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  1. Article ; Online: Trends and variation in treatment of early breast cancer in European certified breast centres: an EUSOMA-based analysis.

    van Walle, Lien / Verhoeven, Didier / Marotti, Lorenza / Ponti, Antonio / Tomatis, Mariano / Rubio, Isabel T

    European journal of cancer (Oxford, England : 1990)

    2023  Volume 192, Page(s) 113244

    Abstract: Background: Practice indicators (PI) measure provided care making use of real-world data. This study describes trends and variations in adjuvant treatment of early breast cancer (EBC) using the European Society of Breast Cancer Specialists (EUSOMA) ... ...

    Abstract Background: Practice indicators (PI) measure provided care making use of real-world data. This study describes trends and variations in adjuvant treatment of early breast cancer (EBC) using the European Society of Breast Cancer Specialists (EUSOMA) database.
    Methods: The analysis was conducted on anonymous cumulative data registered by 56 certified breast centres, which all entered at least 500 new diagnoses in the database in the 10-year period 2010-2019. Practice trends of radiotherapy, endocrine treatment, chemotherapy, and anti-HER2 therapy were evaluated. The association with age group (<50, 50-69, ≥70) and geographical area of the centre (Northern, Central, Southern Europe; NE, CE, SE) was assessed with the Pearson Chi
    Results: In total, 150,150 patients with EBC were selected. Overall, radiotherapy was administered more frequently in NE centres, and conversely, endocrine, chemo-, and anti-HER2 therapy were used more frequently in SE centres (p<0.001). 46.9% of the pN1 patients received postmastectomy radiotherapy, with significant differences by age and geographical region (p < 0.001). Adjuvant endocrine treatment for endocrine-sensitive carcinoma in situ was administered in 46.1%, with a decreasing trend during the study period (58.5-34.5%; p < 0.001). Anti-HER2 therapy was delivered in 75.6% of all patients with HER2BC T1a/bN0, patients older than 70 received anti-HER2 in 67.6% in SE compared to 31.3% in NE centres.
    Conclusion: Important variations in EBC management between European certified breast centres have been demonstrated. PI using real-world data can help to monitor, evaluate, and eventually guide and align good clinical practice in the management of breast cancer.
    MeSH term(s) Humans ; Female ; Breast Neoplasms/therapy ; Mastectomy ; Breast ; Adjuvants, Immunologic ; Carcinoma in Situ
    Chemical Substances Adjuvants, Immunologic
    Language English
    Publishing date 2023-07-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 82061-1
    ISSN 1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
    ISSN (online) 1879-0852
    ISSN 0277-5379 ; 0959-8049 ; 0964-1947
    DOI 10.1016/j.ejca.2023.113244
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  2. Article ; Online: Highly specialized Breast Centers did not experience delay of care during COVID-19 pandemic in Italy: the Senonetwork experience.

    Losurdo, Agnese / Lisa, Andrea Vittorio Emanuele / Tomatis, Mariano / Ponti, Antonio / Montemezzi, Stefania / Bonzano, Elisabetta / Fortunato, Lucio

    Breast cancer research and treatment

    2022  Volume 196, Issue 1, Page(s) 87–95

    Abstract: Aim of the study: The study aims to evaluate the performance of selected, high-volume, highly specialized, Italian Breast Centers at the time of COVID-19 pandemic (year 2020), compared to pre-pandemic time (year 2019), highlighting differences in terms ... ...

