McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

Abstract

Objective: The COVID-19 pandemic had an undoubted impact on the provision of elective and emergency cancer care, including the diagnosis and management of patients with hepatocellular carcinoma (HCC). Our aim was to determine the effects of the COVID-19 pandemic on patients with HCC in the West of Scotland.

Design: This was a retrospective audit of a prospectively collated database of patients presented to the West of Scotland Multidisciplinary Team (MDT) between April and October 2020 (during the pandemic), comparing baseline demographics, characteristics of disease at presentation, diagnostic workup, treatment and outcomes with patients from April to October 2019 (pre pandemic).

Results: There was a 36.5% reduction in new cases referred to the MDT during the pandemic. Patients presented at a significantly later Barcelona Cancer Liver Clinic stage (24% stage D during the pandemic, 9.5% pre pandemic, p<0.001) and with a significantly higher Child-Pugh Score (46% Child-Pugh B/C during the pandemic vs 27% pre pandemic, p<0.001). We observed a reduction in overall survival (OS) among all patients with a median OS during the pandemic of 6 months versus 17 months pre pandemic (p=0.048).

Conclusion: The impact of the COVID-19 pandemic is likely to have contributed to a reduction in the presentation of new cases and survival among patients with HCC in the West of Scotland. The reason for this is likely multifactorial, but disruption of standard care is likely to have played a significant role. Resources should be provided to address the backlog and ensure there are robust investigation and management pathways going forward.

People
McLaren, Alistair Stewart
Author

Fetit, Rana and McLaren, Alistair S. and White, Mark and Mills, Megan L. and Falconer, John and Cortes-Lavaud, Xabier and Gilroy, Kathryn and Lannagan, Tamsin R.M. and Ridgway, Rachel A. and Nixon, Colin and Naiker, Varushka and Njunge, Renee and Clarke, Cassie and Whyte, Declan and Kirschner, Kristina and Jackstadt, Rene and Norman, Jim and Carlin, Leo M. and Campbell, Andrew D. and Sansom, Owen J. and Steele, Colin W. (2024) Characterising neutrophil subtypes in cancer using scRNA sequencing demonstrates the importance of IL-1β/CXCR2 axis in generation of metastasis specific neutrophils. Cancer Research Communications, 4 (2). pp. 588-606. ISSN 2767-9764

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Spoor, Johannes A.
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Cartwright, Douglas
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Naylor, Gregory
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Barclay, Stephen
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Priest, Matthew
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Puttagunta, Srikanth
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Armstrong, Kirsty
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Ballantyne, Stuart
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Stanley, Adrian
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Evans, Thomas R. Jeffry
Author

Pereira, Brooke A. and Ritchie, Shona and Chambers, Cecilia R. and Gordon, Katie A. and Magenau, Astrid and Murphy, Kendelle J. and Nobis, Max and Tyma, Victoria M. and Liew, Ying Fei and Lucas, Morghan C. and Naeini, Marjan M. and Barkauskas, Deborah S. and Chacon-Fajardo, Diego and Howell, Anna E. and Parker, Amelia L. and Warren, Sean C. and Reed, Daniel A. and Lee, Victoria and Metcalf, Xanthe L. and Lee, Young Kyung and O'Regan, Luke P. and Zhu, Jessie and Trpceski, Michael and Fontaine, Angela R.M. and Stoehr, Janett and Rouet, Romain and Lin, Xufeng and Chitty, Jessica L. and Porazinski, Sean and Wu, Sunny Z. and Filipe, Elysse C. and Cadell, Antonia L. and Holliday, Holly and Yang, Jessica and Papanicolaou, Michael and Lyons, Ruth J. and Zaratzian, Anaiis and Tayao, Michael and Da Silva, Andrew and Vennin, Claire and Yin, Julia and Dew, Alysha B. and McMillan, Paul J. and Goldstein, Leonard D. and Deveson, Ira W. and Croucher, David R. and Samuel, Michael S. and Sim, Hao-Wen and Batten, Marcel and Chantrill, Lorraine and Grimmond, Sean M. and Gill, Anthony J. and Samra, Jaswinder and Evans, Thomas R. Jeffry and Sasaki, Takako and Phan, Tri G. and Swarbrick, Alexander and Sansom, Owen J. and Morton, Jennifer P. and Australian Pancreatic Cancer Matrix Atlas (APMA) and Australian Pancreatic Cancer Genome Initiative (APGI) and Pajic, Marina and Parker, Benjamin L. and Herrmann, David and Cox, Thomas R. and Timpson, Paul (2024) Temporally resolved proteomics identifies nidogen-2 as a cotarget in pancreatic cancer that modulates fibrosis and therapy response. Science Advances, 10 (27): eadl1197. ISSN 2375-2548

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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West of Scotland HCC MDT
Author

McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT (2023) Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study. BMJ Open Gastroenterology, 10 (1): e001231. ISSN 2054-4774

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Title:
Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the west of Scotland: a cohort study
Creators:
McLaren, Alistair Stewart and Spoor, Johannes A. and Cartwright, Douglas and Naylor, Gregory and Barclay, Stephen and Priest, Matthew and Puttagunta, Srikanth and Armstrong, Kirsty and Ballantyne, Stuart and Stanley, Adrian and Evans, Thomas R. Jeffry and West of Scotland HCC MDT
Identification Number:
10.1136/bmjgast-2023-001231
Date:
20 November 2023
Divisions:
College of Medical Veterinary and Life Sciences > School of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Publisher:
BMJ Publishing Group
Library
URI:
https://pub.demo35.eprints-hosting.org/id/eprint/459
Item Type:
Article
Depositing User:
Unnamed user with email ejo1f20@soton.ac.uk
Date Deposited:
11 Jun 2025 16:38
Revision:
32
Last Modified:
12 Jun 2025 09:20
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