Outcome of liver cancer patients with SARS‐CoV‐2 infection

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: Multicenter retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February-December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered. Results: Two-hundred-fifty patients from 38 centers were included, 218 with hepatocellular carcinoma (HCC), 32 with intrahepatic cholangiocarcinoma (iCCA). 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=0.0017]. The Hazard Ratio was 1.45 (95%CI 0.49–4.31; p=0.5032) in BCLC-B vs 0/A, and 3.13 (95%CI 1.29–7.62; p=0.0118) in BCLC-C vs 0/A in the Competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, 12 deaths 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