    Abstract Aim of the study: The study aims to evaluate the performance of selected, high-volume, highly specialized, Italian Breast Centers at the time of COVID-19 pandemic (year 2020), compared to pre-pandemic time (year 2019), highlighting differences in terms of clinical presentation of breast cancer (BC) and therapeutic strategies.
    Methods: Patients' data were provided by the Senonetwork data warehouse Senonet. In order to examine changes in the surgical and oncological management of BC patients during different phases of COVID-19 pandemic, we took advantage of a selection quality indicators (QIs). We performed the analyses in two time-frames, from July to September (Jul-Sep) (2019 versus 2020) and from October to December (Oct-Dec) (2019 versus 2020).
    Results: Our analysis did not show any statistically significant difference in terms of diagnosis, surgical, oncological and radiation therapy procedures between the two trimesters 2019 and 2020. Nevertheless, we observed statistically significant differences, favoring 2020, when analyzing time-to surgery and time-to radiotherapy. On the other hand, we observed a significant reduction of neoadjuvant chemotherapy and we did not recollect any data on a major use of neoadjuvant endocrine therapy.
    Conclusions: In Italian Breast Centers, partners of Senonetwork, we could not observe any treatment delay or change in standard clinical practice for BC care during the 2020 pandemic year, compared to 2019 pre-pandemic year. This finding is in contrast with the globally reported decrease in the performance of the Italian Breast Centers due to the COVID-19 pandemic, and has to be linked to the sharp selection of Senonetwork Breast Centers.
    MeSH term(s) Breast ; Breast Neoplasms/diagnosis ; Breast Neoplasms/epidemiology ; Breast Neoplasms/therapy ; COVID-19/epidemiology ; Female ; Humans ; Italy/epidemiology ; Neoadjuvant Therapy ; Pandemics
    Language English
    Publishing date 2022-08-26
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 604563-7
    ISSN 1573-7217 ; 0167-6806
    ISSN (online) 1573-7217
    ISSN 0167-6806
    DOI 10.1007/s10549-022-06694-1
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  3. Article ; Online: Treatment and outcomes in breast cancer patients: A cross section study from the EUSOMA breast centre network.

    Aristei, Cynthia / Tomatis, Mariano / Antonio Ponti / Marotti, Lorenza / Cardoso, Maria Joao / Cheung, Kwok Leung / Curigliano, Giuseppe / De Vries, Jakob / Santini, Donatella / Sardanelli, Francesco / Van Dam, Peter / Rubio, Isabel Teresa

    European journal of cancer (Oxford, England : 1990)

    2023  Volume 196, Page(s) 113438

    Abstract: Introduction: The present study was designed to describe tumour features and treatments for patients with breast cancer. It also aimed at assessing the risk of distant metastases in relation to biological profiles, disease stages and treatment.: ... ...

    Abstract Introduction: The present study was designed to describe tumour features and treatments for patients with breast cancer. It also aimed at assessing the risk of distant metastases in relation to biological profiles, disease stages and treatment.
    Methods: Data were analysed from 81,882 patients in the EUSOMA database (disease stages at diagnosis 0-IV; median age 61 years; range 20-100 years). All patients were treated between January 2016 and December 2021 in 53 Breast Centres within the EUSOMA certification process in 13 European countries. Cases were classified as HR+ /HER2-, HR+ /HER2 + , HR-/HER2 + or HR-/HER2- and data were analysed accordingly.
    Results: Univariable and multivariable analyses for distant metastases were conducted on a subset of 38,119 cases with information on whether or not they had developed them. Potential determinants included sub-group type, Ki67 value, disease stage, adjuvant systemic therapies and post-operative radiation therapy. In multivariable analysis, the HR-/HER2 + and HR-/HER2- sub-groups were associated with a higher risk of distant metastases than HR+ /HER2-. Ki67 > 20 % and advanced stage disease also carried a high risk. Radiation therapy emerged as a protective factor against distant metastases.
    Conclusions: Present results show a large patient database offers an information stream that can be applied to reduce uncertainties in clinical practice. Database parameters need to be updated dynamically for outcome monitoring. Molecular prognostic factors, gene-expression signatures, tumour-infiltrating lymphocytes and circulating tumoral DNA should be added.
    MeSH term(s) Humans ; Middle Aged ; Female ; Breast Neoplasms/drug therapy ; Ki-67 Antigen ; Receptor, ErbB-2 ; Combined Modality Therapy ; Treatment Outcome ; Prognosis
    Chemical Substances Ki-67 Antigen ; Receptor, ErbB-2 (EC 2.7.10.1)
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 82061-1
    ISSN 1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
    ISSN (online) 1879-0852
    ISSN 0277-5379 ; 0959-8049 ; 0964-1947
    DOI 10.1016/j.ejca.2023.113438
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  4. Article: Molecularly Targeted Therapies for Gastric Cancer. State of the Art.

