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Colorectal Neoplasms MalignantCOVID-CRCNCT04712292

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

An observational study of Colorectal Neoplasms Malignant, run by University of Bologna at 45 sites in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

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. Read more about this study

Who is it for?
Any age
Conditions the study is for
Colorectal Neoplasms Malignant
What is being tested?
Surgical procedure for confirmed or suspected colorectal cancer
Type of treatment
Surgery or procedure
How many people
15,000 participants
Where
45 sitesItaly
Study dates
8 Sep 2020to 1 Apr 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: The study will include all adult patients undergoing elective or urgent surgery for proven or suspected colorectal within the study periods

Who may be able to join

  • 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

Who cannot join

  • 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

Trial locations and contacts

45 sites in 1 country.

Matteo Rottoli, MD, PhD contact

+390512145262

matteo.rottoli2@unibo.it

45 sites in 1 country

Italy45 sites, 45 recruiting
  • AOU Policlinico di Bari "M. Rubino"

    Bari

    Gennaro Martines, MD, gerrymartines@virgilio.it

    Recruiting
  • Policlinico di Bari

    Bari

    Leonardo Vincenti, MD, dr.leonardo.vincenti@gmail.com

    Recruiting
  • Humanitas Gavazzeni Hospital

    Bergamo

    Giovanni Dapri, MD, giovanni@dapri.net

    Recruiting
  • Policlinico San Marco

    Bergamo

    Stefano Olmi, MD, stefano.olmi@gmail.com

    Recruiting
  • Maggiore Hospital

    Bologna, 40100

    Elio Jovine, MD, elio.jovine@ausl.bologna.it

    Recruiting
  • Fondazione Poliambulanza

    Brescia

    Moh'd Abu Hilal, MD, mohd.abuhilal@poliambulanza.it

    Recruiting
  • Spedali Civili

    Brescia

    Nazario Portolani, MD, nazario.portolani@unibs.it

    Recruiting
  • Spedali Civili

    Brescia

    Giusto Pignata, MD, giusto.pignata@gmail.com

    Recruiting
  • Santissima Trinità Hospital

    Cagliari

    Nicola Cillara, MD, ncillara@gmail.com

    Recruiting
  • Vittorio Emanuele III Hospital

    Carate Brianza

    Letizia Laface, MD, lafaceletizia@gmail.com

    Recruiting
  • San Paolo Hospital

    Civitavecchia

    Pasquale Lepiane, MD, pasquale.lepiane@aslroma4.it

    Recruiting
  • AUSL Romagna Ravenna-Faenza

    Faenza

    Giampaolo Ugolini, MD, g.ugolini@unibo.it

    Recruiting
  • San Giovanni di Dio Hospital

    Florence

    Giuseppe Canonico, MD, giuseppe.canonico@uslcentro.toscana.it

    Recruiting
  • Gardone Val Trompia Hospital

    Gardone Val Trompia

    Maurizio Ronconi, MD, maurizio.ronconi@asst-spedalicivili.it

    Recruiting
  • ASST FBF Sacco Hospital

    Milan, 20100

    Piergiorgio Danelli, MD, piergiorgio.danelli@unimi.it

    Recruiting
  • San Raffaele Hospital

    Milan, 20100

    Riccardo Rosati, MD, rosati.riccardo@hsr.it

    Recruiting
  • ASST Santi Paolo e Carlo Hospital

    Milan

    Enrico Opocher, MD, enrico.opocher@unimi.it

    Recruiting
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Milano

    Milan

    Luigi Boni, MD, luigi.boni@unimi.it

    Recruiting
  • Istituto Nazionale dei Tumori

    Milan

    Maurizio Cosimelli, MD, mcosimelli@libero.it

    Recruiting
  • Mirano Hospital

    Mirano

    Corrado Da Lio, MD, corrado.dalio@aulss3.veneto.it

    Recruiting
  • AORN Cardarelli

    Naples

    Antonio Castaldi, MD, antonio.castaldi@icloud.com

    Recruiting
  • Università della Campania Luigi Vanvitelli

    Naples

    Gianluca Pellino, MD, gianluca.pellino@unicampania.it

    Recruiting
  • Padova University Hospital

    Padova

    Salvatore Pucciarelli, MD, puc@unipd.it

    Recruiting
  • Veneto Institute of Oncology IOV-IRCCS

    Padova

    Pierluigi Pilati, MD, pierluigi.pilati@iov.veneto.it

    Recruiting
  • Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello

    Palermo

    Marco V Marino, MD, Marco.Vito.marino@gmail.com

    Recruiting
  • AOU Parma

    Parma

    Mario Giuffrida, MD, mario.giuffrida4@gmail.com

    Recruiting
  • San Matteo Hospital

    Pavia

    Andrea Pietrabissa, MD, andrea.pietrabissa@gmail.com

    Recruiting
  • Pederzoli Hospital

    Peschiera del Garda

    Harmony Impellizzeri, MD, harmony85@hotmail.it

    Recruiting
  • Azienda Sanitaria Fiuli Occidentale

    Pordenone

    Stefano MM Basso, MD, drsteba@gmail.com

    Recruiting
  • Rho Memorial Hospital

    Rho, Milan

    Gianluca Sampietro, MD, gianluca.sampietro@unimi.it

    Recruiting
  • Ceccarini Hospital

    Riccione

    Andrea Lucchi, MD, andrea.lucchi@auslromagna.it

    Recruiting
  • Infermi Hospital

    Rimini

    Gianluca Garulli, MD, gianluca.garulli@auslromagna.it

    Recruiting
  • Campus Biomedico

    Roma

    Gabriella T Capolupo, MD, g.capolupo@unicampus.it

    Recruiting
  • Fondazione Policlinico Roma Tor Vergata

    Roma

    Giuseppe Sica, MD, sigisica@gmail.com

    Recruiting
  • Fondazione Policlinico Universitario Agostino Gemelli IRCCS

    Roma

    Carlo Ratto, MD, carloratto@tiscali.it

    Recruiting
  • San Filippo Neri Hospital

    Roma

    Biagio Picardi, MD, biagiopicardi@gmail.com

