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Your search keyword '"HAWKINS, ALEXANDER T."' showing total 10 results
Start Over Author "HAWKINS, ALEXANDER T." Topic colorectal neoplasms
10 results on '"HAWKINS, ALEXANDER T."'

1. The SAGES MASTERS program presents: the top 10 seminal articles for laparoscopic left and sigmoid colectomy pathway for uncomplicated disease.

Author

Chadi SA, Boutros M, Colibaseanu DT, da Silva G, Francone TD, Garrett KA, Harzman AE, Hawkins AT, Kaiser AM, Lee-Kong S, Olson C, and Sylla P

Subjects
Humans, Colon, Sigmoid, Colectomy methods, Laparoscopy, Surgeons, Colorectal Neoplasms
Abstract

Background: As one of the 8 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program clinical pathways, the Colorectal Pathway aims to deliver educational content for the general surgeon organized along 3 levels of performance (competency, proficiency and mastery) each represented by an anchoring procedure. In this article, the SAGES Colorectal Task Force presents focused summaries of the top 10 seminal articles selected for laparoscopic left/sigmoid colectomy for uncomplicated disease., Methods: Using a systematic literature search of Web of Science, the most cited articles on laparoscopic left and sigmoid colectomy were identified, reviewed, and ranked by members of the SAGES Colorectal Task Force. Additional articles not identified in the literature search were included if deemed impactful by expert consensus. The top 10 ranked articles were then summarized, including their findings, strengths and limitations with emphasis on relevance and impact in the field., Results: The top 10 articles selected focus on variations in minimally invasive surgical techniques, video demonstrations, stratified approaches for benign and malignant disease as well as assessments of the learning curve., Conclusions: The selected top 10 seminal articles for laparoscopic left and sigmoid colectomy in uncomplicated disease are considered by the SAGES colorectal task force to be fundamental to the knowledge base of minimally invasive surgeons as they progress to mastery in these procedures., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2023
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2. Collection and Utilization of Patient-Reported Outcome Measures in a Colorectal Surgery Clinic.

Author

Harrison NJ, Lopez AA, Shroder MM, Bachmann JM, Burnell E, Hopkins MB, Geiger TM, and Hawkins AT

Subjects
Humans, Patient Reported Outcome Measures, Quality Improvement, Colorectal Surgery, Colorectal Neoplasms
Abstract

Introduction: The routine collection of patient-reported outcome measures (PROMs) promises to improve patient care. However, in colorectal surgery, PROMs are uncommonly collected outside of clinical research studies and rarely used in clinical care. We designed and implemented a quality improvement project with the goals of routinely collecting PROMs and increasing the frequency that PROMs are utilized by colorectal surgeons in clinical practice., Methods: This mixed-methods, quality improvement project was conducted in the colorectal surgery clinic of a tertiary academic medical center. Patients were administered up to five PROMs before each appointment. PROM completion rates were measured. Additionally, we performed two educational interventions to increase utilization of our electronic health record's PROM dashboard by colorectal surgeons. Utilization rates and attitudes toward the PROM dashboard were measured., Results: Overall, patients completed 3600 of 3977 (90.9%) administered PROMs during the study period. At baseline, colorectal surgeons reviewed 6.7% of completed PROMs. After two educational interventions, this increased to 39.3% (P = 0.004). Colorectal surgeons also felt that the PROM dashboard was easier to use. Barriers to greater PROM dashboard utilization included poor user interface/user experience and a perceived lack of knowledge, time, and relevance., Conclusions: The collection of PROMs in colorectal surgery clinics is feasible and can result in high PROM completion rates. Educational interventions can improve the utilization of PROMs by colorectal surgeons in clinical practice. Our experience collecting PROMs through this quality improvement initiative can serve as a template for other colorectal surgery clinics interested in collecting and utilizing data from PROMs., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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5. Surgical resection and survival outcomes in metastatic young adult colorectal cancer patients.

Author

Arhin ND, Shen C, Bailey CE, Matsuoka LK, Hawkins AT, Holowatyj AN, Ciombor KK, Hopkins MB, Geiger TM, Kam AE, Roth MT, Lebeck Lee CM, Lapelusa M, Dasari A, and Eng C

Subjects
Adult, Colorectal Neoplasms epidemiology, Colorectal Neoplasms pathology, Female, Humans, Incidence, Kaplan-Meier Estimate, Male, Metastasectomy statistics & numerical data, Palliative Care, Proportional Hazards Models, SEER Program, Time Factors, Young Adult, Colorectal Neoplasms mortality, Colorectal Neoplasms surgery, Metastasectomy mortality
Abstract

Background: The incidence of colorectal cancer in adults younger than age 50 has increased with rates expected to continue to increase over the next decade. The objective of this study is to examine the survival benefit of surgical resection (primary and/or metastatic) versus palliative therapy in this patient population., Methods: We identified 6708 young adults aged 18-45 years diagnosed with metastatic colorectal cancer (mCRC) from 2004 to 2015 from the SEER database. Overall survival (OS) was analyzed using Kaplan-Meier estimation, log rank test, and multivariate Cox proportional hazards model., Results: Sixty-three percent of patients in our study underwent primary tumor resection (PTR), with 40% undergoing PTR alone and 23% undergoing both resection of primary disease and metastasectomy. The median OS for patients who underwent both PTR and metastasectomy was 36 months, compared to 13 months for those who did not receive any surgical intervention. The multivariate analysis showed significant OS benefit of receiving both PTR and metastasectomy (HR 0.34, 95% CI: 0.31-0.37, p < 0.001) compared to palliative therapy. Undergoing PTR only and metastasectomy only were also associated with improved OS (HR 0.46, 95% CI: 0.43-0.49, p < 0.001 and HR 0.64, 95% CI: 0.55-0.76, p < 0.001, respectively)., Conclusion: This is the largest observational study to evaluate survival outcomes in young-onset mCRC patients and the role of surgical intervention of the primary and/or metastatic site. Our study provides evidence of statistically significant increase in OS for young mCRC patients who undergo surgical intervention of the primary and/or metastatic site., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Published
2021
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6. Benchmarking patient satisfaction scores in a colorectal patient population.

