Assessing the impact of COVID-19 on liver cancer management (CERO-19).

BCLC, Barcelona Clinic Liver Cancer CERO-19, Liver Cancer Outcome in the COVID-19-pandemic Project COVID-19 COVID-19, coronavirus disease 2019 Cholangiocarcinoma Clinical trials ENS-CCA, European Network for the Study of Cholangiocarcinoma HCC, hepatocellular carcinoma Hepatocellular carcinoma LC, liver cancer LT, liver transplantation Liver cancer Management Nurses SARS-CoV-2, severe acute respiratory syndrome coronavirus-2 iCCA, intrahepatic cholangiocarcinoma

Journal

JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 21 11 2020
revised: 08 02 2021
accepted: 09 02 2021
pubmed: 2 3 2021
medline: 2 3 2021
entrez: 1 3 2021
Statut: ppublish

Résumé

The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic.
METHODS METHODS
An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave.
RESULTS RESULTS
Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37).
CONCLUSIONS CONCLUSIONS
The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making.
LAY SUMMARY BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes.

Identifiants

pubmed: 33644725
doi: 10.1016/j.jhepr.2021.100260
pii: S2589-5559(21)00036-7
pmc: PMC7901294
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100260

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Cancer Research UK
ID : 26813
Pays : United Kingdom

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

SM.-M.: Speaker fees from Bayer and travel funding from 10.13039/100004326Bayer and 10.13039/501100014382Eisai. V.S.: Travel grants from 10.13039/100004326Bayer. A.F.: Lecture fees from Bayer, Gilead and MSD; consultancy fees from Bayer, AstraZeneca, Roche and Guerbert. J-C.N.: Received research grant from 10.13039/100004326Bayer for Inserm UMR1138. L.R.: Reports receiving consulting fees from Amgen, ArQule, AstraZeneca, Basilea, Bayer, Celgene, Eisai, Exelixis, Hengrui, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Sanofi; lectures fees from AbbVie, Amgen, Eisai, Gilead, Incyte, Ipsen, Lilly, Roche, Sanofi; travel fees from Ipsen; and institutional research funding from Agios, ARMO BioSciences, 10.13039/100004325AstraZeneca, BeiGene, 10.13039/501100003769Eisai, 10.13039/100010544Exelixis, 10.13039/100006591Fibrogen, Incyte, 10.13039/501100014382Ipsen, 10.13039/100004312Lilly, 10.13039/100007054MSD, 10.13039/100004337Roche. B.S.: Reports consultancy fees from Adaptimmune, AstraZeneca, Bayer, BMS, BTG, Eli Lilly, Ipsen, Novartis, Merck, Roche, Sirtex Medical, Terumo; and research grants from 10.13039/100002491BMS and Sirtex Medical. J. Bruix: Consultancy: AbbVie, ArQule, Astra, Basilea, Bayer, BMS, Daiichi Sankyo, GlaxoSmithKline, Gilead, Kowa, Lilly, Medimune, Novartis, Onxeo, Polaris, Quirem, Roche, Sanofi-Aventis, Sirtex, Terumo/Grants: 10.13039/100004326Bayer and 10.13039/501100014382Ipsen. M.S.Z.: Received speaker fees and travel grants from 10.13039/100004326Bayer and 10.13039/100014869BTG, 10.13039/100007054MSD. M.B.: Consultant and Advisory Board for: Bayer Pharma, Ipsen, BMS, Eisai, Roche, AstraZeneca, Sirtex Medical. D.J.P.: Received lecture fees from ViiV Healthcare and Bayer Healthcare and travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, and AstraZeneca; received research funding (to institution) from MSD and BMS. T.M.: Consultancy: Eisai, Roche, BTG, Ipsen, Bayer, Adaptimmune. Research funding: Bayer, BTG. H.W.: Served as speaker for Bayer, Eisai, and Ipsen, and as a consultant for Bayer, Eisai, Lilly, BMS, Roche, and Ipsen. B.M.: Consultancy: Bayer-Shering Pharma /Speaker fees: Eisai, MSDG. C. Consultancy fees from Bayer, Ipsen. P.R.G.: Bayer, BMS, MSD, AstraZeneca, Adaptimmune, Sirtex, Lilly Ipsen, Roche, Eisai. M.R.A.S.: Has received Research grants, advisory board or speaker fees for 10.13039/100006483AbbVie, 10.13039/100004326Bayer, Biolab, Intercept, 10.13039/501100014382Ipsen, 10.13039/100008799Gilead, 10.13039/100009947MSD, 10.13039/100004336Novartis, and 10.13039/100004337Roche. J.T.: Has received research grants from 10.13039/100004337Roche and 10.13039/501100014382Ipsen. He has received speaker and consulting honoraria from AstraZeneca, Amgen, Bayer Healthcare, Bristol Myers-Squibb, Eisai, Ipsen, Merck Serono, Merck Sharp & Dome, Lilly Imclone, and Roche. J. Bridgewater: Consultancy Bayer, BMS, Incyte, Taiho, Roche, MSD and Merck Serono. Research funding from Incyte. G.C.: Consultancy fees from Bayer, Ipsen. A.L.: Consultancy CAScination, Advisory Board Neuwave and Histosonics. H.T.: Speaker fees from AbbVie, Gilead, MSD, and Bayer. R.V.: Research grant from 10.13039/100006483Abbvie. A.M.M.P.: Speaker honorarium from Bayer, BMS, Boston Scientific and EISAI. Consulting honorarium from Bayer, AstraZeneca and EISAI. Advisory honorarium from Bayer, AstraZeneca and EISAI. Grants from 10.13039/100004326Bayer and 10.13039/100008497Boston Scientific. M.D.: Has received consulting and training fees from Bayer and Eisai. B.B.: Reports Consultancy for GenMab (paid to Institution); Advisory Boards for Roche (paid to Institution), Eisai Europe Limited (paid to Institution), research grant from 10.13039/100006436Celgene Ltd (paid to Institution), Speakers Bureau for Eisai Europe Limited (paid to Institution), Travel and registration for Congress from Bayer. L.d.F.: Lectures fees from BMS, Roche and Bayer. B.M.M.: Advisory/Speaker: Amgen, AstraZeneca, Bayer, BMS, Eisai, Ipsen, Merck, Roche, Sanoffi Genzyme, Taiho. Expert Testimony: Eisai, Roche. Travel: Eisai, Merck. Research: Sillajen (Individual); AstraZeneca, H3/Eisai, Galera, GSK, Exelixis (Institution). M.S.: Travel/ accommodation/meeting expenses: Bayer. Eisai. Speaker fees: Bayer. C.R.L.: Travel grants from 10.13039/100004326Bayer. M.R-G.: Reports grants from Intercept, grants from 10.13039/100005564Gilead-Sciences, personal fees from Shionogi, personal fees from Alfa-Wasserman, personal fees from Prosciento, personal fees from Kaleido, personal fees from Novonrdisk, personal fees from MSD, personal fees from BMS, personal fees from Allergan, personal fees from Boehriger-Ingelheim, personal fees from Zydus, personal fees from Intercept Pharma, personal fees from Gilead-Sciences, outside the submitted work. F.P.: Disclosures: Received speaker honoraria from Bayer, Roche, LKM-Biotoscana, RAFFO. Research Grants from INC Argentinean 10.13039/100013137National Institute of Corrections, 10.13039/100004337Roche. V.M.: Lectures sponsored by Bayer. G.B.: Advisory board Eli-Lilly and Incyte. M. Vergara: Travel grants from 10.13039/100004326Bayer, 10.13039/100008799Gilead, 10.13039/100009947MSD and 10.13039/100006483Abbvie. Lectures sponsored by Gilead, Abbvie, Intercept, and MSD. M.L.: Lectures and educational presentations: Abbvie. Travel/accommodation, meeting expenses covered by Bayer, Gilead, Abbvie. M.I.: Received speaker honoraria from Bayer, Gilead Sciences, BMS, Janssen, Ipsen, MSD, BTG-Boston Scientific, AbbVie, EISAI, and was consultant for BTG-Boston Scientific, Bayer, and Guerbet. M.R.: Consultancy: Bayer-Schering Pharma, BMS, Roche, Ipsen, AstraZeneca, Lilly, BTG/Paid conferences: Bayer-Schering Pharma, BMS, Gilead, Lilly/Research Grants: 10.13039/100004326Bayer-Schering Pharma, 10.13039/501100014382Ipsen. Please refer to the accompanying ICMJE disclosure forms for further details.

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Auteurs

Sergio Muñoz-Martínez (S)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Victor Sapena (V)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Alejandro Forner (A)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Jean-Charles Nault (JC)

Service d'hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France.
Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris Nord, Paris, France.
Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France.

Gonzalo Sapisochin (G)

Abdominal Transplant & HPB Surgical Oncology, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Canada.

Lorenza Rimassa (L)

Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Bruno Sangro (B)

Unidad de Hepatología, Clínica Universidad de Navarra, IDISNA, CIBERehd, Pamplona, Spain.

Jordi Bruix (J)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Marco Sanduzzi-Zamparelli (M)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Wacław Hołówko (W)

Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.

Mohamed El Kassas (M)

Endemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Tudor Mocan (T)

3rd Medical Department, 'Octavian Fodor' Institute for Gastroenterology and Hepatology, Cluj-Napoca, Romania.

Mohamed Bouattour (M)

AP-HP, Hôpital Beaujon, Department of Digestive Oncology, Clichy, France.

Philippe Merle (P)

Department of Hepatology, Groupement Hospitalier Lyon Nord, Lyon, France.

Frederik J H Hoogwater (FJH)

Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Medical Center Groningen, Groningen, the Netherlands.

Saleh A Alqahtani (SA)

Department of Liver Transplant, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

Helen L Reeves (HL)

Liver Unit, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

David J Pinato (DJ)

Department of Surgery and Cancer, Imperial College London, London, UK.

Emmanouil Giorgakis (E)

Division of Transplantation, Department of Surgery, UAMS Medical Center, Winthrop P. Rockefeller Cancer Institute, Little Rock, AK, USA.

Tim Meyer (T)

Department of Oncology, Royal Free Hospital, London, UK.

Gerda Elisabeth Villadsen (GE)

Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

Henning Wege (H)

Department of Internal Medicine, Gastroenterology and Hepatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Massimiliano Salati (M)

Department of Clinical and Experimental Medicine, University Hospital of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy.

Beatriz Mínguez (B)

Liver Unit, Hospital Universitari Vall d'Hebron, Liver Diseases Research Group, Vall d'Hebron Institut of Research (VHIR), Vall d'Hebron Barcelona Hospital Campus. Universitat Autònoma de Barcelona, Barcelona, Spain.

Giovan Giuseppe Di Costanzo (GG)

Liver Unit, A Cardarelli Hospital, Naples, Italy.

Christoph Roderburg (C)

Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany.

Frank Tacke (F)

Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany.

María Varela (M)

Department of Gastroenterology and Hepatology. Hospital Universitario Central de Asturias, IUOPA, ISPA, Universidad de Oviedo, Oviedo, Spain.

Peter R Galle (PR)

I. Department of Internal Medicine, University Medical Center Mainz, Mainz, Germany.

Mario Reis Alvares-da-Silva (MR)

GI/Liver Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

Jörg Trojan (J)

Medical Clinic 1, Goethe University Hospital, Frankfurt, Germany.

John Bridgewater (J)

Department of Oncology, University College of London, London, UK.

Giuseppe Cabibbo (G)

Section of Gastroenterology and Hepatology, PROMISE, University of Palermo, Palermo, Italy.

Christian Toso (C)

Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.

Anja Lachenmayer (A)

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.

Andrea Casadei-Gardini (A)

Department of Medical Oncology, University of Modena and Reggio Emilia, Modena, Italy.

Hidenori Toyoda (H)

Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.

Tom Lüdde (T)

Clinic for Gastroenterology, Hepatology and Infectious Disease, University Hospital Düsseldorf, Düsseldorf, Germany.

Rosanna Villani (R)

Liver Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy.

Ana María Matilla Peña (AM)

Gastroenterology and Hepatology, H.G.U. Gregorio Marañon, CIBERehd, Madrid, Spain.

Cassia Regina Guedes Leal (CR)

Gastroenterology, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil.

Monica Ronzoni (M)

Medical Oncology Unit, IRCCS Ospedale San Raffaele, Milan, Italy.

Manuel Delgado (M)

Department of Digestive Disease, University Hospital La Coruña, La Coruña, Spain.

Christie Perelló (C)

Department of Gastroenterology and Hepatology, University Hospital Puerta de Hierro, Majadahonda, Spain.

Sonia Pascual (S)

Liver Unit, HGU Alicante, CIBERehd, Alicante, Spain.

José Luis Lledó (JL)

Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain.

Josepmaria Argemi (J)

Internal Medicine - Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain.

Bristi Basu (B)

Department of Oncology, University of Cambridge, Cambridge, UK.
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Leonardo da Fonseca (L)

Department of Clinical Oncology, Sao Paulo Clinicas Liver Cancer group, Insitituto do Cancer do Estado de São Paulo, University of São Paulo, San Paulo, Brazil.

Juan Acevedo (J)

South West Liver Unit, University Hospitals Plymouth NHS Trust, Plymouth, UK.

Alexander R Siebenhüner (AR)

Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Chiara Braconi (C)

Department of Medical Oncology, Beatson West of Scotland Cancer Centre, University of Glasgow, Glasgow, UK.

Brandon M Meyers (BM)

Department of Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.

Alessandro Granito (A)

Division of Internal Medicine, Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

Margarita Sala (M)

Department of Gastroenterology, Hepatology Unit, Hospital Doctor Josep Trueta, CIBERehd, Girona, Spain.

Carlos Rodríguez-Lope (C)

Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.

Lorraine Blaise (L)

Service d'hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France.
Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris Nord, Paris, France.
Centre de Recherche des Cordeliers, Inserm, Sorbonne Université, Université Paris, INSERM UMR 1138 Functional Genomics of Solid Tumors Laboratory, Paris, France.

Manuel Romero-Gómez (M)

SeLiver group, UGC de Enfermedades Digestivas, Instituto de Biomedicina de Sevilla, Hospital Virgen del Rocío, CIBERehd, Seville, Spain.

Federico Piñero (F)

Liver Unit, Hospital Universitario Austral, Pilar, Argentina.

Dhanny Gomez (D)

HPB Surgery and Hepatology, Nottingham University Hospitals NHS Trust, Nottingham, UK.

Vivianne Mello (V)

Department of Oncology, AMO Clinic, Salvador, Brazil.

Rogerio Camargo Pinheiro Alves (RC)

Department of Gastroenterology, Hospital do Servidor Publico Estadual de São Paulo, San Paulo, Brazil.

Alex França (A)

Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.

Fernanda Branco (F)

Department of Hepatology, CliniOnco, Porto Alegre, Brazil.

Giovanni Brandi (G)

Division of Oncology - Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi Hospital, Bologna, Italy.

Gustavo Pereira (G)

Gastroenterology and Hepatology Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.

Susanna Coll (S)

Hepatology Section, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.

Maria Guarino (M)

Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.

Carlos Benítez (C)

Department of Gastroenterology, Pontificia Universidad Católica de Chile, Santiago, Chile.

Maria Margarita Anders (MM)

Sección Hepatología, Hospital Aleman, Buenos Aires, Argentina.

Juan C Bandi (JC)

Department of Hepatology, Hospital Italiano, Buenos Aires, Argentina.

Mercedes Vergara (M)

Unitat d'Hepatologia, Servei d'Aparell Digestiu, Parc Taulí Sabadell Hospital Universitari, Institut d'Investigació i Innovació I3PT, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.
CIBERehd, Instituto Carlos III, Madrid, Spain.

Mariona Calvo (M)

Oncología Médica, Institut Català d'Oncologia, L'Hospitalet del Llobregat, Barcelona, Spain.

Markus Peck-Radosavljevic (M)

Innere Medizin & Gastroenterologie, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria.

Ignacio García-Juárez (I)

Gastroenterology Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.

Vincenzo Cardinale (V)

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy.

Mar Lozano (M)

Aparato Digestivo, Hospital Universitario Infanta Leonor, Madrid, Spain.

Martina Gambato (M)

Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy.
Multivisceral Transplant Unit, Gastroenterology, Padua University Hospital, Padua, Italy.

Stefano Okolicsanyi (S)

Department of Surgical Disciplines, Gastroenterology and Digestive Endoscopy, Umberto Parini Hospital, Aosta, Italy.

Dalia Morales-Arraez (D)

Department of Gastroenterology and Hepatology, Hospital Universitario de Canarias, La Laguna, Spain.

Alessandra Elvevi (A)

Division of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital University of Milano-Bicocca School of Medicine, Monza, Italy.

Alberto E Muñoz (AE)

Sección Hepatología, Hospital Dr. Carlos Bonorino Udaondo, Buenos Aires, Argentina.

Alberto Lué (A)

Gastroenterology, Hepatology and Nutrition Unit, San Jorge General Hospital, Huesca, Spain.

Massimo Iavarone (M)

Foundation IRCCS Ca' Granada Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC 'A.M. and A. Migliavacca' Center for Liver Disease, Milan, Italy.

Maria Reig (M)

BCLC group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain.

Classifications MeSH