异。全身治疗是最常用的治疗方法（39.7–50%）。比较三个时期的所有治疗类型时，未观察到显著差异（p>0.05）。PreP、PandP和PostP时期的中位随访时间分别为157.5天、159.5天和183.5天，无统计学显著差异。生存曲线显示，在九个月随访时，各组间的生存率无统计学显著差异（p>0.05）。结论：COVID-19大流行导致HCC诊断数量下降，PostP时期仅部分回升，未达到PreP时期的水平。尽管PandP时期显示BCLC分期恶化且肿瘤数量增加，但PostP时期的肿瘤分期和治疗与PreP时期相似。同样，三个时期的九个月生存率也保持相似。
肿瘤(癌症)患者之家