Effects of COVID-19 Pandemic on the Outcomes of Colorectal Cancer

NCT ID: NCT04712292

Last Updated: 2022-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

15000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-09-08

Study Completion Date

2022-04-01

Brief Summary

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been identified as the cause of the Coronavirus disease 19 (COVID-19), which was initially reported in December 2019 in China and has since rapidly spread worldwide.

Since then, the COVID-19 pandemic has caused a detrimental effect of the national health care system, causing a drastic reduction of the screening programs for colorectal cancer and requiring the redistribution of the hospital resources from elective surgery to the care of patients with SARS-Cov\_2 infection requiring admission.

Detailed Description

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been identified as the cause of the Coronavirus disease 19 (COVID-19), which was initially reported in December 2019 in China and has since rapidly spread worldwide. Italy witnessed a rapid and uncontrolled spread of the infection after March 2020, and a worrisome increasing number of related deaths.

The need for increased capacity for COVID-19 patients required elective activities to be drastically reduced or canceled. The unprecedented stress on the healthcare system has caused the reduction of the elective surgery and the cancer screening programs during the last 2 years. Studies predicting harmful impact of the COVID-19 pandemic on cancer care have been already published. However, it has not been proved whether the potential delay of screening, diagnosis and treatment could have a measurable effect on patients undergoing surgery for colorectal cancer in the COVID-19 era.

The aim of the study is therefore to compare the 30-day perioperative and oncologic outcomes between patients undergoing surgery for cancer of the colon and rectum between January 2020 and December 2021 (study group) and those who had surgery for colorectal cancer between January 2018 and December 2019 (Control Group), in order to identify:

* any change in the distribution of the histological stage (primary aim)
* any change in the rate of palliative surgery (primary aim)
* any change in the rate of non-radical surgery (R1 or R2 resection) ( primary aim)
* any change in the rate of 30-day postoperative complications (secondary outcome)

Anonimyzed data will be retrospectively collected on a RedCap platform hosted on the servers of the Alma Mater Studiorum University of Bologna. The variables included demographic characteristics, comorbidities, details of the disease at the diagnosis, details of the neoadjuvant therapy, perioperative variables and 30-day postoperative follow-up variables.

Conditions

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Colorectal Neoplasms Malignant

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Study group

Patients undergoing surgery for confirmed or suspected colorectal cancer between January 2020 and December 2021

Surgical procedure for confirmed or suspected colorectal cancer

Intervention Type PROCEDURE

Surgical procedure for cancer may include:

* any radical surgery (right or left hemicolectomy, rectal resection, abdomino-perineal resection, total colectomy, proctocolectomy, and others depending on the tumor site and other tumor characteristics),
* surgery for radicalization of cancer polyps previously removed endoscopically
* surgery for excision of large polyps which are not removable endoscopically
* staging surgery (laparoscopy or laparotomy), in case of advanced-non operable cancer
* palliative surgery (defined as any surgery with no curative intent)

Control group

Patients undergoing surgery for confirmed or suspected colorectal cancer between January 2018 and December 2019

Surgical procedure for confirmed or suspected colorectal cancer

Intervention Type PROCEDURE

Surgical procedure for cancer may include:

* any radical surgery (right or left hemicolectomy, rectal resection, abdomino-perineal resection, total colectomy, proctocolectomy, and others depending on the tumor site and other tumor characteristics),
* surgery for radicalization of cancer polyps previously removed endoscopically
* surgery for excision of large polyps which are not removable endoscopically
* staging surgery (laparoscopy or laparotomy), in case of advanced-non operable cancer
* palliative surgery (defined as any surgery with no curative intent)

Interventions

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Surgical procedure for confirmed or suspected colorectal cancer

Surgical procedure for cancer may include:

* any radical surgery (right or left hemicolectomy, rectal resection, abdomino-perineal resection, total colectomy, proctocolectomy, and others depending on the tumor site and other tumor characteristics),
* surgery for radicalization of cancer polyps previously removed endoscopically
* surgery for excision of large polyps which are not removable endoscopically
* staging surgery (laparoscopy or laparotomy), in case of advanced-non operable cancer
* palliative surgery (defined as any surgery with no curative intent)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Any patient undergoing radical surgery for histologically confirmed diagnosis of cancer located in the colon, the rectum or the anus; or
* any patient undergoing surgery with oncologic intents, for instance: radicalization of endoscopically removed cancerous polyp; radical surgery to remove large, at-risk polyp which are not removable by endoscopy; or
* any patient undergoing planned or unpredicted palliative surgery for a primary cancer localized in the colon, rectum or anus; or
* any patient undergoing a staging procedure (i.e. staging laparoscopy, surgical exploration), which did not result in any radical surgery due to advanced disease, metastasis, etc.

