COVID-19疫情期间对癌症医疗护理的访问和传递造成了压力，但是我们很少了解它如何影响肝细胞癌（HCC）的管理。本研究旨在评估COVID-19疫情对HCC治疗开始时间（TTI）的年度影响。通过查询全国癌症数据库，检索2017-2020年诊断为临床I-IV期HCC的患者。将患者根据诊断年份分类为“COVID前”（2017-2019）和“COVID”（2020）。根据阶段和首次接受的治疗类型比较治疗开始时间（TTI），采用Mann-Whitney U检验。采用Logistic回归模型评估增加TTI和治疗延误（>90天）的因素。总共有18,673例患者在COVID前期被诊断出来，而5249例患者在COVID期间被诊断出来。任何一种一线治疗方式的中位数TTI在COVID年份略短于COVID之前（49 vs. 51天；p<0.0001），尤其是在消融（52 vs. 55天；p=0.0238）、全身治疗（42 vs. 47天；p<0.0001）和放疗（60 vs. 62天；p=0.0177），但手术并没有显著差异（41 vs. 41天；p=0.6887）。在多元分析中，黑人、西班牙裔和无保险/医疗补助政府保险状态的患者TTI增加的因素分别为1.057（95％CI：1.022-1.093；p=0.0013）、1.045（95％CI：1.010-1.081；p=0.0104）和1.088（95％CI：1.053-1.123；p<0.0001）。同样，这些患者人群与延迟治疗时间有关。COVID期间诊断的患者，TTI对于HCC而言，在统计学上有意义，但在临床上没有显着差异。然而，弱势患者更有可能出现TTI增加的情况。©2023年。外科肿瘤学会。

The COVID-19 pandemic strained oncologic care access and delivery, yet little is known about how it impacted hepatocellular carcinoma (HCC) management. Our study sought to evaluate the annual effect of the COVID-19 pandemic on time to treatment initiation (TTI) for HCC.The National Cancer Database was queried for patients diagnosed with clinical stages I-IV HCC (2017-2020). Patients were categorized based on their year of diagnosis as "Pre-COVID" (2017-2019) and "COVID" (2020). TTI based on stage and type of treatment first received was compared by the Mann-Whitney U test. A logistic regression model was used to evaluate factors of increased TTI and treatment delay (> 90 days).In total, 18,673 patients were diagnosed during Pre-COVID, whereas 5249 were diagnosed during COVID. Median TTI for any first-line treatment modality was slightly shorter during the COVID year compared with Pre-COVID (49 vs. 51 days; p < 0.0001), notably in time to ablation (52 vs. 55 days; p = 0.0238), systemic therapy (42 vs. 47 days; p < 0.0001), and radiation (60 vs. 62 days; p = 0.0177), but not surgery (41 vs. 41 days; p = 0.6887). In a multivariate analysis, patients of Black race, Hispanic ethnicity, and uninsured/Medicaid/Other Government insurance status were associated with increased TTI by factors of 1.057 (95% CI: 1.022-1.093; p = 0.0013), 1.045 (95% CI: 1.010-1.081; p = 0.0104), and 1.088 (95% CI: 1.053-1.123; p < 0.0001), respectively. Similarly, these patient populations were associated with delayed treatment times.For patients diagnosed during COVID, TTI for HCC, while statistically significant, had no clinically significant differences. However, vulnerable patients were more likely to have increased TTI.© 2023. Society of Surgical Oncology.