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Management of Primary Hepatic Malignancies During the COVID-19 Pandemic: Recommendations for Risk Mitigation From a Multidisciplinary Perspective |
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Lancet Gastroenterol Hepatol. 2020 Jun 5;S2468-1253(20)30182-5.doi: 10.1016/S2468-1253(20)30182-5. Online ahead of print.
Aisling Barry 1, Smith Apisarnthanarax 2, Grainne M O'Kane 3, Gonzalo Sapisochin 4, Robert Beecroft 5, Riad Salem 6, Sang Min Yoon 7, Young-Suk Lim 8, John Bridgewater 9, Brian Davidson 10, Marta Scorsetti 11, Luigi Solbiati 12, Adam Diehl 13, Pablo Munoz Schuffenegger 14, Jonathan G Sham 15, David Cavallucci 16, Zita Galvin 17, Laura A Dawson 18, Maria A Hawkins 19
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Author information
- 1Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Radiation Medicine Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada. Electronic address: aisling.barry@rmp.uhn.ca.
- 2Seattle Cancer Care Alliance, and Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
- 3Department of Medical Oncology and Haematology, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- 4Princess Margaret Cancer Centre, and Department of Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- 5Department of Medical Imaging, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- 6Department of Interventional Radiology, Northwestern University, Chicago, IL, USA.
- 7Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
- 8Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
- 9UCL Cancer Institute, University College London, London, UK.
- 10Department of Surgical Biotechnology, UCL Division of Surgery and Interventional Science, University College London, London, UK.
- 11Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- 12Radiology Department, Humanitas Clinical and Research Center, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
- 13Department of Medical Oncology, University of Washington, Seattle, WA, USA.
- 14Radiation Oncology Unit, Department of Hematology Oncology, Pontifical Catholic University of Chile, Santiago, Chile.
- 15Department of Surgery, University of Washington, Seattle, WA, USA.
- 16Department of Surgery, Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, QLD, Australia.
- 17Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- 18Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Radiation Medicine Program, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
- 19UCL Cancer Institute, University College London, London, UK; Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
Free PMC article
Abstract
Around the world, recommendations for cancer treatment are being adapted in real time in response to the pandemic of COVID-19. We, as a multidisciplinary team, reviewed the standard management options, according to the Barcelona Clinic Liver Cancer classification system, for hepatocellular carcinoma. We propose treatment recommendations related to COVID-19 for the different stages of hepatocellular carcinoma (ie, 0, A, B, and C), specifically in relation to surgery, locoregional therapies, and systemic therapy. We suggest potential strategies to modify risk during the pandemic and aid multidisciplinary treatment decision making. We also review the multidisciplinary management of intrahepatic cholangiocarcinoma as a potentially curable and incurable diagnosis in the setting of COVID-19.
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