and

* age \> 18 years
* elective or urgent surgery

Exclusion Criteria

* Colorectal cancer recurring after previous surgery;
* Cancer originating from other organs than the colon, the rectum and the anus;
* Lack of significant histological details (expect when the cancer was not removed)
* lack of 30-day follow-up
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Bologna

OTHER

Sponsor Role lead

Responsible Party

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Matteo Rottoli

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Matteo Rottoli, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna

Locations

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Rho Memorial Hospital

Rho, Milan, Italy

Site Status RECRUITING

Humanitas Research Center

Rozzano, Milan, Italy

Site Status RECRUITING

AOU Policlinico di Bari "M. Rubino"

Bari, , Italy

Site Status RECRUITING

Policlinico di Bari

Bari, , Italy

Site Status RECRUITING

Humanitas Gavazzeni Hospital

Bergamo, , Italy

Site Status RECRUITING

Policlinico San Marco

Bergamo, , Italy

Site Status RECRUITING

Maggiore Hospital

Bologna, , Italy

Site Status RECRUITING

Fondazione Poliambulanza

Brescia, , Italy

Site Status RECRUITING

Spedali Civili

Brescia, , Italy

Site Status RECRUITING

Spedali Civili

Brescia, , Italy

Site Status RECRUITING

Santissima Trinità Hospital

Cagliari, , Italy

Site Status RECRUITING

Vittorio Emanuele III Hospital

Carate Brianza, , Italy

Site Status RECRUITING

San Paolo Hospital

Civitavecchia, , Italy

Site Status RECRUITING

AUSL Romagna Ravenna-Faenza

Faenza, , Italy

Site Status RECRUITING

San Giovanni di Dio Hospital

Florence, , Italy

Site Status RECRUITING

Gardone Val Trompia Hospital

Gardone Val Trompia, , Italy

Site Status RECRUITING

ASST FBF Sacco Hospital

Milan, , Italy

Site Status RECRUITING

San Raffaele Hospital

Milan, , Italy

Site Status RECRUITING

ASST Santi Paolo e Carlo Hospital

Milan, , Italy

Site Status RECRUITING

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Milano

Milan, , Italy

Site Status RECRUITING

Istituto Nazionale dei Tumori

Milan, , Italy

Site Status RECRUITING

Mirano Hospital

Mirano, , Italy

Site Status RECRUITING

AORN Cardarelli

Napoli, , Italy

Site Status RECRUITING

Università della Campania Luigi Vanvitelli

Napoli, , Italy

Site Status RECRUITING

Padova University Hospital

Padua, , Italy

Site Status RECRUITING

Veneto Institute of Oncology IOV-IRCCS

Padua, , Italy

Site Status RECRUITING

Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello

Palermo, , Italy

Site Status RECRUITING

AOU Parma

Parma, , Italy

Site Status RECRUITING

San Matteo Hospital

Pavia, , Italy

Site Status RECRUITING

Pederzoli Hospital

Peschiera del Garda, , Italy

Site Status RECRUITING

Azienda Sanitaria Fiuli Occidentale

Pordenone, , Italy

Site Status RECRUITING

Ceccarini Hospital

Riccione, , Italy

Site Status RECRUITING

Infermi Hospital

Rimini, , Italy

Site Status RECRUITING

Campus Biomedico

Roma, , Italy

Site Status RECRUITING

Fondazione Policlinico Roma Tor Vergata

Roma, , Italy

Site Status RECRUITING

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Roma, , Italy

Site Status RECRUITING

San Filippo Neri Hospital

Roma, , Italy

Site Status RECRUITING

Sant'Eugenio Hospital

Roma, , Italy

Site Status RECRUITING

UOSD Tor Vergata

Roma, , Italy

Site Status RECRUITING

AOU Sassari

Sassari, , Italy

Site Status RECRUITING

Regional Hospital Treviso

Treviso, , Italy

Site Status RECRUITING

University Hospital of Trieste

Trieste, , Italy

Site Status RECRUITING

AOU Città della Salute e della Scienza

Turin, , Italy

Site Status RECRUITING

Mauriziano Hospital

Turin, , Italy

Site Status RECRUITING

ASST Vimercate

Vimercate, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Matteo Rottoli, MD, PhD

