Outcome of liver cancer patients with SARS‐CoV‐2 infection: An International, Multicentre, Cohort Study
Sergio Muñoz, Víctor Sapena, Alejandro Forner, Jordi Bruix, Marco Sanduzzi‐Zamparelli, José Ríos, Mohamed Bouattour, Mohamed El‐Kassas, Cássia Regina Guedes Leal, Tudor Mocan, Jean‐Charles Nault, Rogério Camargo Pinheiro Alves, Helen L. Reeves, Leonardo Gomes da Fonseca, Ignacio García‐Juárez, David J. Pinato, Marı́a Varela, Saleh A. Alqahtani, Mário Reis Álvares‐da‐Silva, Juan Carlos Bandi, Lorenza Rimassa, Mar Lozano, Jesús M. González‐Santiago, Frank Tacke, Margarita Sala, Margarita Anders, Anja Lachenmayer, Federico Piñero, Alex Vianey Callado França, Maria Guarino, Alessandra Elvevi, Giuseppe Cabibbo, Markus Peck‐Radosavljevic, Ángela Rojas, Mercedes Vergara, Chiara Braconi, Sonia Pascual, Christie Perelló, Vivianne Mello, Carlos Rodríguez de Lope, Juan Acevedo, Rosanna Villani, Clémence Hollande, Valérie Vilgrain, Ahmed Tawheed, Carmem Theodoro, Zeno Spârchez, Lorraine Blaise, Daniele E. Viera‐Alves, Robyn Watson, Flair José Carrilho, Carlos Moctezuma‐Velázquez, Antonio D’Alessio, Massimo Iavarone, María Reig
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: Multicentre retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February and December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered. RESULTS: Two hundred fifty patients from 38 centres were included, 218 with hepatocellular carcinoma (HCC) and 32 with intrahepatic cholangiocarcinoma (iCCA). The 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 = .0017). The hazard ratio was 1.45 (95% CI 0.49-4.31; p = .5032) in BCLC-B versus 0/A, and 3.13 (95% CI 1.29-7.62; p = .0118) in BCLC-C versus 0/A in the competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, and 12 deaths were 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.