    Reddavid, Rossella / Dagatti, Simona / Franco, Caterina / Puca, Lucia / Tomatis, Mariano / Corso, Simona / Giordano, Silvia / Degiuli, Maurizio

    Cancers

    2021  Volume 13, Issue 16

    Abstract: Many phase III trials failed to demonstrate a survival benefit from the addition of molecular therapy to conventional chemotherapy for advanced and metastatic gastric cancer, and only three agents were approved by the FDA. We examined the efficacy and ... ...

    Abstract Many phase III trials failed to demonstrate a survival benefit from the addition of molecular therapy to conventional chemotherapy for advanced and metastatic gastric cancer, and only three agents were approved by the FDA. We examined the efficacy and safety of novel drugs recently investigated. PubMed, Embase and Cochrane Library were searched for phase III randomized controlled trials published from January 2016 to December 2020. Patients in the experimental arm received molecular therapy with or without conventional chemotherapy, while those in the control arm had conventional chemotherapy alone. The primary outcomes were overall and progression-free survival. The secondary outcomes were the rate of tumor response, severe adverse effects, and quality of life. Eight studies with a total of 4223 enrolled patients were included. The overall and progression-free survival of molecular and conventional therapy were comparable. Most of these trials did not find a significant difference in tumor response rate and in the number of severe adverse effects and related deaths between the experimental and control arms. The survival benefits of molecular therapies available to date for advanced and metastatic gastric cancer are rather unclear, mostly due to inaccurate patient selection, particularly concerning oncogene amplification and copy number.
    Language English
    Publishing date 2021-08-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13164094
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  5. Article ; Online: The impact of the SARS-COV-2 pandemic on the quality of breast cancer care in EUSOMA-certified breast centres.

    van Dam, Peter / Tomatis, Mariano / Ponti, Antonio / Marotti, Lorenza / Aristei, Cynthia / Biganzoli, Laura / Cardoso, Maria J / Cheung, Kwok L / Curigliano, Giuseppe / De Vries, Jakob / Santini, Donatella / Sardanelli, Francesco / Rubio, Isabel Teresa

    European journal of cancer (Oxford, England : 1990)

    2022  Volume 177, Page(s) 72–79

    Abstract: Aims: We analysed the impact of the SARS-CoV-2 pandemic (COVID-19) on the quality of breast cancer care in certified EUSOMA (European Society of Breast Cancer Specialists) breast centres.: Materials and methods: The results of the EUSOMA quality ... ...

    Abstract Aims: We analysed the impact of the SARS-CoV-2 pandemic (COVID-19) on the quality of breast cancer care in certified EUSOMA (European Society of Breast Cancer Specialists) breast centres.
    Materials and methods: The results of the EUSOMA quality indicators were compared, based on pseudonymised individual records, for the periods 1 March 2020 till 30 June 2020 (first COVID-19 peak in most countries in Europe) and 1 March 2019 till 30 June 2019. In addition, a questionnaire was sent to the participating Centres for investigating the impact of the COVID-19 pandemic on the organisation and the quality of breast cancer care.
    Results: Forty-five centres provided data and 31 (67%) responded to the questionnaire. The total number of new cases dropped by 19% and there was a small significant higher tumour (p = 0.003) and lymph node (p = 0.011) stage at presentation. Comparing quality indicators (12,736 patients) by multivariable analysis showed mostly non-significant differences. Surgery could be performed in a COVID-free zone in 94% of the centres, COVID testing was performed before surgery in 96% of the centres, and surgical case load was reduced in 55% of the centres. Modifications of the indications for neoadjuvant endocrine therapy, chemotherapy, and targeted therapy were necessary in 23%, 23%, and 10% of the centres; changes in indications for adjuvant endocrine, chemo-, targeted, immune, and radiotherapy in 3%, 19%, 3%, 6%, and 10%, respectively.
    Conclusion: Quality of breast cancer care was well maintained in EUSOMA breast centres during the first wave of the COVID-19 pandemic. A small but significantly higher tumour and lymph node stage at presentation was observed.
    MeSH term(s) Humans ; Female ; Pandemics ; SARS-CoV-2 ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/therapy ; Breast Neoplasms/pathology ; COVID-19 ; COVID-19 Testing
    Language English
    Publishing date 2022-10-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 82061-1
    ISSN 1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
    ISSN (online) 1879-0852
    ISSN 0277-5379 ; 0959-8049 ; 0964-1947
    DOI 10.1016/j.ejca.2022.09.027
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  6. Article ; Online: Trends in axillary lymph node dissection for early-stage breast cancer in Europe: Impact of evidence on practice.

