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.
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.
Study Type
OBSERVATIONAL
Enrollment
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)
Oncologic stage
The stage will be reported at the histological examination according to TNM classification
Time frame: 30 days from the surgery
Palliative surgery
Rate of palliative surgery (defined as any procedure which did not have the aim of radically removing the primary cancer, either planned preoperatively in order to reduce the symptoms, or which became necessary during surgery due to unexpected findings
Time frame: at time 0 (surgery)
Rate of radical surgery
Surgery is defined radical according to the absence of cancer (R0) at the surgical margins on the histological specimen
Time frame: 30 days from surgery
Aggressive cancer biology
Biology was considered aggressive if any of the following characteristics were found at the histological examination: signet ring cells, mucinous tumor, tumor budding, lymphovascular invasion, perineurial invasion, lymphangitis.
Time frame: 30 days from the surgery
Rate of clinical T4 cancer at the preoperative staging
Clinical T4 cancer are defined as those with high suspicious of local invasion of adjacent organs or structures, not necessary confirmed as T4 at the histological examination
Time frame: At time 0 (surgery)
Liver metastases
Rate of single/multiple liver metastases
Time frame: At the preoperative staging or at surgery (time 0)
Lung metastases
Rate of single/multiple lung metastases
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
15,000
Rho Memorial Hospital
Rho, Milan, Italy
RECRUITINGHumanitas Research Center
Rozzano, Milan, Italy
RECRUITINGAOU Policlinico di Bari "M. Rubino"
Bari, Italy
RECRUITINGPoliclinico di Bari
Bari, Italy
RECRUITINGHumanitas Gavazzeni Hospital
Bergamo, Italy
RECRUITINGPoliclinico San Marco
Bergamo, Italy
RECRUITINGMaggiore Hospital
Bologna, Italy
RECRUITINGFondazione Poliambulanza
Brescia, Italy
RECRUITINGSpedali Civili
Brescia, Italy
RECRUITINGSpedali Civili
Brescia, Italy
RECRUITING...and 35 more locations
Time frame: At the preoperative staging or at surgery (time 0)
Associated symptoms
Rate of patients who had a diagnosis of cancer without any associated symptoms - as sign of effectiveness of the screening
Time frame: Before surgery
Emergency surgery
rate of operations requiring surgery within 48 hours from the unpredicted admission to hospital
Time frame: surgery (time 0)
Postoperative complications
Rate of 30-day complications graded according to the Clavien-Dindo Classification
Time frame: 30 days from surgery
Mortality
Rate of 30-day deaths
Time frame: 30 days from surgery