    Recruiting
  • Sant'Eugenio Hospital

    Roma

    Massimo Carlini, MD, massimo.carlini@aslroma2.it

    Recruiting
  • UOSD Tor Vergata

    Roma

    Michela Campanelli, MD, michelacampanelli@live.it

    Recruiting
  • Humanitas Research Center

    Rozzano, Milan, 40100

    Antonino Spinelli, MD, antonino.spinelli@humanitas.it

    Recruiting
  • AOU Sassari

    Sassari

    Alberto Porcu, MD, alberto.porcu.1@gmail.com

    Recruiting
  • Regional Hospital Treviso

    Treviso

    Ugo Grossi, MD, ugo.grossi@aulss2.veneto.it

    Recruiting
  • University Hospital of Trieste

    Trieste

    Nicolò De Manzini, MD, ndemanzini@units.it

    Recruiting
  • AOU Città della Salute e della Scienza

    Turin

    Mario Morino, MD, mario.morino@unito.it

    Recruiting
  • Mauriziano Hospital

    Turin

    Alessandro Ferrero, MD, aferrero@mauriziano.it

    Recruiting
  • ASST Vimercate

    Vimercate

    Alice Frontali, MD, frontalice@gmail.com

    Recruiting

Other trials in Italy

About this study

Official title: Effects of the COVID-19 Pandemic on the Diagnosis, Treatment and Outcomes of Patients Affected by Colorectal Cancer Requiring Surgery: Results From a National Multicentre Cohort Study

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.

Read the detailed description

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.

Being tested
Surgical procedure for confirmed or suspected colorectal cancer
Keywords
colorectal cancer, diagnosis, screening, COVID-19, surgery, outcomes
Medical subject headings
Colonic Neoplasms, Colorectal Neoplasms, Disease, COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Surgical procedure for confirmed or suspected colorectal cancerProcedure or surgery

    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)
Study groups in NCT04712292
Study groupRoleWhat they receive
Study groupPatients undergoing surgery for confirmed or suspected colorectal cancer between January 2020 and December 2021
Receives: Procedure: Surgical procedure for confirmed or suspected colorectal cancer
Control groupPatients undergoing surgery for confirmed or suspected colorectal cancer between January 2018 and December 2019
Receives: Procedure: Surgical procedure for confirmed or suspected colorectal cancer

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Oncologic stage

    The stage will be reported at the histological examination according to TNM classification

    Measured: 30 days from the surgery

  2. 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

    Measured: at time 0 (surgery)

  3. Rate of radical surgery

    Surgery is defined radical according to the absence of cancer (R0) at the surgical margins on the histological specimen

    Measured: 30 days from surgery

Secondary outcomes (8)
  1. 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.

    Measured: 30 days from the surgery

  2. 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

    Measured: At time 0 (surgery)

  3. Liver metastases

    Rate of single/multiple liver metastases

    Measured: At the preoperative staging or at surgery (time 0)

  4. Lung metastases

    Rate of single/multiple lung metastases

    Measured: At the preoperative staging or at surgery (time 0)

  5. Associated symptoms

    Rate of patients who had a diagnosis of cancer without any associated symptoms - as sign of effectiveness of the screening

    Measured: Before surgery

  6. Emergency surgery

    rate of operations requiring surgery within 48 hours from the unpredicted admission to hospital

    Measured: surgery (time 0)

  7. Postoperative complications

    Rate of 30-day complications graded according to the Clavien-Dindo Classification

    Measured: 30 days from surgery

  8. Mortality

    Rate of 30-day deaths

    Measured: 30 days from surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jan 2021
  2. Study start8 Sep 2020
  3. Primary completion15 Feb 2022 (estimated)
  4. Study completion1 Apr 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Retrospective
Enrolment
15,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04712292
Sponsor's protocol ID
854/2020/Oss/AOUBo
Acronym
COVID-CRC
Status last verified
Feb 2022
First submitted
13 Jan 2021
Last updated
28 Feb 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • 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.

    PubMed 33097915
  • 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.

    PubMed 32986516
  • 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.

    PubMed 32675512
  • 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.

    PubMed 33339569
  • 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.

    PubMed 32203977

Questions about this trial

What is this clinical trial studying?

An observational study of Colorectal Neoplasms Malignant, run by University of Bologna at 45 sites in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Matteo Rottoli, MD, PhD (+390512145262, matteo.rottoli2@unibo.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Oncologic stage (time frame: 30 days from the surgery). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04712292, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Feb 2022.

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