Author

Kavalukas SL, Baucom RB, Geiger TM, Ford MM, Muldoon RL, Cavin NA, Killion BE, Hopkins MB, Rothman RL, Penson DF, and Hawkins AT

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Benchmarking, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Young Adult, Colorectal Neoplasms psychology, Patient Satisfaction statistics & numerical data
Abstract

Background: Healthcare reimbursement is rapidly moving away from a fee-for-service model toward value-based purchasing. An integral component of this new focus on quality is patient-centered outcomes. One metric used to define patient satisfaction is the Press Ganey Patient Satisfaction Survey. Data are lacking to accurately benchmark these scores based on diagnosis. We sought to identify if different colorectal disease processes affected a patient's perception of their healthcare experience., Methods: Adult colorectal patients seen between July 2015 and September 2016 in a tertiary hospital colorectal clinic were mailed a Press Ganey survey. Patients were stratified based on diagnosis: neoplasia, IBD, anorectal and benign colorectal disease. Survey scores were compared across the groups with adjustment for confounding variables., Results: 312 patients responded and formed the cohort. The mean age was 61 (range 18-93) and 56% were women. The cohort breakdown was 38% neoplasia, 32% anorectal, 21% benign, and 9% IBD. In a multivariable model, there was a difference in PG scores by diagnosis; patients with neoplasia had higher Overall scores (β 10.2; Std Error 4.0; p = 0.01), Care Provider scores (β 8.5; Std Error 4.2; p = 0.04), Nurse Assistant scores (β 15.0; Std Error 5.7; p = 0.01), and Personal Issues scores (β 11.8; Std Error 5/0; p = 0.01)., Conclusion: Press Ganey scores were found to vary significantly. Patients with a neoplasia diagnosis reported higher overall satisfaction, Care Provider, Nurse Assistant, and Personal Issues scores. Adjustment for disease condition is important when assessing patient satisfaction as an indicator of quality and as a metric for reimbursement. This study adds to increasing evidence about bias in these scores.

Published
2021
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7. Colorectal Cancer in Northern Tanzania: Increasing Trends and Late Presentation Present Major Challenges.

Author

Herman AM, Hawkins AT, Misso K, Issangya C, Tarmohamed M, Mremi A, Serventi F, Msuya D, and Philemon R

Subjects
Adult, Colonoscopy, Humans, Male, Middle Aged, Retrospective Studies, Tanzania epidemiology, Colorectal Neoplasms diagnosis, Colorectal Neoplasms epidemiology, Early Detection of Cancer
Abstract

Purpose: A trend of increasing incidence of colorectal cancer (CRC) has been observed in northern Tanzania. Studies have shown a six-fold increase in CRC in the past decade, with 90% of patients presenting in late stages, with resultant high morbidity and mortality rates. In this study, we aimed to document the burden of CRC in the northern zone of Tanzania from 1998 to 2018, focusing on patient presentation, clinical features, and treatment at a tertiary hospital., Methods: Pathological and clinical records for all patients from 1998 to 2018 were identified and reviewed. Records of patients whose CRC was diagnosed histologically were retrospectively reviewed., Results: Approximately 313 CRC cases were documented. The majority age group (29.1%) was between 50 and 64 years (mean [standard deviation], 54.28 [16.75] years). However, together, the age groups of patients younger than 50 years was 41.5% (n = 130). Of 174 patients with complete records, most (29.3%) were between 35 and 49 years of age. The median age was 52 (interquartile range, 40-67) years. Men accounted for 62.1% of patients and were mostly from the Kilimanjaro region. More than half (54.7%) presented > 3 months after symptom debut; 62.6% first sought care at lower-level health facilities. Most (64.9%) presented as emergencies, necessitating colostomy for fecal diversion as the initial surgical procedure in 60.3% of patients. Colonoscopy was performed for 38.6% of the study participants. Most tumors (72.7%) originated from the sigmoid and rectum. Adenocarcinoma was the most prevalent histologic type., Conclusion: High proportions of young individuals with CRC pose great concern and a need for further appraisal. Furthermore, late emergency presentation and low colonoscopy rates highlights underlying system challenges and need for education campaigns.

Published
2020
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8. Morbidity Associated with Diverting Loop Ileostomies: Weighing Diversion in Rectosigmoid Resection.

Author

Belkin N, Bordeianou LG, Shellito PC, and Hawkins AT

Subjects
Female, Humans, Male, Middle Aged, Morbidity, Prospective Studies, Colorectal Neoplasms surgery, Ileostomy adverse effects, Ileostomy methods, Postoperative Complications epidemiology, Postoperative Complications etiology, Rectal Neoplasms surgery, Sigmoid Neoplasms surgery
Abstract

Anterior resection with primary anastomosis is the procedure of choice for patients with rectosigmoid cancers with good sphincter function. Surgeons may perform an associated diverting loop ileostomy (DLI) to minimize the likelihood and/or the severity of an anastomotic leak. To examine the morbidity of DLIs, we performed a review of a prospectively maintained database. Participants included all patients at the Massachusetts General Hospital who underwent anterior resection from January 2013 to July 2015 for rectosigmoid cancers and who subsequently underwent adjuvant chemotherapy. The primary outcome was time to start of adjuvant chemotherapy. Secondary outcomes included length of hospitalization, perioperative complications, and 60-day postoperative complications. Inclusion criteria were met in 57 patients and DLI was performed in 21 (37%). The DLI group had higher estimated blood loss (431.7 vs 192.1 mL, P = 0.03) and a longer operation time (3.7 vs 2.3 hours, P = 0.0007). The DLI group took over a week longer to start adjuvant chemotherapy than the non-DLI group (median time to chemo: 43 vs 34 days, P = 0.002). Postoperatively, DLI was associated with a longer hospitalization (6.7 vs 3.1 days, P = 0.0003), more perioperative complications (57.1% vs 13.9%, P = 0.0006), and more 60-day readmissions or emergency department visits (38.1% vs 5.6%, P = 0.002). Ostomies are associated with appreciable morbidity. In turn, they do not eliminate postoperative complications. Surgeons should closely consider ostomy morbidity in rectosigmoid resection and institute a proactive approach toward identification and prevention of complications.

