Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study
Authors: Glasbey James C. , Nepogodiev Dmitri , Simoes Joana F.F. , Omar Omar , Li Elizabeth , Venn Mary L. , PGDME  , Abou Chaar Mohammad K. , Capizzi Vita , Chaudhry Daoud , Desai Anant , Edwards Jonathan G. , Evans Jonathan P. , Fiore Marco , Videria Jose Flavio , Ford Samuel J. , Ganly Ian , Griffiths Ewen A. , Gujjuri Rohan R. , Kolias Angelos G. , Kaafarani Haytham M.A. , Minaya-Bravo Ana , McKay Siobhan C. , Mohan Helen M. , Roberts Keith J. , San Miguel-Méndez Carlos , Pockney Peter , Shaw Richard , Smart Neil J. , Stewart Grant D. , Sundar, MRCOG Sudha , Vidya Raghavan , Bhangu Aneel A. ,   on behalf of the COVIDSurg Collaborative, Glasbey James C , Nepogodiev Dmitri , Simoes Joana FF , Omar Omar , Li Elizabeth , Venn Mary L , Chaar Mohammad Abou , Capizzi Vita , Chaudhry Daoud , Desai Anant , Edwards Jonathan G , Evans Jonathan P , Fiore Marco , Videria Jose Flavio , Ford Samuel J , Ganyli Ian , Griffiths Ewen A , Gujjuri Rohan R , Kolias Angelos G , Kaafarani Haytham MA , Minaya-Bravo Ana , McKay Siobhan C , Mohan Helen M , Roberts Keith , San Miguel-Méndez Carlos , Pockney Peter , Shaw Richard , Smart Neil J , Stewart Grant D , Sundar Sudha , Vidya Raghavan , Bhangu Aneel A , Glasbey James C , Omar Omar , Bhangu Aneel A , Siaw-Acheampong Kwabena , Benson Ruth A , Bywater Edward , Chaudhry Daoud , Dawson Brett E , Evans Jonathan P , Glasbey James C , Gujjuri Rohan R , Heritage Emily , Jones Conor S , Kamarajah Sivesh K , Khatri Chetan , Khaw Rachel A , Keatley James M , Knight Andrew , Lawday Samuel , Li Elizabeth , Mann Harvinder S , Marson Ella J , McLean Kenneth A , McKay Siobhan C , Mills Emily C , Nepogodiev Dmitri , Pellino Gianluca , Picciochi Maria , Taylor Elliott H , Tiwari Abhinav , Simoes Joana FF , Trout Isobel M , Venn Mary L , Wilkin Richard JW , Bhangu Aneel A , Glasbey James C , Smart Neil J , Minaya-Bravo Ana , Evans Jonathan P , Gallo Gaetano , Moug Susan , Pata Francesco , Pockney Peter , Di Saverio Salomone , Vallance Abigail , Vimalchandran Dale , Griffiths Ewen A , Kamarajah Sivesh K , Evans Richard PT , Townend Philip , Roberts Keith , McKay Siobhan , Isaac John , Satoi Sohei , Edwards John , Coonar Aman S , Marchbank Adrian , Caruana Edward J , Layton Georgia R , Patel Akshay , Brunelli Alessandro , Ford Samuel , Desai Anant , Gronchi Alessandro , Fiore Marco , Almond Max , Tirotta Fabio , Dumitra Sinziana , Kolias Angelos , Price Stephen J , Fountain Daniel M , Jenkinson Michael D , Hutchinson Peter , Marcus Hani J , Piper Rory J , Lippa Laura , Servadei Franco , Esene Ignatius , Freyschlag Christian , Neville Iuri , Rosseau Gail , Schaller Karl , Demetriades Andreas K , Robertson Faith , Alamri Alex , Shaw Richard , Schache Andrew G , Winter Stuart C , Ho Michael , Nankivell Paul , Biel Juan Rey , Batstone Martin , Ganly Ian , Vidya Raghavan , Wilkins Alex , Singh Jagdeep K , Thekinkattil Dinesh , Sundar Sudha , Fotopoulou Christina , Leung Elaine , Khan Tabassum , Chiva Luis , Sehouli Jalid , Fagotti Anna , Cohen Paul , Gutelkin Murat , Ghebre Rahel , Konney Thomas , Pareja Rene , Bristow Rob , Dowdy Sean , Shylasree TS , Seenivasagam R Kottayasamy , Ng Joe , Fujiwara Keiiji , Stewart Grant D , Lamb Benjamin , Narahari Krishna , McNeill Alan , Colquhoun Alexandra , McGrath John , Bromage Steve , Barod Ravi , Kasivisvanathan Veeru , Klatte Tobias , Simoes Joana FF , Abbott Tom EF , Abukhalaf Sadi , Adamina Michel , Ademuyiwa Adesoji O , Agarwal Arnav , Akkulak Murat , Alameer Ehab , Alderson Derek , Alakaloko Felix , Albertsmeiers Markus , Alser Osaid , Alshaar Muhammad , Alshryda Sattar , Arnaud Alexis P , Augestad Knut Magne , Ayasra Faris , Azevedo José , Bankhead-Kendall Brittany K , Barlow Emma , Beard David , Benson Ruth A , Blanco-Colino Ruth , Brar Amanpreet , Minaya-Bravo Ana , Breen Kerry A , Bretherton Chris , Buarque Igor Lima , Burke Joshua , Caruana Edward J , Chaar Mohammad , Chakrabortee Sohini , Christensen Peter , Cox Daniel , Cukier Moises , Cunha Miguel F , Davidson Giana H , Desai Anant , Di Saverio Salomone , Drake Thomas M , Edwards John G , Elhadi Muhammed , Emile Sameh , Farik Shebani , Fiore Marco , Fitzgerald J Edward , Ford Samuel , Garmanova Tatiana , Gallo Gaetano , Ghosh Dhruv , Ataíde Gomes Gustavo Mendonça , Grecinos Gustavo , Griffiths Ewen A , Gründl Madalegna , Halkias Constantine , Harrison Ewen M , Hisham Intisar , Hutchinson Peter J , Hwang Shelley , Isik Arda , Jenkinson Michael D , Jonker Pascal , Kaafarani Haytham MA , Keller Debby , Kolias Angelos , Kruijff Schelto , Lawani Ismail , Lederhuber Hans , Leventoglu Sezai , Litvin Andrey , Loehrer Andrew , Löffler Markus W , Lorena Maria Aguilera , Modolo Maria Marta , Major Piotr , Martin Janet , Mashbari Hassan N , Mazingi Dennis , Metallidis Symeon , Minaya-Bravo Ana , Mohan Helen M , Moore Rachel , Moszkowicz David , Moug Susan , Ng-Kamstra Joshua S , Maimbo Mayaba , Negoi Ionut , Niquen Milagros , Ntirenganya Faustin , Olivos Maricarmen , Oussama Kacimi , Outani Oumaima , Parreno-Sacdalanm Marie Dione , Pata Francesco , Perez Rivera Carlos Jose , Pinkney Thomas D , van der Plas Willemijn , Pockney Peter , Qureshi Ahmad , Radenkovic Dejan , Ramos-De la Medina Antonio , Roberts Keith , Roslani April C , Rutegård Martin , Segura-Sampedro Juan José , Santos Irène , Satoi Sohei , Sayyed Raza , Schache Andrew , Schnitzbauer Andreas A , Seyi-Olajide Justina O. , Sharma Neil , Shaw Richard , Shu Sebastian , Soreide Kjetil , Spinelli Antonino , Stewart Grant D , Sund Malin , Sundar Sudha , Tabiri Stephen , Townend Philip , Tsoulfas Georgios , van Ramshorst Gabrielle H , Vidya Raghavan , Vimalachandran Dale , Warren Oliver J , Wedderburn Duane , Wright Naomi , Allemand C , Boccalatte L , Figari M , Lamm M , Larrañaga J , Marchitelli C , Noll F , Odetto D , Perrotta M , Saadi J , Zamora L , Alurralde C , Caram EL , Eskinazi D , Mendoza JP , Usandivaras M , Badra R , Esteban A , García JS , García PM , Gerchunoff JI , Lucchini SM , NIgra MA , Vargas L , Hovhannisyan T , Stepanyan A , Gould T , Gourlay R , Griffiths B , Gananadha S , McLaren M , Cecire J , Joshi N , Salindera S , Sutherland A , Ahn JH , Charlton G , Chen S , Gauri N , Hayhurst R , Jang S , Jia F , Mulligan C , Yang W , Ye G , Zhang H , Ballal M , Gibson D , Hayne D , Moss J , Richards T , Viswambaram P , Vo UG , Bennetts J , Bright T , Brooke-Smith M , Fong R , Gricks B , Lam YH , Ong BS , Szpytma M , Watson D , Bagraith K , Caird S , Chan E , Dawson C , Ho D , Jeyarajan E , Jordan S , Lim A , Nolan GJ , Oar A , Parker D , Puhalla H , Quennell A , Rutherford L , Townend P , Von Papen M , Wullschleger M , Blatt A , Cope D , Egoroff N , Fenton M , Gani J , Lott N , Pockney P , Shugg N , Elliott M , Phung D , Phan D , Townend D , Bong C , Gundara J , Frankel A , Bowman S , Guerra GR , Bolt J , Buddingh K , Dudi-Venkata NN , Jog S , Kroon HM , Sammour T , Smith R , Stranz C , Batstone M , Lah K , McGahan W , Mitchell D , Morton A , Pearce A , Roberts M , Sheahan G , Swinson B , Alam N , Banting S , Chong L , Choong P , Clatworthy S , Foley D , Fox A , Hii MW , Knowles B , Mack J , Read M , Rowcroft A , Ward S , Wright G , Lanner M , Königsrainer I , Bauer M , Freyschlag C , Kafka M , Messner F , Öfner D , Tsibulak I , Emmanuel K , Grechenig M , Gruber R , Harald M , Öhlberger L , Presl J , Wimmer A , Namazov İ , Samadov E , Barker D , Boyce R , Corbin S , Doyle A , Eastmond A , Gill R , Haynes A , Millar S , O’Shea M , Padmore G , Paquette N , Phillips E , St. John S , Walkes K , Flamey N , Pattyn P , Oosterlinck W , Van den Eynde J , Van den Eynde R , Gatti A , Nardi C , Oliva R , De Cicco R , Cecconello I , Gregorio P , Pontual Lima L , Ribeiro Junior U , Takeda F , Terra RM , Sokolov M , Kidane B , Srinathan S , Boutros M , Caminsky N , Ghitulescu G , Jamjoum G , Moon J , Pelletier J , Vanounou T , Wong S , Boutros M , Dumitra S , Kouyoumdjian A , Johnston B , Russell C , Boutros M , Demyttenaere S , Garfinkle R , Abou-Khalil J , Nessim C , Stevenson J , Heredia F , Almeciga A , Fletcher A , Merchan A , Puentes LO , Mendoza Quevedo J , Bačić G , Karlović D , Kršul D , Zelić M , Luksic I , Mamic M , Bakmaz B , Ćoza I , Dijan E , Katusic Z , Mihanovic J , Rakvin I , Frantzeskou K , Gouvas N , Kokkinos G , Papatheodorou P , Pozotou I , Stavrinidou O , Yiallourou A , Martinek L , Skrovina M , Szubota I , Žatecký J , Javurkova V , Klat J , Avlund T , Christensen P , Harbjerg JL , Iversen LH , Kjaer DW , Kristensen HØ , Mekhael M , Ebbehøj AL , Krarup P , Schlesinger N , Smith H , Abdelsamed A , Azzam AY , Salem H , Seleim A , Abdelmajeed A , Abdou M , Abosamak NE , AL Sayed M , Ashoush F , Atta R , Elazzazy E , Elhoseiny M , Elnemr M , Elqasabi MS , Elsayed Hewalla ME , Elsherbini I , Essam E , Eweda M , Ghallab I , Hassan E , Ibrahim M , Metwalli M , Mourad M , Qatora MS , Ragab M , Sabry A , Saifeldin H , Saleh Mesbah Mohamed Elkaffas M , Samih A , Samir Abdelaal A , Shehata S , Shenit K , Attia D , Kamal N , Osman N , Abbas AM , Abd Elazeem HAS , Abdelkarem MM , Alaa S , Ali AK , Ayman A , Azizeldine MG , Elkhayat H , M.elghazaly S , Monib FA , Nageh MA , Saad MM , Salah M , Shahine M , Yousof EA , Youssef A , Eldaly A , ElFiky M , Nabil A , Amira G , Sallam I , Sherief M , Sherif A , Abdelrahman A , Aboulkassem H , Ghaly G , Hamdy R , Morsi A , Salem H , Sherif G , Abdeldayem H , Abdelkader Salama I , Balabel M , Fayed Y , Sherif AE , Bekele D , Kauppila J , Sarjanoja E , Helminen O , Huhta