How Should We Modify Management of Patients With HCC?
To avoid SARS‐CoV‐2 exposures, all associations recommend reducing patient visits and a delay in HCC ultrasound surveillance. It is uncertain whether HCC treatment should be deferred or started as usual in patients with COVID‐19 with newly diagnosed HCC, and whether tyrosine kinase inhibitors (TKIs) or checkpoint inhibitors should be stopped in patients with COVID‐19 who are already receiving such therapy. Delaying or withdrawing treatment increases the risk for HCC progression with detrimental outcomes, whereas surgical resection may increase risk for transmission to health care personnel, and checkpoint inhibitors might worsen COVID‐19 by exacerbating a cytokine storm. AASLD recommends HCC treatments should proceed. EASL recommends locoregional therapies should be postponed whenever possible and immune‐checkpoint inhibitor therapy be temporarily withdrawn. TKI in nonsevere COVID‐19 should be taken on a case‐by‐case basis. APASL recommends postponing elective transplant/resection surgery, whereas radiofrequency ablation, transcatheter arterial chemoembolization, TKI, or immunotherapy can be initiated with change of immunotherapy schedules to every 4 to 6 weeks.