Published
2017

9. Retrospective evaluation of elastic stain in the assessment of serosal invasion of pT3N0 colorectal cancers.

Author

Liang WY, Chang WC, Hsu CY, Arnason T, Berger D, Hawkins AT, Sylla P, and Lauwers GY

Subjects
Adult, Aged, Aged, 80 and over, Colorectal Neoplasms metabolism, Colorectal Neoplasms mortality, Female, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Retrospective Studies, Staining and Labeling methods, Young Adult, Colorectal Neoplasms pathology, Elastic Tissue pathology, Neoplasm Metastasis diagnosis, Neoplasm Staging methods
Abstract

Peritoneal involvement is an important adverse prognostic factor in colorectal cancer (CRC) and determines a shift in the pathologic tumor node metastasis stage. Because peritoneal involvement is difficult to identify, use of special stains highlighting the peritoneal elastic lamina and mesothelial surface has been proposed. This study aims to determine whether use of elastic stain or CK7 immunohistochemistry on a single tissue section can refine the level of tumor invasion and determine whether restaging based on this assessment has prognostic significance in pT3N0 CRCs. Elastic stains were applied to 1 block per case from 244 consecutively resected pT3N0M0 CRCs. CK7 was evaluated in a 169-case subset. The elastic lamina was identified in only 101 cases (41%). Of those, 60 cases (24.6%) displayed elastic lamina invasion (ELI). This finding was associated with significantly worse (P<0.001) disease-free survival (DFS) (5-y DFS=60%) and significantly worse (P=0.01) overall survival (OS) (5-y OS=66.7%) compared with patients with no ELI (5-y DFS=87.8%, OS=92.7%) and those for whom no elastic lamina was identified (5-y DFS=82.5%, OS=86.0%). CK7 staining highlighted mesothelial cells in only 27 of 169 cases tested and helped demonstrate serosal invasion in only 5 cases (3%). In summary, the use of a single elastic stain is a useful and inexpensive method to demonstrate peritoneal involvement by tumor and should be considered for routine use in all pT3N0 CRCs. As tumors with ELI have an adverse prognosis, we propose that they should be upstaged compared with pT3N0 tumors without ELI.

Published
2013
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10. DElayed COloRectal cancer care during COVID-19 Pandemic (DECOR-19): Global perspective from an international survey