H , Kauppila JH , Beyrne C , Jouffret L , Lugans L , Marie-Macron L , Chouillard E , De Simone B , Bettoni J , Dakpé S , Devauchelle B , Lavagen N , Testelin S , Boucher S , Breheret R , Gueutier A , Kahn A , Kün-Darbois J , Barrabe A , Lakkis Z , Louvrier A , Manfredelli S , Mathieu P , Chebaro A , Drubay V , El amrani M , Eveno C , Lecolle K , Legault G , Martin L , Piessen G , Pruvot FR , Truant S , Zerbib P , Ballouhey Q , Barrat B , Laloze J , Salle H , Taibi A , Usseglio J , Bergeat D , Merdrignac A , Le Roy B , Perotto LO , Scalabre A , Aimé A , Ezanno A , Malgras B , Bouche P , Tzedakis S , Cotte E , Glehen O , Kepenekian V , Lifante J , Passot G , D’Urso A , Felli E , Mutter D , Pessaux P , Seeliger B , Bardet J , Berry R , Boddaert G , Bonnet S , Brian E , Denet C , Fuks D , Gossot D , Grigoroiu M , Laforest A , Levy-Zauberman Y , Louis-Sylvestre C , Moumen A , Pourcher G , Seguin-givelet A , Tribillon E , Duchalais E , Espitalier F , Ferron C , Malard O , Bork U , Distler M , Fritzmann J , Kirchberg J , Praetorius C , Riediger C , Weitz J , Welsch T , Wimberger P , Beyer K , Kamphues C , Lauscher J , Loch FN , Schineis C , Albertsmeier M , Angele M , Kappenberger A , Niess H , Schiergens T , Werner J , Becker R , Jonescheit J , Pergolini I , Reim D , Boeker C , Hakami I , Mall J , Liokatis P , Smolka W , Nowak K , Reinhard T , Hölzle F , Modabber A , Winnand P , Knitschke M , Kauffmann P , Wolfer S , Kleeff J , Lorenz K , Michalski C , Ronellenfitsch U , Schneider R , Bertolani E , Königsrainer A , Löffler MW , Quante M , Steidle C , Überrück L , Yurttas C , Betz CS , Bewarder J , Böttcher A , Burg S , Busch C , Gosau M , Heuer A , Izbicki J , Klatte TO , Koenig D , Moeckelmann N , Nitschke C , Priemel M , Smeets R , Speth U , Thole S , Uzunoglu FG , Vollkommer T , Zeller N , Battista MJ , Gillen K , Hasenburg A , Krajnak S , Linz V , Schwab R , Angelou K , Haidopoulos D , Rodolakis A , Antonakis P , Bramis K , Chardalias L , Contis I , Dafnios N , Dellaportas D , Fragulidis G , Gklavas A , Konstadoulakis M , Memos N , Papaconstantinou I , Polydorou A , Theodosopoulos T , Vezakis A , Antonopoulou MI , Manatakis DK , Tasis N , Arkadopoulos N , Danias N , Economopoulou P , Kokoropoulos P , Larentzakis A , Michalopoulos N , Selmani J , Sidiropoulos T , Tsaousis V , Vassiliu P , Bouchagier K , Klimopoulos S , Paspaliari D , Stylianidis G , Baxevanidou K , Bouliaris K , Chatzikomnitsa P , Efthimiou M , Giaglaras A , Kalfountzos C , Koukoulis G , Ntziovara AM , Petropoulos K , Soulikia K , Tsiamalou I , Zervas K , Zourntou S , Baloyiannis I , Diamantis A , Gkrinia E , Hajiioannou J , Korais C , Koukoura O , Perivoliotis K , Saratziotis A , Skoulakis C , Symeonidis D , Tepetes K , Tzovaras G , Zacharoulis D , Alexoudi V , Antoniades K , Astreidis I , Christidis P , Deligiannidis D , Grivas T , Ioannidis O , Kalaitsidou I , Loutzidou L , Mantevas A , Michailidou D , Paraskevopoulos K , Politis S , Stavroglou A , Tatsis D , Tilaveridis I , Vahtsevanos K , Venetis G , Karaitianos I , Tsirlis T , Charalabopoulos A , Liakakos T , Mpaili E , Schizas D , Spartalis E , Syllaios A , Zografos C , Anthoulakis C , Christou C , Papadopoulos V , Tooulias A , Tsolakidis D , Tsoulfas G , Zouzoulas D , Athanasakis E , Chrysos E , Tsiaoussis J , Xenaki S , Xynos E , Futaba K , Ho MF , Hon SF , Mak TWC , Ng SSM , Foo CC , Banky B , Suszták N , Aremu M , Canas-Martinez A , Cullivan O , Murphy C , Owens P , Pickett L , Akmenkalne L , Byrne J , Corrigan M , Cullinane C , Daly A , Fleming C , Jordan P , Killeen S , Lynch N , McCarthy A , Mustafa H , O’Brien S , O’Leary P , Syed WAS , Vernon L , Callanan D , Huang L , Ionescu A , Sheahan P , Balasubramanian I , Boland M , Conlon K , Evoy D , Fearon N , Gallagher T , Geraghty J , Heneghan H , Kennedy N , Maguire D , McCartan D , McDermott EW , Prichard RS , Winter D , Alazawi D , Barry C , Boyle T , Butt W , Connolly EM , Donlon N , Donohue C , Fahey BA , Farrell R , Fitzgerald C , Kinsella J , Larkin JO , Lennon P , Maguire PJ , Mccormick P , Mehigan BJ , Mohan H , Nugent T , O’Sullivan H , Ravi N , Reynolds JV , Rogers A , Shokuhi P , Smith J , Smith LA , Timon C , Bashir Y , Bass G , Connelly T , Creavin B , Earley H , Elliott JA , Gillis A , Kavanagh D , Neary P , O’riordan J , Reynolds IS , Rice D , Ridgway P , Umair M , Whelan M , Carroll P , Collins C , Corless K , Finnegan L , Fowler A , Hogan A , Kerin M , Lowery A , McAnena P , McKevitt K , Nizami K , Ryan É , Samy A , Coffey JC , Cunningham R , Devine M , Nally D , Peirce C , Tormey S , Hardy N , Neary P , O’Malley S , Ryan M , Macina S , Mariani NM , Opocher E , Pisani Ceretti A , Ferrari F , Odicino F , Sartori E , Cotsoglou C , Granieri S , Bianco F , Camillo’ A , Colledan M , Tornese S , Zambelli MF , Bissolotti G , Fusetti S , Lemma F , Marino MV , Mirabella A , Vaccarella G , Agostini C , Alemanno G , Bartolini I , Bergamini C , Bruscino A , Checcucci C , De Vincenti R , Di Bella A , Fambrini M , Fortuna L , Maltinti G , Muiesan P , Petraglia F , Prosperi P , Ringressi MN , Risaliti M , Sorbi F , Taddei A , Tucci R , Bassi C , Bortolasi L , Campagnaro T , Casetti L , De Pastena M , Esposito A , Fontana M , Guglielmi A , Landoni L , Malleo G , Marchegiani G , Nobile S , Paiella S , Pedrazzani C , Rattizzato S , Ruzzenente A , Salvia R , Turri G , Tuveri M , Bellora P , D’Aloisio G , Ferrari M , Francone E , Gentilli S , Nikaj H , Bianchini M , Chiarugi M , Coccolini F , Di Franco G , Furbetta N , Gianardi D , Guadagni S , Morelli L , Palmeri M , Tartaglia D , Anania G , Carcoforo P , Chiozza M , De Troia A , Koleva Radica M , Portinari M , Sibilla MG , Urbani A , Fabbri N , Feo CV , Gennari S , Parini S , Righini E , Ampollini L , Bellanti L , Bergonzani M , Bertoli G , Bocchialini G , D’Angelo G , Lanfranco D , Musini L , Poli T , Santoro GP , Varazzani A , Aguzzoli L , Borgonovo G , Castro Ruiz C , Coiro S , Falco G , Mandato VD , Mastrofilippo V , Montella MT , Annessi V , Zizzo M , Grossi U , Novello S , Romano M , Rossi S , Zanus G , Esposito G , Frongia F , Pisanu A , Podda M , Belluco C , Lauretta A , Montori G , Moras L , Olivieri M , Bussu F , Carta AG , Cossu ML , Cottu P , Fancellu A , Feo CF , Ginesu GC , Giuliani G , Madonia M , Perra T , Piras A , Porcu A , Rizzo D , Scanu AM , Tedde A , Tedde M , Delrio P , Rega D , Badalamenti G , Campisi G , Cordova A , Franza M , Maniaci G , Rinaldi G , Toia F , Calabrò M , Farnesi F , Lunghi EG , Muratore A , Pipitone Federico NS , Bàmbina F , D’Andrea G , Familiari P , Picotti V , De Palma G , Luglio G , Pagano G , Tropeano FP , Baldari L , Beltramini GA , Boni L , Cassinotti E , Gianni’ A , Pignataro L , Torretta S , Abatini C , Baia M , Biasoni D , Bogani G , Cadenelli P , Capizzi V , Cioffi SPB , Citterio D , Comini LV , Cosimelli M , Fiore M , Folli S , Gennaro M , Giannini L , Gronchi A , Guaglio M , Macchi A , Martinelli F , Mazzaferro V , Mosca A , Pasquali S , Piazza C , Raspagliesi F , Rolli L , Salvioni R , Sarpietro G , Sarre C , Sorrentino L , Agnes A , Alfieri S , Belia F , Biondi A , Cozza V , D’Amore A , D’Ugo D , De Simone V , Fagotti A , Gasparini G , Gordini L , Litta F , Lombardi CP , Lorenzon L , Marra AA , Marzi F , Moro A , Parello A , Perrone E , Persiani R , Ratto C , Rosa F , Saponaro G , Scambia G , Scrima O , Sganga G , Tudisco R , Belli A , Granata V , Izzo F , Palaia R , Patrone R , Carrano FM , Carvello MM , De Virgilio A , Di Candido F , Ferreli F , Gaino F , Mercante G , Rossi V , Spinelli A , Spriano G , Donati DM , Frisoni T , Palmerini E , Aprile A , Barra F , Batistotti P , Ferrero S , Fregatti P , Scabini S , Sparavigna M , Asti E , Bernardi D , Bonavina L , Lovece A , Adamoli L , Ansarin M , Cenciarelli S , Chu F , De Berardinis R , Fumagalli Romario U , Mastrilli F , Pietrobon G , Tagliabue M , Badellino E , Ferrero A , Massobrio R , De Manzoni Garberini A , Federico P , Maida P , Marra E , Marte G , Petrillo A , Tammaro T , Tufo A , Berselli M , Borroni G , Cocozza E , Conti L , Desio M , Livraghi L , Quintodei V , Rizzi A , Zullo A , Baldi C , Corbellini C , Sampietro GM , Cellerino P , Baldini E , Capelli P , Conti L , Isolani SM , Ribolla M , Bondurri A , Colombo F , Ferrario L , Guerci C , Maffioli A , Armao T , Ballabio M , Bisagni P , Gagliano A , Longhi M , Madonini M , PizziCni P , Baietti AM , Biasini M , Maremonti P , Neri F , Prucher GM , Ricci S , Ruggiero F , Zarabini AG , Barmasse R , Mochet S , Morelli L , Usai A , Bianco F , Incollingo P , Mancini S , Marino Cosentino L , Sagnotta A , Fruscio R , Grassi T , Nespoli LC , Tamini N , Anastasi A , Bartalucci B , Bellacci A , Canonico G , Capezzuoli L , Di Martino C , Ipponi P , Linari C , Montelatici M , Nelli T , Spagni G , Tirloni L , Vitali A , Abate E , Casati M , Casiraghi T , Laface L , Schiavo M , Arminio A , Cotoia A , Lizzi V , Vovola F , Vergari R , D’Ugo S , Depalma N , Spampinato MG , Bartolucci P , Brachini G , Bruzzaniti P , Chiappini A , Chiarella V , Ciccarone F , Cicerchia PM , Cirillo B , De Toma G , Di bartolomeo A , Fiori E , Fonsi GB , Franco G , Frati A , Giugliano M , Iannone I , La Torre F , Lapolla P , Leonardo C , Marruzzo G , Meneghini S , Mingoli A , Ribuffo D , Salvati M , Santoro A , Sapienza P , Scafa AK , Simonelli L , Zambon M , Capolupo GT , Carannante F , Caricato M , Mascianà G , Mazzotta E , Gattolin A , Migliore M , Rimonda R , Sasia D , Travaglio E , Cervellera M , Gori A , Sartarelli L , Tonini V , Giacometti M , Zonta S , Chessa A , Fiorini A , Norcini C , Colletti G , Confalonieri M , Costanzi A , Frattaruolo C , Mari G , Monteleone M , Bandiera A , Bocciolone L , Bonavina G , Candiani M , Candotti G , De Nardi P , Gagliardi F , Medone M , Mortini P , Negri G , Parise P , Piloni M , Sileri P , Vignali A , Belvedere A , Bernante P , Bertoglio P , Boussedra S , Brunocilla E , Cipriani R , Cisternino G , De Crescenzo E , De Iaco P , Dondi G , Frio F , Jovine E , Mineo Bianchi F , Neri J , Parlanti D , Perrone AM , Pezzuto AP , Pignatti M , Pinto V , Poggioli G , Ravaioli M , Rottoli M , Schiavina R , Serenari M , Serra M , Solli P , Taffurelli M , Tanzanu M , Tesei M , Violante T , Zanotti S , Borghi F , Cianflocca D , Di Maria Grimaldi S , Donati D , Gelarda E , Geretto P , Giraudo G , Giuffrida MC , Marano A , Palagi S , Pellegrino L , Peluso C , Testa V , Agresta F , Prando D , Zese M , Aquila F , Gambacciani C , Lippa L , Pieri F , Santonocito OS , Armatura G , Bertelli G , Frena A , Marinello P , Notte F , Patauner S , Scotton G , Fulginiti SF , Gallo G , Sammarco G , Vescio G , Balercia P , Catarzi L , Consorti G , Di Marzo F , Fontana T , Daiko H , Ishikawa M , Ishiyama K , Iwata S , Kanematsu K , Kanemitsu Y , Kato T , Kawai A , Kobayashi E , Kobayashi Kato M , Moritani K , Nakatani F , Oguma J , Tanase Y , Uno M , Al Abdallah M , Ayasra F , Ayasra Y , Qasem A , Abu Za’nouneh FJ , Fahmawee T , Hmedat A , Ibrahim A , Obeidat K , Abdel Al S , Abdel Jalil R , Abou Chaar MK , Al-Masri M , Al-Najjar H , Alawneh F , Alsaraireh O , Elayyan M , Ghanem R , Lataifeh I , Alkadeeki GZ , Al Maadany FS , Aldokali N , Senossi O , Subhi MT , Burgan D , Kamoka E , Kilani AI , Salamah A , Salem M , Shuwayyah A , Abdulwahed E , Alshareea E , Aribi N , Aribi S , Biala M , Ghamgh R , Morgom M , Aldayri Z , Ellojli I , Kredan A , Bradulskis S , Dainius E , Kubiliute E , Kutkevičius J , Parseliunas A , Subocius A , Venskutonis D , Rasoaherinomenjanahary F , Razafindrahita JB , Samison LH , Ong EC , Hamdan 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Grotenhuis B , Hartveld L , Reijers S , Van Houdt W , Baaij J , Bolster-van Eenennaam M , De Graaff M , Sloothaak D , Van Duijvendijk P , Posma-Bouman L , Derksen T , Franken J , Oosterling S , De Bree R , Konsten J , Van Heinsbergen M , Fidelis L , Sholadoye TT , Tolani MA , Olaogun J , Egbuchulem IK , Lawal TA , Ogundoyin O , Olulana DI , Abdur-Rahman L , Adeyeye A , Aremu I , Bello J , Olasehinde O , Popoola A , Massoud J , Massoud R , Sorour TM , Jamal A , Kerawala AA , Memon AS , Nafees Ahmed R , Rai L , Ayub B , Hassan N , Martins RS , Ramesh P , Sayyed R , Butt U , Kashif M , Kashif M , Khan WH , Qureshi A , Umar M , Waris Farooka M , Wasim T , Ayubi A , Rashid I , Waqar SH , Falcon GM , Robles R , Jocson R , Teh C , Major P , Bobiński M , Kotarski J , Rasoul-Pelińska K , Azevedo C , Machado D , Mendes F , De Sousa X , Fernandes U , Ferreira C , Guidi G , Leal C , Marçal A , Marques R , Martins D , Melo A , Tenreiro N , Vaz Pereira R , Vieira B , Almeida JI , Correia de Sá T , 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Dunđerović D , Jelovac D , Jezdic Z , Konstantinovic V , Kotlar B , Kuzmanovic C , Lazić M , Petrovic M , Popovic F , Pucar A , Romic M , Sumrak S , Vujanac V , Bascarevic V , Bogdanović I , Grujičić D , Ilic R , Milićević M , Milisavljević F , Miljković A , Paunovic A , Šćepanović V , Stanimirovic A , Todorovic M , Jotic A , Milovanovic J , Trivic A , Bumbasirevic U , Dzamic Z , Kajmaković B , Prijović N , Zivkovic M , Buta M , Cvetkovic A , Djurisic I , Gacic S , Goran M , Inic Z , Jeftic N , Jevric M , Jokic V , Markovic I , Milanović M , Nikolic S , Pejnovic L , Savković N , Spurnic I , Stevic D , Stojiljkovic D , Vucic N , Zegarac M , Karamarkovic A , Kenic M , Kovacevic B , Krdzic I , Milutinović V , Chan CW , Lieske B , Gális B , Šimko K , Almgla N , Bernon M , Boutall A , Cairncross L , Herman A , Hilton T , Jonas E , Kloppers C , Malherbe F , Mugla W , Nel D , Rayamajhi S , Van Wyngaard T , Vogel J , Castaño-Leon AM , Delgado Fernandez J , Eiriz Fernandez C , Espino 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, Bravo Infante R , De Lacy FB , Di Somma A , Díaz-Feijoo B , Enseñat Nora J , Fabregas N , Ferrés A , Gil Ibañez B , Gonzalez Sanchez JJ , Gracia I , Hoyos Castro JA , Lacy AM , Langdon C , Momblán D , Morales X , Oleaga L , Otero A , Pedrosa L , Poblete Carrizo J , Reyes Figueroa LA , Roldan Ramos P , Rumia-Arboix J , Tercero-Uribe AI , Topczewski TE , Torales J , Torne A , Torné R , Turrado-Rodriguez V , Valero R , Valverde S , Anula R , Cano-Valderrama O , Del Campo Martín M , Díez-Valladares L , Domínguez I , Dziakova J , García Alonso M , García Romero E , Gómez Latorre L , Muguerza JM , Pizarro MJ , Saez Carlin