    Garcia-Etienne, Carlos A / Mansel, Robert E / Tomatis, Mariano / Heil, Joerg / Biganzoli, Laura / Ferrari, Alberta / Marotti, Lorenza / Sgarella, Adele / Ponti, Antonio

    Breast (Edinburgh, Scotland)

    2019  Volume 45, Page(s) 89–96

    Abstract: Background: Data from recently published trials have provided practice-changing recommendations for the surgical approach to the axilla in breast cancer. Patients with T1-2 lesions, treated with breast conservation, who have not received neoadjuvant ... ...

    Abstract Background: Data from recently published trials have provided practice-changing recommendations for the surgical approach to the axilla in breast cancer. Patients with T1-2 lesions, treated with breast conservation, who have not received neoadjuvant chemotherapy and have 1-2 positive sentinel nodes (Z0011-criteria) may avoid axillary lymph node dissection (ALND). We aim to describe the dissemination of this practice in Europe over an extended period of time.
    Methods: Our source of data was the eusomaDB, a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists (EUSOMA). We identified cases fulfilling Z0011-criteria from 2005 to 2016 from 34 European breast centers and report trends in ALND. Data derived from Germany, Italy, Belgium, Switzerland, Austria, and Netherlands.
    Results: 6671 patients fulfilled Z0011-criteria. Rates of ALND showed a statistically significant decrease from 2010 (89%) to 2011 (73%), reaching 46% in 2016 (p < 0.001). After multivariable analysis, factors associated with higher probability of ALND were earlier year of surgery, younger age, increasing tumor size and grade, and being operated in Italy (p < 0.001). The minimum and maximal rates of ALND in the most recent two-year period (2015-2016) were 0% and 83% in two centers located in different countries (p < 0.001).
    Conclusion: Our study demonstrates, a decrease in rates of ALND that started after year 2010 through the end of the study period. Wide differences were observed among centers and countries indicating the need to spread unified clinical guidelines in Europe to allow for homogeneous evidence-based practice patterns.
    MeSH term(s) Adult ; Aged ; Axilla ; Breast/pathology ; Breast Neoplasms/pathology ; Breast Neoplasms/surgery ; Europe ; Female ; Humans ; Lymph Node Excision/trends ; Lymph Nodes/pathology ; Lymph Nodes/surgery ; Middle Aged ; Practice Patterns, Physicians'/trends
    Language English
    Publishing date 2019-03-11
    Publishing country Netherlands
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 1143210-x
    ISSN 1532-3080 ; 0960-9776
    ISSN (online) 1532-3080
    ISSN 0960-9776
    DOI 10.1016/j.breast.2019.03.002
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  7. Article ; Online: Response to the author: invitation to cancer screening: putting the car before the horse?

    Vale, Diama B / Anttila, Ahti / Ponti, Antonio / Senore, Carlo / Sankaranaryanan, Rengaswamy / Ronco, Guglielmo / Segnan, Nereo / Tomatis, Mariano / Žakelj, Maja P / Elfström, Klara M / Lönnberg, Stefan / Dillner, Joakim / Basu, Partha

    European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)

    2019  Volume 28, Issue 5, Page(s) 458–459

    MeSH term(s) Animals ; Automobiles ; Colorectal Neoplasms ; Early Detection of Cancer ; European Union ; Horses ; Mass Screening
    Language English
    Publishing date 2019-08-05
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1137033-6
    ISSN 1473-5709 ; 0959-8278
    ISSN (online) 1473-5709
    ISSN 0959-8278
    DOI 10.1097/CEJ.0000000000000474
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    Zs.A 3621: Show issues Location:
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  8. Article ; Online: Low-grade screen-detected ductal carcinoma in situ progresses more slowly than high-grade lesions: evidence from an international multi-centre study.