Author

Santoro, Giulio A., Grossi, Ugo, Murad-Regadas, Sthela, Nunoo-Mensah, Joseph W., Mellgren, Anders, Di Tanna, Gian Luca, Gallo, Gaetano, Tsang, Charles, Wexner, Steven D, LA TORRE, Filippo, Abary Ryan Rainiel, A, Philippines, Abdelwahab Khaled M, Egypt, Abellán Antonio M, Spain, Abraham Ned, Australia, Achkasov Sergey I, Russia, Adamina Michel, Switzerland, Adamo Vincenzo, Italy, Agapov Mikhail, Russia, Agarwal Amit, Usa, Aguado López Héctor, Spain, Aguilar Werner, Chile, AguilarMartínez María Del Mar AM, Spain, Aguilera Asuncion, Spain, Ahmed Jamil, Uk, Aiello Domenico, Italy, Akagi Tomonori, Japan, Akcakaya Adem, Turkey, Akhtar Khalid I, Pakistan, Akiba Ricardo, Brazil, Akrami Majid, Iran, Akyol Cihangir, Turkey, Alaamer Ohood H, Saudi Arabia, Alapati Kishore, India, Alasari Sami, Saudi Arabia, Albastaki Sara, Uae, Albergaria Diogo, Portugal, Alconchel Felipe, Spain, Alerta-Torre Andrea J, Philippines, Alex Ochsner, Switzerland, Alexander Herold, Germany, Alfaro Samuel, El Salvador, Ali Jehangir F, Pakistan, Aliyazicioglu Tolga, Turkey, Almgla Naser, South Africa, Alonsopoza Alfredo, Spain, Al-Radjid Jamiri, Philippines, Alselaim Nahar A, Saudi Arabia, Altaf Kiran K, Uk, Althebaity Rasha, Saudi Arabia, Altinel Yuksel, Turkey, Altiparmak Basak, Turkey, Altomare Donato F, Italy, Alvandipour Mina, Iran, Alvarez-Gallego Mario, Spain, Alyami Mohammad, Saudi Arabia, Amado Sandra, Portugal, Amato Antonio, Italy, Amodio Pietro M, Italy, Ana-Maria Mușină, Romania, Andrade Luis, Chile, Andreas Kohler, Switzerland, Angelini Giulio, Italy, Angenete Eva, Sweden, Annicchiarico Alfredo, Italy, Antelo Galarza Renan, Bolivia, Anwer Mariyah, Pakistan, Aparício David J, Portugal, Arciniega Jose A, Mexico, Arezzo Alberto, Italy, Argenio Giulio, Italy, Arenas Mara, Belgium, Arnaud Alves AA, France, Arredondo Jorge, Spain, Arslan Baha, Turkey, Arya Shobhit, Uk, Aselmann Heiko, Germany, Aumann Georg, Germany, Avanzolini Andrea, Italy, Avendano Rodolfo, Chile, Awedew Atalel F, Ethiopia, Ayantunde Abraham, Uk, Aycan Ilker, Turkey, Aytac Erman, Turkey, Azevedo Constança TM, Portugal, Ba Am, Iraq, Bader Fg, Germany, Baehrle Markus, Germany, Bagaglini Giulia, Italy, Balaban Vladimir, Russia, Balciscueta Zutoia, Spain, Balciscueta Izaskun, Spain, Baldazzi Gianandrea, Italy, Balik Emre, Turkey, Bandolon Robert, Philippines, Barberis Andrea, Italy, Barisic Goran I, Serbia, Barrera Alejandro, Chile, Barros Inês MSF, Portugal, Basaran Betul, Turkey, Basilio Pedro C, Brazil, Bech Flemming, Denmark, Behboo Roubik, Iran, Behboudi Behnam, Iran, Beitia Ivan E, Panama, Bellato Vittoria, Italy, Bellolio Felipe, Chile, Benli Sami, Turkey, Bernal Jc, Spain, Bernante Paolo, Italy, Berrospi Francisco E, Peru, Bertelson Noelle, Usa, Bevan Katharine, Uk, Bhama Anuradha, Usa, Bianco Francesco, Italy, Bievel Radulescu Raluca, Romania, Bintraiki Thamer, Saudi Arabia, Bisgin Tayfun, Turkey, Bislenghi Gabriele, Belgium, Blaslaina Juanluis, Spain, Bloom Itm, Uk, Boehm Gabriele, Germany, Bogoni Selene, Italy, Bohlooli Mehrdad, Iran, Bondurri Andrea, Italy, Boni Luigi, Italy, Bonomi Alessandro Michele, Italy, Booning Nitikun, Thailand, Boonpipattanapong Teeranut, Thailand, Bordeianou Liliana, Usa, Bossard Kerrie, Usa, Botelho Maria, Portugal, Boto Carlos, Portugal, Bottini Corrado, Italy, Bouchagier Konstantinos, Greece, Boutall Adam, South Africa, Bowers Dan, Usa, Bozbiyik Osman, Turkey, Brambilla Eduardo, Brazil, Brisinda Giuseppe, Italy, Brizzi Maria Pia, Italy, Brizzolari Marco, Italy, Brusciano Luigi, Italy, Bucci Luigi, Italy, Buchwald Pam, Sweden, Bugra Dursun, Turkey, Bui Andrew, Australia, Buldanlı Mehmet Zeki, Turkey, Bulut Orhan, Denmark, Cagigas Fernandez Carmen, Spain, Cai Yuankun, China, Calcerrada Alises Enrique, Spain, Caldes Pedro, Portugal, Calussi Marco, Italy, Calvo Espino Pablo, Spain, Campanelli Michela, Italy, Campbell Ken, Uk, Campennì Paola, Italy, Canda Arasemre, Turkey, Capolupo Gabriella T, Italy, Caravana Jorge, Portugal, Carballo Federico HE, Argentina, Carbone Fabio, Italy, Carcamo Leonardo C, Chile, Cardoso Paulo, Portugal, Cariati Maria, Italy, Caricato Marco, Italy, Carmona Maria, Spain, Carpelan Holmstrom Monika, Finland, Carrié Augusto J, Argentina, Carrino Francesco, Italy, Cartucho Daniel DF, Portugal, Carvalho Marcia, Portugal, Carvas João M, Portugal, Casagranda Biagio, Italy, Casimiro Carlos, Portugal, Castro Anyely, Dominican Republic, Catiwala-An Michael T, Philippines, Caushaj Philip F, Usa, Cavallo Debora, Italy, Cedermas Mariela, Argentina, Celayir Fevzi, Turkey, Celentano Valerio, Uk, Cengiz Fevzi, Turkey, Chaisomboon Nopdanai, Thailand, Chenghua Luo, China, Cherepenin Mikhail, Russia, Chessa Antonella, Italy, Chierici Andrea, France, Chok Aikyong, Singapore, Chouliaras Christos, Greece, Chowchankit Irin, Thailand, Christou Niki, France, Chun Hokyung, South Korea, Cillara Nicola, Italy, Cinza Margarida, Portugal, Cione Gianpiero, Italy, Cipe Gokhan, Turkey, Ciprian Duta, Romania, Cirocco William, Usa, Citgez Bulent, Turkey, Clark Jill E, Usa, Clementi Ilaria IC, Italy, Clerc Daniel, Switzerland, Clermonts Journal Pre-proof 39 Stefan HEM, Netherlands, Cobellis Luigi, Italy, Colak Tahsin, Turkey, Colao Garcia Laura, Spain, Colombo Francesco, Italy, Comba Andrea, Italy, Coret Franco Alba CFA, Spain, Correa Bonito Alba, Spain, Cosman Bard, Usa, Costa Susana GS, Portugal, Costa Marta RP, Portugal, Costa