P , Sánchez del Pueblo C , Sánchez-Pernaute A , Sanz Ortega G , Sanz-Lopez R , Torres A , Garcés-Albir M , Lopez F , Martín-Arévalo J , Moro-Valdezate D , Pla-Marti V , Beltrán de Heredia J , De Andrés Asenjo B , Gómez Sanz T , Jezieniecki C , Nuñez Del Barrio H , Ortiz de Solórzano Aurusa FJ , Romero de Diego A , Ruiz Soriano M , Trujillo Díaz J , Vazquez fernandez A , Lora-Cumplido P , Sosa MV , Gonzalez-Gonzalez E , Minaya Bravo AM , Alonso de la Fuente N , Cazador Labat M , Cecchini L , Espinosa CA , Jimenez Toscano M , López Campillo A , Mancebo G , Martorell P , Munarriz M , Grau-Talens EJ , Martin-Perez B , Benavides Buleje JA , Carrasco Prats M , Fernández PV , Fernández-López A , García Escudero D , García Porcel VJ , Garcia Soria V , Giménez Francés C , González Valverde FM , Gurrea E , López-Morales P , Marco Garrido A , Martínez Alonso JA , Medina E , Muñoz Camarena JM , Parra Baños PA , Peña Ros E , Ramirez Faraco M , Ruiz-Marín M , Sanchez Rodriguez C , Valero Soriano M , Estaire Gómez M , Fernández Camuñas Á , Garcia Santos EP , Jimenez Higuera E , Martínez-Pinedo C , Muñoz-Atienza V , Padilla-Valverde D , Picón Rodríguez R , Redondo Calvo FJ , Sánchez-García S , Sanchez-Pelaez D , Colombari RC , Del valle E , Fernández M , Lozano Lominchar P , Martín L , Rey Valcarcel C , Steiner MA , Tudela M , Zorrilla Ortúzar J , Alcaide Matas F , 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N , Frías L , García Pineda V , Gegúndez Simón A , Gortázar S , Gracia M , Guevara J , Hernández Gutierrez A , Loayza A , María Dolores DT , Martí C , Melendez M , Moreno-Palacios E , Perez Y , Prieto Nieto MI , Ramos-Martín P , Rubio-Perez I , Saavedra J , Sanchez-Mendez JI , Siegrist Ridruejo J , Urbieta A , Zapardiel I , Cantalejo diaz M , De Miguel Ardevines MDC , Duque-Mallén V , Gascon Ferrer I , González-Nicolás Trébol MT , Gracia-Roche C , Herrero Lopez M , Jariod Ferrer UM , Lanzon A , Martinez German A , Matute M , Redondo C , Sánchez Fuentes N , Sánchez-Rubio M , Santero-Ramirez MS , Saudí S , Simón Sanz MV , Uson-Bouthelier T , Blazquez Martin A , Diez Alonso M , García Rico E , Garcia-Loarte Gomez E , Garcia-Moreno Nisa F , Gutierrez Calvo A , Hernandez P , Lasa I , Mendoza-Moreno F , Morales Palacios N , Ovejero Merino E , Vera Mansilla C , Acebes García F , Bailón M , Bueno Cañones AD , Choolani Bhojwani E , Marcos-Santos P , Miguel T , Pacheco Sánchez D , Pérez-Saborido 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GD , Tan XS , Townson A , Tweedle E , Walker C , Waseem S , Yordanov S , Jones T , Kattakayam A , Loh C , Lunevicius R , Pringle S , Schache A , Shaw R , Sheel A , Rossborough C , Angelou D , Choynowski M , McAree B , McCanny A , Neely D , Tutoveanu G , Ahad S , De La Cruz Monroy MFI , Mosley F , Oktseloglou V , Alanbuki A , Patel M , Shabana A , Perera E , Raveendran D , Ravi-Shankar K , Thiruchelvam J , Arrowsmith L , Campbell W , Grove T , Kontovounisios C , Warren O , Rolland P , Aggarwal A , Brown S , Jelley C , Neal N , Clifford R , Eardley N , Krishnan E , Manu N , Martin E , Roy Mahapatra S , Serevina OL , Smith C , Vimalachandran D , Bordenave M , Houston R , Putnam G , Robson A , Tustin H , Emslie K , Labib PL , Marchbank A , Miller D , Minto G , Natale J , Nwinee H , Panahi P , Rogers L , Abubakar A , Akhter Rahman MM , Chan E , Ko KYK , O’Brien H , Sasapu K , Woodun H , Inglis R , Ng HJ , De Gea Rico A , Ghazali N , Lambert J , Markose G , Math S , Sarantitis I , Shrestha D , Sultana A , Taggarsi M , Timbrell S , Vaz OP , Vitone L , Day A , Dent H , Fahim M , Waheed S , Hunt A , Laskar N , Gupta A , Steinke J , Thrumurthy S , Massie E , McGivern K , Rutherford D , Wilson M , Hardie J , Kazzaz S , Handa S , Kaushal M , Kler A , Patel P , Redfern J , Tezas S , Aawsaj Y , Amonkar S , Barry C , Blackwell L , Blake D , Carter J , Emerson H , Fisher A , Katory M , Korompelis P , McCormick W , Mustafa A , Pearce L , Ratnavelu N , Reehal R , Kretzmer L , Lalou L , Manku B , Parwaiz I , Stafford J , Abdelkarim M , Asqalan A , Gala T , Ibrahim S , Maw A , Mithany R , Morgan R , Sundaram Venkatesan G , Ang K , Caruana EJ , Chowdhry MF , Mohammad A , Nakas A , Rathinam S , Boal M , Brown O , Dwerryhouse S , Higgs S , Vallance A , Boyd E , Irvine V , Kirk A , Bakolas G , Boulton A , Chandock A , Khan T , Kumar M , Agoston P , Billè A , Challacombe B , Fraser S , Harrison-Phipps K , King J , Mehra G , Mills L , Najdy M , Nath R , Okiror L , Pilling J , Rizzo V , Routledge T , Sayasneh A , Stroman L , Wali A , Fehervari M , Fotopoulou C , Habib N , Hamrang-Yousefi S , Jawad Z , Jiao L , Pai M , Ploski J , Rajagopal P , Saso S , Sodergren M , Spalding D , Laws S , Hardie C , McNaught C , Alam R , Budacan A , Cahill J , Kalkat M , Karandikar