Table 2.

Recommendations for treatment of hepatocellular carcinoma during COVID-19 pandemic

Interventions	Recommendations
General principles	Whether to perform, postpone or suspend treatment should be decided for each individual case not only from medical but also from logistical viewpoint It is recommended not to delay a curative treatment such as surgery and ablation Cytoreductive or non-curative treatment such as vascular interventions and systemic therapy may be postponed For patients with confirmed or suspected to be infected with the novel coronavirus, treatments should be postponed until the virus is eliminated or they are confirmed as not being infected with it
Liver resection	Generally, liver resection with curative intent should not be delayed However, in cases of high risk of decompensation or comorbidities, surgical intervention should be postponed or alternative therapy such as ablation should be adapted There has been some concern on the safety of surgery as surgery cannot be performed without aerosol generating procedures
Liver transplantation	Liver transplantation for patients with poor short-term prognosis should not be delayed Elective living donor transplantation may be suspended In patients with complete response to bridging therapy on transplant list, transplantation may be suspended
Ablation	Ablation with curative intent should not be delayed Ablation is an acceptable alternative to resection for cases of three or fewer tumors, each 3 cm or smaller, and of Child–Pugh class A or B liver dysfunction
Vascular interventions	Vascular interventions may be postponed because they are used as cytoreductive treatments in most cases Vascular interventions should be suspended in cases of risk of decompensation or comorbidities that increase the risk of severe COVID-19
Radiation therapy	Radiation therapy for cases of symptoms control or at low risk of progression may be postponed However, radiation therapy for function- or life-threatening situation have to be treated without delay The course of radiation should be shortened when appropriate
Systemic therapy	Oral tyrosine kinase inhibitors would be better than infusional regimens during the pandemic The impact of immunotherapy on the course of COVID-19 is not known