Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic
On April 27, 2020, COVID-19 pandemic affected more than 2,5 million of people in more than 200 countries and caused 185 000 deaths. Healthcare systems have come under enormous stress. In COVID-19 pandemic oncological patients face two serious challenges: the risk of severe infectious disease course...
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Remedium Group LLC
2020-07-01
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doaj-a82960d6a9944b19951d1a0f822cd75c2021-07-28T13:29:46ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902020-07-010922623110.21518/2079-701X-2020-9-226-2315219Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemicV. V. Petkau0V. V. Breder1E. N. Bessonova2K. K. Laktionov3I. S. Stilidi4Urals State Medical UniversityN.N. Blokhin National Medical Research Center of OncologyUrals State Medical University; Sverdlovsk Regional Clinical Hospital No. 1N.N. Blokhin National Medical Research Center of Oncology; Pirogov Russian National Research Medical UniversityN.N. Blokhin National Medical Research Center of Oncology; Pirogov Russian National Research Medical UniversityOn April 27, 2020, COVID-19 pandemic affected more than 2,5 million of people in more than 200 countries and caused 185 000 deaths. Healthcare systems have come under enormous stress. In COVID-19 pandemic oncological patients face two serious challenges: the risk of severe infectious disease course and the risk of malignant tumor progression. Forced correction of existing oncological standards of care is based on expert and professional community opinions, and daily gaining experience. The issue resumes the data on COVID-19 influence on liver function among the patients with chronic liver diseases and hepatocellular carcinoma. The guidance on HCC management in COVID-19 pandemic are provided. More than 1,5 million of people suffers from the liver pathology caused by chronic virus hepatitis, alcohol consumption, nonalcoholic fatty liver disease. Mild COVID-19 is often followed by transient liver function disorder which do not need specific treatment. Severe COVID-19 lids to the increase of aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), to the decrease of serum albumin in most cases. Regarding the HCC treatment preference should be given to telemedicine, limitation of contacts in health-care facilities, outpatient treatment, including oral medication (tyrosine kinase inhibitors), and if possible delay of invasive procedures with the help of bridge-therapy and active monitoring. Selecting the patients for surgery, ablation or transarterial chemoembolization (TACE) patients with minimal risk of decompensation, with maximum treatment benefit (on the base of prognostic scales), with lack of comorbid should be preferred. Selective and super selective TACE with drug-eluting beads or radioembolization should be used to reduce the risk of immunosuppression and postembolic syndrome. Live organ transplantation should be considered to be postponed. Targeted therapy could be a temporarily alternative to invasive procedures.https://www.med-sovet.pro/jour/article/view/5739hepatocellular carcinoma (hcc)liver cancercovid-19coronavirustargeted therapytransarterial chemoembolization (tace) |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
V. V. Petkau V. V. Breder E. N. Bessonova K. K. Laktionov I. S. Stilidi |
spellingShingle |
V. V. Petkau V. V. Breder E. N. Bessonova K. K. Laktionov I. S. Stilidi Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic Медицинский совет hepatocellular carcinoma (hcc) liver cancer covid-19 coronavirus targeted therapy transarterial chemoembolization (tace) |
author_facet |
V. V. Petkau V. V. Breder E. N. Bessonova K. K. Laktionov I. S. Stilidi |
author_sort |
V. V. Petkau |
title |
Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic |
title_short |
Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic |
title_full |
Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic |
title_fullStr |
Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic |
title_full_unstemmed |
Oncological care for the patients with hepatocellular carcinoma in COVID-19 pandemic |
title_sort |
oncological care for the patients with hepatocellular carcinoma in covid-19 pandemic |
publisher |
Remedium Group LLC |
series |
Медицинский совет |
issn |
2079-701X 2658-5790 |
publishDate |
2020-07-01 |
description |
On April 27, 2020, COVID-19 pandemic affected more than 2,5 million of people in more than 200 countries and caused 185 000 deaths. Healthcare systems have come under enormous stress. In COVID-19 pandemic oncological patients face two serious challenges: the risk of severe infectious disease course and the risk of malignant tumor progression. Forced correction of existing oncological standards of care is based on expert and professional community opinions, and daily gaining experience. The issue resumes the data on COVID-19 influence on liver function among the patients with chronic liver diseases and hepatocellular carcinoma. The guidance on HCC management in COVID-19 pandemic are provided. More than 1,5 million of people suffers from the liver pathology caused by chronic virus hepatitis, alcohol consumption, nonalcoholic fatty liver disease. Mild COVID-19 is often followed by transient liver function disorder which do not need specific treatment. Severe COVID-19 lids to the increase of aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT), to the decrease of serum albumin in most cases. Regarding the HCC treatment preference should be given to telemedicine, limitation of contacts in health-care facilities, outpatient treatment, including oral medication (tyrosine kinase inhibitors), and if possible delay of invasive procedures with the help of bridge-therapy and active monitoring. Selecting the patients for surgery, ablation or transarterial chemoembolization (TACE) patients with minimal risk of decompensation, with maximum treatment benefit (on the base of prognostic scales), with lack of comorbid should be preferred. Selective and super selective TACE with drug-eluting beads or radioembolization should be used to reduce the risk of immunosuppression and postembolic syndrome. Live organ transplantation should be considered to be postponed. Targeted therapy could be a temporarily alternative to invasive procedures. |
topic |
hepatocellular carcinoma (hcc) liver cancer covid-19 coronavirus targeted therapy transarterial chemoembolization (tace) |
url |
https://www.med-sovet.pro/jour/article/view/5739 |
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