    Ponti, Antonio / Ronco, Guglielmo / Lynge, Elsebeth / Tomatis, Mariano / Anttila, Ahti / Ascunce, Nieves / Broeders, Mireille / Bulliard, Jean-Luc / Castellano, Isabella / Fitzpatrick, Patricia / Frigerio, Alfonso / Hofvind, Solveig / Májek, Ondřej / Segnan, Nereo / Taplin, Stephen

    Breast cancer research and treatment

    2019  Volume 177, Issue 3, Page(s) 761–765

    Abstract: Purpose: Nuclear grade is an important indicator of the biological behaviour of ductal carcinoma in situ (DCIS). De-escalation of treatment has been suggested for low-grade DCIS. Our aim is to estimate the relative rate of progression of DCIS by nuclear ...

    Abstract Purpose: Nuclear grade is an important indicator of the biological behaviour of ductal carcinoma in situ (DCIS). De-escalation of treatment has been suggested for low-grade DCIS. Our aim is to estimate the relative rate of progression of DCIS by nuclear grade by analysing the distribution of nuclear grade by detection at initial or subsequent screening.
    Methods: We asked International Cancer Screening Network sites to complete, based on their screening and clinical databases, an aggregated data file on DCIS detection, diagnosis and treatment.
    Results: Eleven screening programs reported 5068 screen-detected pure DCIS in nearly 7 million screening tests in women 50-69 years of age. For all programs combined, low-grade DCIS were 20.1% (range 11.4-31.8%) of graded DCIS, intermediate grade 31.0% and high grade 48.9%. Detection rates decreased more steeply from initial to subsequent screening in low compared to high-grade DCIS: the ratios of subsequent to initial detection rates were 0.39 for low grade, 0.51 for intermediate grade, and 0.75 for high grade (p < 0.001).
    Conclusions: These results suggest that the duration of the preclinical detectable phase is longer for low than for high-grade DCIS. The findings from this large multi-centre, international study emphasize that the management of low-grade DCIS should be carefully scrutinized in order to minimize overtreatment of screen-detected slow-growing or indolent lesions. The high variation by site in the proportion of low grade suggests that further pathology standardization and training would be beneficial.
    MeSH term(s) Aged ; Breast Neoplasms/diagnosis ; Breast Neoplasms/epidemiology ; Carcinoma, Intraductal, Noninfiltrating/diagnosis ; Carcinoma, Intraductal, Noninfiltrating/epidemiology ; Disease Progression ; Early Detection of Cancer ; Female ; Humans ; Mass Screening ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; United States/epidemiology
    Language English
    Publishing date 2019-06-28
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study
    ZDB-ID 604563-7
    ISSN 1573-7217 ; 0167-6806
    ISSN (online) 1573-7217
    ISSN 0167-6806
    DOI 10.1007/s10549-019-05333-6
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  9. Article ; Online: Performance indicators in breast cancer screening in the European Union: A comparison across countries of screen positivity and detection rates.

    Armaroli, Paola / Riggi, Emilia / Basu, Partha / Anttila, Ahti / Ponti, Antonio / Carvalho, Andre L / Dillner, Joakim / Elfström, Miriam K / Giordano, Livia / Lönnberg, Stefan / Ronco, Gugliemo / Senore, Carlo / Soerjomataram, Isabelle / Tomatis, Mariano / Vale, Diama B / Jarm, Katja / Sankaranarayanan, Rengaswamy / Segnan, Nereo

    International journal of cancer

    2020  Volume 147, Issue 7, Page(s) 1855–1863

    Abstract: Comparable performance indicators for breast cancer screening in the European Union (EU) have not been previously reported. We estimated adjusted breast cancer screening positivity rate (PR) and detection rates (DR) to investigate variation across EU ... ...

    Abstract Comparable performance indicators for breast cancer screening in the European Union (EU) have not been previously reported. We estimated adjusted breast cancer screening positivity rate (PR) and detection rates (DR) to investigate variation across EU countries. For the age 50-69 years, the adjusted EU-pooled PR for initial screening was 8.9% (cross-programme variation range 3.2-19.5%) while DR of invasive cancers was 5.3/1,000 (range 3.8-7.4/1,000) and DR of ductal carcinoma in situ (DCIS) was 1.3/1,000 (range 0.7-2.7/1,000). For subsequent screening, the adjusted EU-pooled PR was 3.6% (range 1.4-8.4%), the DR was 4.0/1,000 (range 2.2-5.8/1,000) and 0.8/1,000 (range 0.5-1.3/1,000) for invasive and DCIS, respectively. Adjusted performance indicators showed remarkable heterogeneity, likely due to different background breast cancer risk and awareness between target populations, and also different screening protocols and organisation. Periodic reporting of the screening indicators permits comparison and evaluation of the screening activities between and within countries aiming to improve the quality and the outcomes of screening programmes. Cancer Screening Registries would be a milestone in this direction and EU Screening Reports provide a fundamental contribution to building them.
    MeSH term(s) Aged ; Breast Neoplasms/diagnosis ; Early Detection of Cancer/methods ; European Union/organization & administration ; Female ; Humans ; Middle Aged ; Predictive Value of Tests ; Quality Indicators, Health Care
    Language English
    Publishing date 2020-03-23
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 218257-9
    ISSN 1097-0215 ; 0020-7136
    ISSN (online) 1097-0215
    ISSN 0020-7136
    DOI 10.1002/ijc.32968
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    Zs.MO 576: Show issues

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  10. Article ; Online: Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): A nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group.

    Degiuli, Maurizio / Elmore, Ugo / De Luca, Raffaele / De Nardi, Paola / Tomatis, Mariano / Biondi, Alberto / Persiani, Roberto / Solaini, Leonardo / Rizzo, Gianluca / Soriero, Domenico / Cianflocca, Desiree / Milone, Marco / Turri, Giulia / Rega, Daniela / Delrio, Paolo / Pedrazzani, Corrado / De Palma, Giovanni D / Borghi, Felice / Scabini, Stefano /
    Coco, Claudio / Cavaliere, Davide / Simone, Michele / Rosati, Riccardo / Reddavid, Rossella

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2021  Volume 24, Issue 3, Page(s) 264–276

    Abstract: Aim: Anastomotic leakage after restorative surgery for rectal cancer shows high morbidity and related mortality. Identification of risk factors could change operative planning, with indications for stoma construction. This retrospective multicentre ... ...

    Abstract Aim: Anastomotic leakage after restorative surgery for rectal cancer shows high morbidity and related mortality. Identification of risk factors could change operative planning, with indications for stoma construction. This retrospective multicentre study aims to assess the anastomotic leak rate, identify the independent risk factors and develop a clinical prediction model to calculate the probability of leakage.
    Methods: The study used data from 24 Italian referral centres of the Colorectal Cancer Network of the Italian Society of Surgical Oncology. Patients were classified into two groups, AL (anastomotic leak) or NoAL (no anastomotic leak). The effect of patient-, disease-, treatment- and postoperative outcome-related factors on anastomotic leak after univariable and multivariable analysis was measured.
    Results: A total of 5398 patients were included, 552 in group AL and 4846 in group NoAL. The overall incidence of leaks was 10.2%, with a mean time interval of 6.8 days. The 30-day leak-related mortality was 2.6%. Sex, body mass index, tumour location, type of approach, number of cartridges employed, weight loss, clinical T stage and combined multiorgan resection were identified as independent risk factors. The stoma did not reduce the leak rate but significantly decreased leak severity and reoperation rate. A nomogram with a risk score (RALAR score) was developed to predict anastomotic leak risk at the end of resection.
    Conclusions: While a defunctioning stoma did not affect the leak risk, it significantly reduced its severity. Surgeons should recognize independent risk factors for leaks at the end of rectal resection and could calculate a risk score to select high-risk patients eligible for protective stoma construction.
    MeSH term(s) Anastomosis, Surgical/adverse effects ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Humans ; Models, Statistical ; Prognosis ; Rare Diseases ; Rectal Neoplasms/complications ; Retrospective Studies ; Risk Factors ; Surgical Oncology
    Language English
    Publishing date 2021-12-06
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15997
    Database MEDical Literature Analysis and Retrieval System OnLINE

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