Role: CONTACT

+390512145262

Facility Contacts

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Gianluca Sampietro, MD

Role: primary

Antonino Spinelli, MD

Role: primary

Gennaro Martines, MD

Role: primary

Leonardo Vincenti, MD

Role: primary

Giovanni Dapri, MD

Role: primary

Stefano Olmi, MD

Role: primary

Elio Jovine, MD

Role: primary

Moh'd Abu Hilal, MD

Role: primary

Nazario Portolani, MD

Role: primary

Giusto Pignata, MD

Role: primary

Nicola Cillara, MD

Role: primary

Letizia Laface, MD

Role: primary

Pasquale Lepiane, MD

Role: primary

Giampaolo Ugolini, MD

Role: primary

Giuseppe Canonico, MD

Role: primary

Maurizio Ronconi, MD

Role: primary

Piergiorgio Danelli, MD

Role: primary

Riccardo Rosati, MD

Role: primary

Enrico Opocher, MD

Role: primary

Luigi Boni, MD

Role: primary

Maurizio Cosimelli, MD

Role: primary

Corrado Da Lio, MD

Role: primary

Antonio Castaldi, MD

Role: primary

Gianluca Pellino, MD

Role: primary

Salvatore Pucciarelli, MD

Role: primary

Pierluigi Pilati, MD

Role: primary

Marco V Marino, MD

Role: primary

Mario Giuffrida, MD

Role: primary

Andrea Pietrabissa, MD

Role: primary

Harmony Impellizzeri, MD

Role: primary

Stefano MM Basso, MD

Role: primary

Andrea Lucchi, MD

Role: primary

Gianluca Garulli, MD

Role: primary

Gabriella T Capolupo, MD

Role: primary

Giuseppe Sica, MD

Role: primary

Carlo Ratto, MD

Role: primary

Biagio Picardi, MD

Role: primary

Massimo Carlini, MD

Role: primary

Michela Campanelli, MD

Role: primary

Alberto Porcu, MD

Role: primary

Ugo Grossi, MD

Role: primary

Nicolò De Manzini, MD

Role: primary

Mario Morino, MD

Role: primary

Alessandro Ferrero, MD

Role: primary

Alice Frontali, MD

Role: primary

References

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Greenwood E, Swanton C. Consequences of COVID-19 for cancer care - a CRUK perspective. Nat Rev Clin Oncol. 2021 Jan;18(1):3-4. doi: 10.1038/s41571-020-00446-0.

Reference Type RESULT
PMID: 33097915 (View on PubMed)

Jazieh AR, Akbulut H, Curigliano G, Rogado A, Alsharm AA, Razis ED, Mula-Hussain L, Errihani H, Khattak A, De Guzman RB, Mathias C, Alkaiyat MOF, Jradi H, Rolfo C; International Research Network on COVID-19 Impact on Cancer Care. Impact of the COVID-19 Pandemic on Cancer Care: A Global Collaborative Study. JCO Glob Oncol. 2020 Sep;6:1428-1438. doi: 10.1200/GO.20.00351.

Reference Type RESULT
PMID: 32986516 (View on PubMed)

Torzilli G, Vigano L, Galvanin J, Castoro C, Quagliuolo V, Spinelli A, Zerbi A, Donadon M, Montorsi M; COVID-SURGE-ITA group. A Snapshot of Elective Oncological Surgery in Italy During COVID-19 Emergency: Pearls, Pitfalls, and Perspectives. Ann Surg. 2020 Aug;272(2):e112-e117. doi: 10.1097/SLA.0000000000004081.

Reference Type RESULT
PMID: 32675512 (View on PubMed)

Mitchell EP. Declines in Cancer Screening During COVID-19 Pandemic. J Natl Med Assoc. 2020 Dec;112(6):563-564. doi: 10.1016/j.jnma.2020.12.004. No abstract available.

Reference Type RESULT
PMID: 33339569 (View on PubMed)

Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020 May 12;323(18):1775-1776. doi: 10.1001/jama.2020.4683. No abstract available.

Reference Type RESULT
PMID: 32203977 (View on PubMed)

Other Identifiers

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854/2020/Oss/AOUBo

Identifier Type: -

Identifier Source: org_study_id

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