S , Kenyon L , Naumann D , Patel A , Ayorinde J , Chase T , Cuming T , Ghanbari A , Humphreys L , Tayeh S , Aboelkassem Ibrahim A , Bichoo R , Cao H , Chai AKW , Choudhury J , Evans C , Fitzjohn H , Ikram H , Langstroth M , Loubani M , McMillan A , Nazir S , Qadri SSA , Robinson A , Ross E , Sehgal T , Wilkins A , Dixon J , Dunning J , Freystaetter K , Jha M , Lester S , Madhavan A , Thulasiraman SV , Viswanath Y , Curl-Roper T , Delimpalta C , Liao CCL , Velchuru V , Westwood E , Belcher E , Bond-Smith G , Chidambaram S , Di Chiara F , Fasanmade K , Fraser L , Fu H , Ganau M , Gore S , Graystone J , Jeyaretna D , Khatkar H , Lami M , Maher M , Mastoridis S , Mihai R , Piper R , Prabhu S , Risk OBF , Selbong U , Shah K , Smillie R , Soleymani majd H , Sravanam S , Stavroulias D , Tebala GD , Vatish M , Verberne C , Wallwork K , Winter S , Bhatti MI , Boyd-Carson H , Elsey E , Gemmill E , Herrod P , Jibreel M , Lenzi E , Saafan T , Sapre D , Sian T , Watson N , Athanasiou A , Bourke G , Bradshaw L , Brunelli A , Burke J , Coe P , Costigan F , Elkadi H , Ho M , Johnstone J , Kanatas A , Kantola V , Kaufmann A , Laios A , Lam S , MacInnes E , Munot S , Nahm C , Otify M , Pompili C , Smith I , Theophilou G , Toogood G , Wade R , Ward D , West C , Annamalai S , Ashmore C , Boddy A , Hossain T , Kourdouli A , Gvaramadze A , Jibril A , Prusty L , Thekkinkattil D , Harky A , Shackcloth M , Askari A , Chan C , Cirocchi N , Kudchadkar S , Patel K , Sagar J , Shaw S , Talwar R , Abdalla M , Edmondson R , Ismail O , Jones D , Newton K , Stylianides N , Aderombi A , Andaleeb U , Bajomo O , Beatson K , Garrett W , Mehmood M , Ng V , Al-Habsi R , Divya GS , Keeler B , Al-Sarireh B , Egan R , Harries R , Henry A , Kittur M , Li Z , Parkins K , Soliman F , Spencer N , Thompson D , Burgess C , Gemmell C , Grieco C , Hollyman M , Hunt L , Morrison J , Ojha S , Ryan N , Abbadessa F , Barnard S , Chan C , Dawe N , Hammond J , Mahmoud Ali F , McPherson I , Mellor C , Moir J , Pandanaboyana S , Powell J , Rai B , Rogers A , Roy C , Sachdeva A , Saleh C , Tingle S , Williams T , Manickavasagam J , McDonald C , McGrath N , McSorley N , Ragupathy K , Ramsay L , Solth A , Kakisi O , Seebah K , Shaikh I , Sreedharan L , Youssef M , Shah J , Ameerally P , McLarty N , Mills S , Shenfine A , Sahnan K , Abu J , Addae-Boateng E , Bratt D , Brock L , Burnside N , Cadwell-Sneath S , Gajjar K , Gan C , Grundy C , Hallam K , Hassell K , Hawari M , Joshi A , Khout H , Konstantinidi K , Lee RXN , Nunns D , Schiemer R , Walton T , Weaver H , Whisker L , Williamson K , McVeigh J , Myatt R , Williams MA , Kaur R , Leung E , Sundar S , Michel M , Patil S , Ravindran S , Sarveswaran J , Scott L , Edmond M , King E , Almond M , Bhangu A , Breik O , Cato LD , Desai A , Ford S , Griffiths E , Idle M , Kamal M , Kisiel A , Kulkarni R , Mak JKC , Martin T , Nankivell P , Parente A , Parmar S , Pathanki AM , Phelan L , Praveen P , Saeed S , Sharma N , Singh J , Tirotta F , Vijayan D , Geddes A , McCaul J , McMahon J , Khan AH , Khan F , Mansuri A , Mukherjee S , Patel M , Sarigul M , Singh S , Tan KL , Woodham A , Adiamah A , Brewer H , Chowdhury A , Evans J , Humes D , Jackman J , Koh A , Lewis-Lloyd C , Oyende O , Reilly J , Worku D , Cool P , Cribb G , Shepherd K , Bisset C , Moug S , Elson N , Faulkner G , Saleh P , Underwood C , Brixton G , Findlay L , Klatte T , Majkowska A , Manson J , Potter R , Bhalla A , Chia Z , Daliya P , Goyal A , Grimley E , Hamad A , Kumar A , Malcolm FL , Theophilidou E , Bowden J , Campain N , Daniels I , Evans C , Fowler G , John J , Massey L , McDermott F , McGrath J , McLennan A , Ng M , Pascoe J , Rajaretnam N , Bulathsinhala S , Davidson B , Fusai G , Hidalgo Salinas C , Machairas N , Pissanou T , Pollok JM , Raptis DA , Soggiu F , Tzerbinis H , Xyda SE , Beamish A , Davies E , Foulkes R , Magowan D , Nassa H , Ooi R , Price C , Smith L , Solari F , Tang A , Williams G , Al-Tamimi Y , Bacon A , Beasley N , Chew D , Crank M , Ilenkovan N , Macdonald M , Narice B , Rominiyi O , Thompson A , Varley I , Drake T , Harrison E , Linder G , Mayes J , McGregor R , Skipworth R , Zamvar V , Davies E , Hawkin P , Raymond T , Ryska O , Baron R , Dunne D , Gahunia S , Halloran C , Howes N , McKinney R , McNicol F , Russ J , Szatmary P , Tan JR , Thomas A , Whelan P , Anzak A , Banerjee A , Fuwa O , Hughes F , Jayasinghe JD , Knowles C , Kocher H , Leal Silva I , Ledesma FS , Minicozzi A , Navaratne L , Rahman R , Ramamoorthy R , Sohrabi C , Thaha M , Thakur B , Venn M , Yip V , Baumber R , Parry J , Evans S , Jeys L , Morris G , Parry M , Stevenson J , Ahmadi N , Aresu G , Barrett-Brown ZM , Coonar AS , Durio Yates H , Gearon D , Hogan J , King M , Peryt A , Pradeep IS , Smith C , Adishesh