Pereira Joaquim, Portugal, Cózar Lozano Coral, Spain, Cravero Francesca, Italy, Creavin Ben, Ireland, Cross Katie LR, Uk, Cruz Arturo, Spain, Cui Junhui, China, Cunha Miguel F, Portugal, Curado Antonio, Portugal, D'Ugo Stefano, Italy, Dajti Irida, Albania, Dalessandro Antonio, France, Dal Monte Giorgio, Italy, Danelli Piergiorgio, Italy, Daniels Ian R, Uk, Dar Asif M, India, Davies Richard J, Uk, De Andrés Beatriz, Spain, De Angelis Marsilio, Italy, De Falco Nadia, Italy, De Luca Maurizio, Italy, De Luca Raffaele, Italy, De Nardi Paola, Italy, De Rosa Michele, Italy, De Silva Kaluthanthiri Patabanadi VR, Sri Lanka, De Simone Veronica, Italy, De Wilt Johannes HW, Netherlands, De-León-Rendón Jorge Luis, Mexico, Dean Phillip, Usa, Deangelis Nicola, France, Dedemadi Georgia, Greece, Delgadillo Xavier, Switzerland, Delgadillo Edgar, Switzerland, D’Elia Antonio, Italy, Delibegovic Samir, Bosnia and Herzegovina, Delis S, Greece, Della Porta Massimiliano, Italy, Del Rio Paolo, Italy, De Marano Gaetano, Italy, Demey Karel, Belgium, Demirli Atıcı Semra, Turkey, Denoya Paula I, Usa, Derebey Murat, Turkey, De Santis Mariangela, France, Devezas Vítor BS, Portugal, Dhaif Ali, Bahrain, Diaconescu Bogdan, Romania, Di Candido Francesca, Italy, Die Javier, Spain, Dieguez Beatriz, Spain, Dieter Hahnloser, Switzerland, Diez Alonso Manuel, Spain, Dimaren Ishmael, Philippines, Disimone Massimo, Italy, Doerner Johannes, Germany, Domingos Hugo VG, Portugal, Dominguez Rubén RD, Paraguay, Dorenbusch Michael, Usa, Doulias Triantafyllos A, Uk, Duff Sarah, Uk, Dulskas Audrius, Lithuania, Dunn Gary, Usa, Duque-Mallén Victoria, Spain, Dusek Tomas, Czech Republic, Dusitanond Navara, Thailand, Dzulkarnaen Zakaria Andee, Malaysia, Dworkin Michael, United Kingdom, Dybau Aleh, Belarus, Dziakova Jana, Spain, Dziki Lukasz, Poland, Dziki Adam, Poland, Efetov Sergey K, Russia, Eisa Mohamed, Egypt, Eisenstat Ted, Usa, El Sorogy Mohamed, Egypt, El-Hussuna Alaa, Denmark, Elfeki Hossam, Egypt, Elhussuna Alaa, Denmark, Eliasrabelo Fernanda, Brazil, Ellis Tyler, Usa, Elzalabany Tamer, Egypt, Emile Sameh H, Egypt, Emiroglu Mustafa, Turkey, Emmanuel Odet, France, Enomoto Masanobu, Japan, Epifani Angelo Gabriele, Italy, Erenler Ilknur, Turkey, Erkan Arman, Usa, Erol Timuçin, Turkey, Erturk Suphan, Turkey, Escalante Ricardo, Venezuela, Escartin Jorg, Spain, Escrevente Ricardo, Portugal, Espin-Basany Eloy, Spain, Estaire-Gomez Mercedes, Spain, Falaschi Federica, Italy, Falken Ylva, Sweden, Fantini Corrado, Italy, Fantozzi Mauricio, Argentina, Farid Asim, Usa, Farina Pablo, Argentina, Farmer Russ, Usa, Farmer Martin, Uk, Faul Eleanor M, Ireland, Favara Andrea, Italy, Febra Pedro, Portugal, Fenner Lyra Junior Humberto, Brazil, Fermani Claudio, Argentina, Fernandes Fábio FN, Portugal, Fernandes Miguel, Portugal, Ferracci Federica, Italy, Ferrara Francesco, Italy, Ferrari Giovanni, Italy, Ferrario Luca, Italy, Ferreira Rita, Portugal, Ferreira Carlos, Portugal, Ferris Jeff, Usa, Ferronetti Antonio, Italy, Fialho Guilherme L, Portugal, Fichera Alessandro, Usa, Figueiredo Odete, Portugal, Filipe Vieira Pedro JG, Portugal, Fiore Felicia, Italy, Folliero Cristina, Italy, Folstad Torbjorn, Norway, Forerotorres Alexander, Spain, Forgan Timothy R, South Africa, Franceschilli Marzia, Italy, Frizelle Frank, New Zealand, Froehner Junior Ilario, Brazil, Frois Miguel, Portugal, Frontali Alice, France, Fu Chuangang, China, Fulginiti Serena, Italy, Galiffa Giampaolo, Italy, Gallagher Hugh J, Uk, Gallardo Cristian, Chile, Galleano Raffaele, Italy, Gama Barbara, Portugal, Garcia Conde Maria, Spain, Garcia Granero Alvaro, Spain, Garcia Esther, Spain, García Sánchez Felipe, Spain, Garcia Septiem Javier, Spain, Garcia Walter, Argentina, Garcia-Urena Miguel Angel, Spain, Garmanova Tatiana N, Russia, Garofalo Thomas, Usa, Garoufalia Zoe, Greece, Garulli Gianluca, Italy, Gatti Matteo, Italy, Gecim Ethem, Turkey, Gellona Jose, Chile, Gercek Yuksel, Uk, Ghignone Federico, Italy, Gianchandani Moorjani Rajesh, Spain, Gianfrancisco James A, Usa, Giani Iacopo, Italy, Gibert Juan, Spain, Gilles Manceau, France, Gilmore Andrew, Australia, Gilsanz Carlos, Spain, Gilshtein Hayim, Usa, Girgin Behic, Turkey, Giria Joao, Portugal, Giuffrida Maria Carmela, Italy, Giuliani Antonio, Italy, Goi Gloria, Italy, Golovina Anastasiya, Russia, Gomez Rosado Juan Carlos, Spain, González Enrique, Spain, Granada Nemesio, Philippines, Grimme Frederike, Netherlands, Grobler Stephen, South Africa, Guaitoli Eleonora, Italy, Guerci Claudio, Italy, Guerra Daniel, Mexico, Guerreiro José MM, Portugal, Guido Jutten, Belgium, Gulcu Baris, Turkey, Gunay Emre, Turkey, Gundes Ebubekir, Turkey, Gurbuz Bulent, Turkey, Gurjar Shashank, Uk, Hainsworth Alison J, Uk, Hall Nigel, Uk, Hamed Hosam H, Egypt, Hammer Clare, Uk, Hannon Rob, Ireland, Harmston Christopher, New Zealand, Harran Nadine, South Africa, Hartendorp Paul, Usa, Hassan Iyad, Uae, Hassan Imran, Usa, Hawkins Alexander T, Usa, Hayssen Theresa, Usa, Hendren Samantha, Usa, Hernandez Garcia Miguel, Spain, Hershman Michael, Journal Pre-proof 40 UK, Hild Stefanie, Germany, Hilton Joanna, Uk, Hiranyakas Art, Thailand, Ho Ming, Australia, Hollington Paul, Australia, Holubar Stefan, Usa, Hompes Roel, Netherlands, Houcine Maghrebi, Tunisia, Hovsepyan Vardges, Armenia, Hul Rene, Netherlands, Hunt Louise E, Uk, Hyder Zargham, Uk, Ibrahim Aini F, Malaysia, Iglesias Gustavo, Brazil, Iesalnieks Igors, Germany, Ilkanich Andrei, Russia, Imanova Nargiz, Azerbaijan, Isik Arda, Turkey, Jayathilaka Buddika, Uk, Jimenez Virginia, Spain, Jimenez-Gomez Luis Miguel, Spain, Jitmungngan Romyen, Thailand, Joelsson Magnus, Sweden, Joshi Heman, Uk, Juloski Jovan T, Serbia, Juwid Abdallah E, Libya, Kanjanasilp Prapon, Thailand, Kannappa Lava, Uk, Kanno Danilo, Brazil, Kaplan Esin, Turkey, Kara Yasin, Turkey, Kartal Abdulcabbar, Turkey, Kawamura Junichiro, Japan, Kaya Tayfun, Turkey, Kazemi Nava Andrea, Italy, Kazachenko Ekaterina A, Russia, Kelkar Ashish, Uk, Kelly Michael E, Ireland, Keramati Mohammad Reza, Iran, Kerawala Asad, Pakistan, Khalil Mohammad I, Bangladesh, Khan Jim S, Uk, Khan Rbn, Uk, Khitaryan Alexander, Russia, Kinjo Tatsuya, Japan, Kirilova Tanya N, Bulgaria, Kirmizi Yasemin, Turkey, Klaristenfeld Daniel, Usa, Knapp Jens, Norway, Koc Mehmet A, Turkey, Kocián Petr, Czechia, Konishi Tsuyoshi, Japan, Konstantoudakis Georgios, Cyprus, Konsten Joop, Netherlands, Kontovounisios Christos, Uk, Korkmaztoker Melike, Turkey, Kørner, Hartwig, Norway, Krdzic Igor, D, Serbia, Krivokapic Zoran, Serbia, Kumar Sanjeev, India, Kumar Sandip, Malaysia, Kushtrim Shala, Germany, Kynaston James, Uk, Langmayr Johannes, Austria, La Torre Marco, Italy, La Torre Filippo, Italy, Labalde Maria, Spain, Lagopoulos Vasileios, Greece, Lal Roshan, Uk, Landaluce- Olavarria Aitor, Spain, Langone Antonio, Italy, Lapolla Pierfrancesco, Italy, Larach Sergio, Usa, Larach, Andres, Chile, Larsson, Peranders, Sweden, Lasala Alfred, Philippines, Lauretta Andrea, Italy, Leao Pedro, Portugal, Lee Pamela C, Usa, Lee Suk-Hwan, South Korea, Lee Wooyong, South Korea, Lefevre Jeremie H, France, Leite Julio, Portugal, Lemaire Julien, Belgium, Lemma Maria, Italy, Lemme Gustavo Nestor, Argentina, Lenna Giovanni, Italy, Leo Cosimo Alex, Uk, Leventoglu Sezai, Turkey, Licardie Eugenio, Spain, Lienert Mark, Germany, Lima Sergio, Brazil, Limbert Manuel CSB, Portugal, Lisi Giorgio, Italy, Litta Francesco, Italy, Littaua Dennis, Philippines, Liu Fanlong, China, Liyanage Chris, New Zealand, Llovera Antony, Cuba, Lo Oswens, China, Lo Dico Rea, France, Lobascio Pierluigi, Italy, Lohsiriwat Varut, Thailand, Lombana Luis, Colombia, Lopez Marc, Philippines, Lopez Jose, Mexico, Lopez Francisco, Chile, Lorber Julie, Usa, Losada Manuel, Spain, Lowenfeld Lea, Usa, Lucci Enrico, Italy, Luglio Gaetano, Italy, Lynch Craig, Australia, Luqman, Pakistan, Machairas Nikolaos, Uk, Maciel João MRP, Portugal, Madbouly Khaled, Egypt, Madhoun, Nisreen, Usa, Maffioli, Anna, Italy, Magbojos Christian Raymond S, Philippines, Magistro Carmelo CM, Italy, Magrino Thomas, Usa, Makhoul Rami, Usa, Mallmann Karen DP, Brazil, Manatakis Dimitrios K, Greece, Mancini Stefano, Italy, Manfredelli Simone, France, Mangione John, Usa, Manso Antonio, Portugal, Marakutsa Eugen V, Moldova, Marano Alessandra, Italy, Marchesi Federico, Italy, Marchiori Mauro, Brazil, Marfan Michael, Australia, Marianelli Raphael, Brazil, Mariani Nicolò M, Italy, Marimuthu Kalimuthu, Uk, Marinello Franco, Spain, Marinis Athanasios, Greece, Marino Marco V, Italy, Markides Georgios, Cyprus, Marquez Lucila, Spain, Marra Angelo A, Italy, Martín Navarro Fabian, Mexico, Martin-Martin Gonzalo P, Spain, Martinez Javier, Spain, Martinez-Iglesias Marta A, Uk, Martins Ruben AFP, Portugal, Martins Ana RG, Portugal, Mascali Davide DM, Italy, Massucco Paolo, Italy, Matas Fernando, Spain, Mathew Alexander, Usa, Matzel Klaus E, Germany, Maun Dipen, Usa, Maurus Christine F, Switzerland, McCormick Jim, Usa, McIntyre Robert, Uk, McKinley Aileen, Uk, McLemore Lisa, Usa, McNeil Jennifer, Usa, McNevin Shane, Usa, Medich David, Usa, Medina Cesar, Mexico, Medina Quintana Rita E, Spain, Melo Ingrid, Paraguay, Melstrom Kurt A, Usa, Mendoza-Moreno Fernando, Spain, Menna Maria Paola, Italy, Mentz Ricardo, Argentina, Merlini David A, Italy, Mihmanli Mehmet, Turkey, Mike Spencer, Usa, Millan Monica, Spain, Miller Jerad, Usa, Milone Marco, Italy, Minahi Ilyas, Uk, Minaya-Bravo Ana María, Spain, Mingoli Andrea, Italy, Minicozzi Annamaria, Uk, Miranda Pedro, Portugal, Miro Antonio, Italy, Miskovic Danilo, Uk, Mistrangelo Massimiliano, Italy, Mitra Rajarshi, Uae, Mittal Rohin, India, Mladenovikj Dragoslav P, North Macedonia, Moctezuma Velázquez Paulina, Mexico, Mohamed Kamil Nil Amri, Malaysia, Mohammed Mohammed MH, Egypt, Mohsen Yasser MA, Uk, Monami Benoit N, Belgium, Monroe Justin, Usa, Monroy Hermogenes DJ, Philippines, Montori Giulia, Italy, Montuori Mauro, Italy, Mora-Guzmán Ismael, Spain, Moraes Ana, Brazil, Morales Carlos, Usa, Morelli Luca, Italy, Moreno Almudena, Spain, Moretto Gianluigi, Italy, Morici Riccardo, Italy, Morini Andrea, Italy, Moro-Valdezate David, Spain, Moroni Eliana, Italy, Morton Dion, Uk, Moura Catarina, Portugal, Moysidis Moysis M, Greece, Mozo Ana S, Spain, Nacion Aeris Jane D, Philippines, Nada Mohamed, Journal Pre-proof 41 Egypt, Nagasaki Toshiya, Japan, Nakamoto Yoshihiko, Japan, Neary Peter, Ireland, Negoi Ionut, Romania, Neijenhuis Peter A, Niger, Ng Simon SM, China, Niazi Samiullah, Pakistan, Nikoupour Hamed, Iran, Nogueiro Jorge PM, Portugal, Noguera Jose, Spain, Nova Carlos, Portugal, Nunes Amadeu, Portugal, O'Riordain Micheal G, Ireland, Oke Olatunbosun A, Nigeria, Okkabaz Nuri, Turkey, Oliva Cristiano, Italy, Oliveira Olga, Portugal, Oliveira Manuel, Portugal, Oliveira Antonio, Portugal, Oliveira Lucia CC, Brazil, Olivier James B, Uk, Olivier Pittet, Switzerland, Omejc Mirko, Slovenia, Ong Loreto B, Philippines, Ong David, Malaysia, Onglao Mark, Philippines, Onody Peter, Hungary, Orefice Raffaele, Italy, Ortega David, Peru, Ozben Volkan, Turkey, Ozcan Onder, Turkey, Ozturk Ersin, Turkey, Pacheco Andre, Portugal, Paci Marco, France, Paczosa Marcin, Poland, Padmanabhan Anantha, Usa, Pai Ajit, India, Palmer Gabriella, Sweden, Pandey Diwakar, India, Panis Yves, France, Pantel, Haddon, Paonariang Krisada, Thailand, Papa Mario V, Italy, Papadopoulos Aristeidis, Greece, Papagni Vincenzo, Italy, Papp Andras, Sweden, Parello Angelo, Italy, Parente Alessandro, Uk, Parra Pedro, Spain, PascualMigueláñez Isabel, Spain, Pata Francesco, Italy, Patel Nikhil, Usa, Patel Reeya, Uk, Pattyn Paul RL, Belgium, Paul Bikram, Usa, Pavanello Maurizio, Italy, Pedro Luis E, Argentina, Pellino Gianluca, Spain, Peltrini Roberto, Italy, Peña Ros Emilio, Spain, Pennacchi Luca UC, Italy, Pereira André, A Portugal, Pereira Bela, Portugal, Perez Guillermo, Ecuador, Perez Horacio, Portugal, Perez Natalia, Spain, Perez Flecha Marina, Spain, Perinotti Roberto, Italy, Pernazza Graziano, Italy, Perra Teresa, Italy, Pertile Davide, Italy, Pessia Beatrice, Italy, Pessoa Joana, Brazil, Petagna Lorenzo, Italy, Peters Walter, Usa, Petit Mindy, Usa, Petracca Gabriele Luciano, Italy, Pezzolla Francesco, Italy, Philp Matthew, Usa, Pianim Nana, Usa, Picciariello Arcangelo, Italy, Piccinini Pablo E, Argentina, Piccinni Giuseppe, Italy, Piccolo Davide, Italy, Pigalarga, Rodolfo, Pikarsky Alon J, Israel, Pimentel Alice, Portugal, Pinchot Scott, Usa, Pinotti Enrico, Italy, Pinto Diogo, Portugal, Pirozzi Felice, Italy, Plastiras Aris, Greece, Platto Marco, Italy, Plerhoples Tim, Usa, Podda Mauro, Italy, Poggi Luis, Peru, Polastri Roberto, Italy, Porcu Alberto, Italy, Porter Michael, Usa, Poskus Eligijus, Lithuania, Potolicchio Analia I, Argentina, Poylin Vitaliy, Usa, Pozzo Mauro, Italy, Pramateftakis Manos, Greece, Pravosudov Igor V, Russia, Praxedes Vanessa P, Portugal, Primoromaguera Vicent, Spain, Progno Valerio C, Italy, Proud David M, Australia, Pucciarelli Salvatore, Italy, Qadir Abdul, Uk, Qayoom Hina, Pakistan, Quindos Patricia, Spain, Quintanilha Rui, Portugal, Quinteros Francisco A, Usa, Qureshi Nafees, Uk, Rachadell Juan J, Portugal, Ralf Schmidt, Germany, Raman Shankar, Usa, Ramos Diego, Spain, Ramos Jose, Portugal, Ramwell, Andrew, Randazzo, Valentina, Rattanarpichart Patsaporn, Thailand, Ratto Carlo, Italy, Rautio Tero, Finland, Raviolo Carla, Italy, Read Thomas, Usa, Real Joao, Portugal, Rega Daniela, Italy, Regadas Francisco, Brazil, Regenbogen Scott, Usa, Reia Marta, Portugal, Reina Angel, Spain, Rems Miran, Slovenia, Rencuzogullari Ahmet, Turkey, Renwick Andrew A, Uk, Reyes Juan C, Colombia, Reyes Jeryl Anne Silvia R, Philippines, Ribeiro Jr Ulysses, Brazil, Ridzuan Farouk, Singapore, Ripetti Valter, Italy, Ripoll Cristina, Mexico, Ripollés-Melchor Javier, Spain, Rizal Rizal, Indonesia, Rizk Mariam, Uk, Rizvi Irfan, Usa, Robinson Jonathan, Uk, Rodimov Sergei, Russia, Rodrigues João VL, Brazil, Rodriguez Javier, Mexico, Rodriguez Cristian, Argentina, Rodriguez Homero, Panama, Rodriguez Garcia Jaime, Mexico, Roig Jose, Spain, Rojanasakul Arun, Thailand, Rojas Julio, Chile, Romanelli Elena, France, Rosa Fausto, Italy, Rosato Guillermo, Argentina, Rosenberg Robert, Switzerland, Rosete Manuel, Portugal, Roslani April C, Malaysia, Rottoli Matteo, Italy, Roxas Manuel Francisco Roxas T, Philippines, Roxburgh Campbell S, Uk, Ruan Joseph, Usa, Rubbini Michele M, Italy, Rubio Eduardo, Spain, Ruddy Theresa, Usa, Rueda Camilo, Spain, Ruiztovar Jaime, Spain, Rusconi Andrea, Italy, Rutegård Martin, Sweden, Sá Milene RRM, Portugal, Saad Luiz Henrique Cury, Brazil, Sadien Iannish D, Uk, Sadowski Brian M, Usa, Saeed Mirza Faraz, Bahrain, Safiyeva Aynur K, Azerbaijan, Sagap Ismail, Malaysia, Sahnan Kapil, Uk, Sairafi Rami, Saudi Arabia, Saklami Avanish P, India, Salgado-Nesme Noel NSN, Mexico, Salman Nevriye, Turkey, Samalavicius Narimantas E, Lithuania, Sambucci Daniele, Italy, Sanchez Noel, Usa, Sanchez Robles Juan Carlos, Mexico, Sanmiguel Carlos, Spain, Santacruz Eduardo, Paraguay, Santoni Simone, Italy, Santos Pedro MD, Portugal, Santos Brian U, Argentina, Santos Carlos, Portugal, Sapienza Paolo, Italy, Saracoglu Ayten, Turkey, Saracoglu Kemal T, Turkey, Sardinas Carlos, Venezuela, Sari Ramazan, Turkey, Sarma Diwakar, Uk, Sartori Alberto A, Italy, Sasia Diego, Italy, Sbaih Mohammed H, Saudi Arabia, Scabini Stefano, Italy, Scaringi Stefano, Italy, Scheinin Tom M, Finland, Schiavo Marcello, Italy, Schizas Alexis, Uk, Sciaudone Guido, Italy, Scognamillo Fabrizio, Italy, Scott Kelley, Usa, Scow Jeffrey S, Usa, Sechi Raffaele, Italy, Seehra Harkiran, Uk, Segering Joerg, Germany, Selcuk Mehtap, Turkey, Journal Pre-proof 42 Selemane Carlos, Mozambique, Seltman Ann, Usa, Selvaggi Francesco, Italy, Sensi Bruno, Italy, SeowChoen Francis, Singapore, Sernagiotto Carlo, Italy, Serralta De Colsa Daniel, Spain, Serrano González Javier, Spain, Sert Ismail, Turkey, Serventi Alberto, Italy, Sforza Sergio, Italy, Shabbir Jamshed, Uk, Shabeeb Fadel, Uae, Shafik Ali, Egypt, Shalaby Mostafa, Egypt, Shanker Bethann, Usa, Shanmugam Venkatesh, Uk, Shariff Umar, Uk, Shehta Ahmed, Egypt, Shelton Andrew, Usa, Shintaro Akamoto, Japan, Shlyk Daria, Russia, Shukla Amit, Uk, Sibio Simone, Italy, Sietze Koopal, Netherlands, Sigurdardottir Johanna, Sweden, Silva Jorge, Mexico, Silva Anaisa, Portugal, Simianu Val, Usa, Singh Baljit, Uk, Siragusa Leandro, Italy, Sirikurnpiboon Siripong, Thailand, Sivrikoz Emre, Turkey, Sizonenko Nikolay, Russia, Slavchev Mihail T, Bulgaria, Sniuolis Pranas, Lithuania, Soares Duarte, Qatar, Sojar Valentin, Slovenia, Sokmen Selman, Turkey, Sokol Thomas, Usa, Soldatov Denis, Russia, Soncini Stefania, Italy, Sordo Ricardo, Mexico, Sosa María V, Spain, Sousa Xavier, Portugal, Sozutek Alper, Turkey, Spiezio Giovanni, Italy, Spinelli Antonino, Italy, Stahl Etienne, Mexico, Stanojevic Goran Z, Serbia, Steckel Brian, Usa, Stefan Neagu, Romania, Stefanescu Victor, Romania, Steinhagen Randolph, Usa, Stella Marco, Italy, Stephensen Bree D, Australia, Stevenson Andrew RL, Australia, Stitzenberg Karyn, Usa, Strombom Paul, Usa, Sturiale Alessandro, Italy, Suhail Anjum, Pakistan, Sungurtekin Ugur, Turkey, Sutton Jeffrey M, Usa, Suwannakij Chanchai, Thailand, Szczepkowski Marek, Poland, Sztipits Tamas, Hungary, Takashi Akiyoshi, Japan, Takkenberg Marijn, Netherlands, Tallon-Aguilar Luis, Spain, Tam Michael, Usa, Tamburini Andrea M, Italy, Tamini Nicolò, Italy, Tammaro Pasquale, Italy, Tan Kerkan, Singapore, Tan Teerasan, Thailand, Tanal Mert, Turkey, Tanda Cinzia, Italy, Tang Jinghua, China, Tapiolas Ingrid, Uk, Täreby Magnus, Sweden, Tariverdiev Andrey, Russia, Tayar Serkan, Turkey, Tejedor Patricia, Spain, Terrosu Giovanni, Italy, Testa Alessandro, Italy, Tewari Shirish, Uk, Thabet Waleed, Egypt, Thakur Sukesh, India, Thomas Ehmann, Germany, Thomas Kuruc, Germany, Tiesi Vincenzo, Italy, Tin Moemoetin, Myanmar, Tita Agustin C, Argentina, Titu Liviu V, Uk, Tkachenko Fedot, Ukraine, Tonello Paolo, Italy, Tooley Richard, Usa, Torres Juan, Spain, Troci Albert, Italy, Trompetto Mario, Italy, Troncoso Pereira Paula, Spain, Tropeano Francesca Paola FP, Italy, Trostchansky Ivan, Uruguay, Tsujinaka Shingo, Japan, Tufo Andrea, Italy, Tulina Inna, Russia, Turati Luca, Italy, Turchina Catalin, Sweden, Turina Matthias, Switzerland, Tutino Roberta, Italy, Tyler Km, Usa, Uemura Mamoru, Japan, Unal Ayse G, Turkey, Uraiqat Ahmad, Jordan, Uribe Sebastián, Chile, V Duke, Usa, Vailati Bruna, Brazil, Vaingurt Mariano, Argentina, Valente Michael, Usa, Van Dellen Jonathan, Uk, Van Ramshorst Gabrielle H, Belgium, Vannelli Alberto, Italy, Vanriel W, Belgium, Varabei Aliaksandr, Belarus, Varcada Massimo, Uk, Varela Cristopher L, Venezuela, Varma Madhulika G, Usa, Vasapollo Leoluca F, Italy, Venn Mary L, Uk, Vercillo Kristin, Usa, Vergara-Fernandez Omar, Mexico, Veronesi Paolo, Italy, Vicente Aline, Brazil, Victor Tomulescu, Romania, Vieiradesousa Paulo, Portugal, Vignali Andrea, Italy, Vigorita Vincenzo, Spain, Vilchis Jose, Mexico, Villaverde Kathia, Peru, Vindevoghel Koen, Belgium, Violante Tommaso, Italy, Vitoopinyoparb Kasidin, Thailand, Voutsarakis Athanasios, Uk, Wainstein Ricardo, Argentina, Wakefield Simon, Uk, Wallon Conny, Sweden, Wang Yongbing, China, Wang Xiaodong, China, Wang Xiaofeng, China, Warden Claire, South Africa, Wei Rockson, China, Wheeler Matthew, Usa, Willem Bemelman, Netherlands, Wilson Matthew, Usa, Winter Des C, Ireland, Wongwiwatseree Yongsun, Thailand, Woon Kyung Jeong, South Korea, Wright Danette B, Australia, Wu Jiong, China, Wuraola Funmilola O, Nigeria, Xenaki Sofia A, Greece, Xiaohua Jiang, China, Xiaoqiang Jia, China, Xue Yahong, China, Xynos Evangelos, Greece, Yamada Kazunosuke, Japan, Yanar Hakan, Turkey, Yang Bolin, China, Yanishev Alexey, Russia, Yildirim Ali C, Turkey, Yildiz Ufukmete, Turkey, Yildiz Alp, Turkey, Yilmaz Mehmet, Turkey, Younis Muhammad Umar MUY, Uae, Yousef Zeyad, Saudi Arabia, Yu Dongsheng, China, Zalucki James, Usa, Zaman Ahamaduz, Bangladesh, Zamora Aída T, Spain, Zampitis Nikolaos, Cyprus, Zanus Giacomo, Italy, Zapata Gonzalo H, Argentina, Zelic Marko, Croatia, Zenger Serkan, Turkey, Zheng Jianyong, China, Zigiotto Daniele, Italy, Zmora Oded, Israel, Zoikas Athanasios, Greece, Zorcolo Luigi, Italy, Zucchella Martino, Italy, Zuhdy, Mohammad, Santoro G.A., Grossi U., Murad-Regadas S., Nunoo-Mensah J.W., Mellgren A., Di Tanna G.L., Gallo G., Tsang C., Rottoli M., and Wexner S.D.

Subjects
Male, medicine.medical_specialty, Delayed Diagnosis, Internationality, Colorectal cancer, colorectal surgery - COVID-19 - delay - treatment - outcomes, MEDLINE, colorectal cancer, 030230 surgery, medicine.disease_cause, Article, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Pandemic, medicine, Humans, Practice Patterns, Physicians', Elective surgery, Personal protective equipment, SARS-CoV-2, COVID-19, delayed surgery, Coronavirus, Infection Control, business.industry, Outbreak, medicine.disease, 030220 oncology & carcinogenesis, Preparedness, Emergency medicine, Female, Surgery, Colorectal Neoplasms, business, Colorectal Surgery
Abstract

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care., Global changes in both diagnostic and therapeutic practices in colorectal cancer care were evident in this survey conducted to analyze the impact of COVID-19 outbreak. The importance of this finding is that changes were associated with differences in health care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical variations.

Published
2021

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