M , Atherton R , Baxter K , Brocklehurst M , Chaudhury M , Krishnamohan N , McAleer J , Owens G , Parkin E , Patkar P , Phang I , Aladeojebi A , Ali M , Barmayehvar B , Gaunt A , Gowda M , Halliday E , Kitchen M , Mansour F , Thomas M , Zakai D , Abbassi-Ghadi N , Assalaarachchi H , Currie A , Flavin M , Frampton A , Hague M , Hammer C , Hopper J , Horsnell J , Humphries S , Kamocka A , Madhuri TK , Preston S , Singh P , Stebbing J , Tailor A , Walker D , Aljanadi F , Jones M , Mhandu P , O’Donnell C , Turkington R , Al-Ishaq Z , Bhasin S , Bodla AS , Burahee A , Crichton A , Fossett R , Pigadas N , Pickford S , Rahman E , Snee D , Vidya R , Yassin N , Colombo F , Fountain D , Hasan MT , Karabatsou K , Laurente R , Pathmanaban O , Al-mukhtar A , Brown S , Edwards J , Giblin A , Kelty C , Lee M , Lye G , Newman T , Sharkey A , Steele C , Sureshkumar Shah N , Whitehall E , Athwal R , Baker A , Jones L , Konstantinou C , Ramcharan S , Singh S , Vatish J , Wilkin R , Ethunandan M , Sekhon GK , Shields H , Singh R , Wensley F , Lawday S , Lyons A , Abbott T , Anwar S , Ghufoor K , Sohrabi C , Chung E , Hagger R , Hainsworth A , Karim A , Owen H , Ramwell A , Williams K , Baker C , Davies A , Gossage J , Kelly M , Knight W , Hall J , Harris G , James G , Kang C , Lin DJ , Rajgor AD , Royle T , Scurrah R , Steel B , Watson LJ , Choi D , Hutchison R , Jain A , Luoma V , Marcus H , May R , Menon A , Pramodana B , Webber L , Aneke IA , Asaad P , Brown B , Collis J , Duff S , Khan A , Moura F , Wadham B , Warburton H , Elmoslemany T , Jenkinson M , Millward C , Zakaria R , Mccluney S , Parmar C , Shah S , Allison J , Babar MS , Collard B , Goodrum S , Lau K , Patel A , Scott R , Thomas E , Whitmore H , Balasubramaniam D , Jayasankar B , Kapoor S , Ramachandran A , Elhamshary A , Imam SMB , Kapriniotis K , Kasivisvanathan V , Lindsay J , Rakhshani-Moghadam S , Beech N , Chand M , Green L , Kalavrezos N , Kiconco H , McEwen R , Schilling C , Sinha D , Pereca J , Singh J , Chopra S , Egbeare D , Thomas R , Combellack T , Jones SEF , Kornaszewska M , Mohammed M , Sharma A , Tahhan G , Valtzoglou V , Williams J , Eskander P , Gash K , Gourbault L , Hanna M , Maccabe T , Newton C , Olivier J , Rozwadowski S , Teh E , West D , Al-omishy H , Baig M , Bates H , Di Taranto G , Dickson K , Dunne N , Gill C , Howe D , Jeevan D , Khajuria A , Martin-Ucar AMcEvoy K , Naredla P , Ng V , Robertson S , Sait M , Sarma DR , Shanbhag S , Shortland T , Simmonds S , Skillman J , Tewari N , Walton G , Akhtar MA , Brunt A , McIntyre J , Milne K , Rashid MM , Sgrò A , Stewart KE , Turnbull A , Aguilar Gonzalez M , Talukder S , Boyle C , Fernando D , Gallagher K , Laird A , Tham D , Bath M , Patki P , Sohrabi C , Tanabalan C , Arif T , Magee C , Nambirajan T , Powell S , Vinayagam R , Flindall I , Hanson A , Mahendran V , Green S , Lim M , MacDonald L , Miu V , Onos L , Sheridan K , Young R , Alam F , Griffiths O , Houlden C , Jones R , Kolli VS , Lala AK , Leeson S , Peevor R , Seymour Z , Chen L , Henderson E , Loehrer A , Brown K , Fleming D , Haynes A , Heron C , Hill C , Kay H , Leede E , McElhinney K , Olson K , Osterberg EC , Riley C , Srikanth P , Thornhill M , Blazer D , DiLalla G , Hwang ES , Lee W , Lidsky M , Plichta J , Rosenberger L , Scheri R , Shah K , Turnage K , Visgauss J , Zani S , Farma J , Clark J , Kwon D , Etchill E , Gabre-Kidan AJenny HE , Kent A , Ladd M , Long C , Malapati H , Margalit A , Rapaport S , Rose J , Stevens K , Tsai L , Vervoort D , Yesantharao P , Dehal A , Klaristenfeld D , Huynh K , Brown L , Ganly I , Mullinax J , Gusani N , Hazelton J , Maines J , Oh JS , Ssentongo A , Ssentongo P , Azam M , Choudhry A , Marx W , Fleming J , Fuson A , Gigliotti J , Ovaitt A , Ying Y , Abel MK , Andaya V , Bigay K , Boeck MA , Chen L , Chern H , Corvera C , El-sayed I , Glencer A , Ha P , Hamilton BCS , Heaton C , Hirose K , Jablons DM , Kirkwood K , Kornblith LZ , Kratz JR , Lee R , Miller PN , Nakakura E , Nunez-Garcia B , O’Donnell R , Ozgediz D , Park P , Robinson B , Sarin A , Sheu B , Varma M , Wai K , Wustrack R , Xu MJ , Beswick D , Goddard J , Manor J , Song J , Fullmer T , Gaskill C , Gross N , Kiong K , Roland CL , Zafar SN , Abdallah M , Abouassi A , Almasri M , Kulkarni G , Marwan H , Mehdi M , Aoun S , Ban VS , Batjer HH , Caruso J , Abbott D , Acher A , Aiken T , Barrett J , Foley E , Schwartz P , Zafar SN , Hawkins A , Maiga A , Laufer J , Scasso S 
Published: October 2020

PURPOSE

As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway.

PATIENTS AND METHODS

This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation).

RESULTS

Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76).

CONCLUSION

Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks.