Impact of preoperative radiotherapy on patient-reported outcomes in rectal cancer
Corresponding Author
Robert Siegel
Colorectal Cancer Center, Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany
Correspondence
Robert Siegel, Division of Colorectal Surgery, Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
Email: [email protected]
Contribution: Conceptualization, Investigation, Writing - original draft, Writing - review & editing, Validation, Supervision
Search for more papers by this authorNora Tabea Sibert
Department of Health Services Research, German Cancer Society, Berlin, Germany
Oncological Health Services Research, Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Dusseldorf, Germany
Contribution: Conceptualization, Writing - original draft, Methodology, Validation, Writing - review & editing, Formal analysis, Supervision
Search for more papers by this authorClara Breidenbach
Department of Health Services Research, German Cancer Society, Berlin, Germany
Contribution: Writing - review & editing, Validation
Search for more papers by this authorCihan Gani
Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
Contribution: Writing - review & editing, Validation, Supervision
Search for more papers by this authorPhilipp Alexander Neumann
Department of Surgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Contribution: Investigation, Conceptualization, Writing - review & editing, Validation
Search for more papers by this authorStefan Rolf Benz
Department of Surgery, Sindelfingen-Böblingen Hospital, Böblingen, Germany
Contribution: Supervision, Validation, Investigation, Writing - review & editing
Search for more papers by this authorStefan Post
Universitätsmedizin Mannheim, Mannheim, Germany
Contribution: Investigation, Validation, Writing - review & editing, Supervision
Search for more papers by this authorThomas Seufferlein
Department of Internal Medicine I, University of Ulm, Ulm, Germany
Contribution: Supervision, Validation, Writing - review & editing, Investigation
Search for more papers by this authorVanessa Kolb
ClarData GmbH, Neu-Ulm, Germany
Contribution: Writing - review & editing, Software, Data curation
Search for more papers by this authorMatthias Behrend
Department of Visceral, Thoracic and Vascular Surgery, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorRichard David Blossey
Allgemein-, Viszeral- und Onkologische Chirurgie und Koloproktologie, Vinzenkrankenhaus Hannover, Hanover, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorJörg Bunse
Department of General and Visceral Surgery, Sana Hospital Lichtenberg, Berlin, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorMarc Dahlke
Department of Surgery, Robert-Bosch-Hospital, Stuttgart, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorRicarda Diller
Department of General and Visceral Surgery, Brüderkrankenhaus St. Josef Paderborn, Paderborn, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorNikos Emmanouilidis
General, Visceral, Thoracic and Minimalinvasive Surgery, St. Elisabeth Hospital Gütersloh, Gütersloh, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorThomas J. Ettrich
Department of Internal Medicine I, University of Ulm, Ulm, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorJörg Fahlke
General and Visceral Surgery, Johanniter Hospital Stendal, Stendal, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorSven Flemming
Department of General, Visceral, Transplantation, Vascular and Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorBjörn Freitag
Department of General and Visceral Surgery, St. Josef-Hospital, Bochum, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMartin Fuchs
Gastroenterology, Hepatology and Gastroenterological Oncology, München Klinik Bogenhausen, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorLars Haeder
Department of General and Visceral Surgery, Diakovere Henriettenstift, Hannover, Hanover, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorStephan Hollerbach
Department of Gastroenterology, Allgemeines Krankenhaus Celle, Celle, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJens Höppner
Department of Surgery, University Medical Center OWL – Campus Hospital LippeUniversity of Bielefeld, Detmold, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMia Kim
Clinic for Coloproctology, München Klinik Neuperlach, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristian Klink
Department of General and Visceral Surgery, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJürgen Knuth
Department of General, Visceral, Vascular and Thoracic Surgery, Hospital of Kempten, Kempten, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorStefan Koeppen
Clinic for Gastroenterology and Oncology, Helios Klinikum Hildesheim, Hildesheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJörg Köninger
Department of General, Visceral, Thorax and Transplantation Surgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorErnst Wolfgang Kolbe
University Clinic of General, Abdominal and Thoracic Surgery, Hospital of Herford, Herford, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorFlorian Kühn
Department of General, Visceral and Transplant Surgery, University Hospital of Munich, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorShueb Mussa
Department of General and Visceral Surgery, Ev. Diakonissenkrankenhaus Leipzig, Leipzig, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorRobert Oehring
Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Harzklinikum D.C. Erxleben, Quedlinburg, Germany
Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorSebastian Petzoldt
Clinic for General, Visceral and Minimally Invasive Surgery DRK Kliniken Berlin Köpenick, Berlin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorPompiliu Piso
Department of General and Visceral Surgery, Krankenhaus Barmherzige Brüder, Regensburg, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristian Prause
Department of Gastroenterology, Hepatology, Hematology, Oncology, Palliative Medicine, Helios Park-Klinikum Leipzig, Leipzig, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorChristian Prinz
Clinic for Gastroenterology – Hepatology – Diabetology – Endocrinology, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristoph Reißfelder
Department of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMaren Riechmann
Department for General, Visceral and Thoratic Surgery, Sana Klinikum Hof, Hof, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJörg-Peter Ritz
Department for General and Visceral Surgery, Helios Klinikum Schwerin, Schwerin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJens Rolinger
Department of General and Visceral Surgery, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorRobert Rosenberg
Department of General and Visceral Surgery, Kantonsspital Basel, Basel, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorHubert Scheuerlein
Clinic for General, Visceral and Pediatric Surgery, St. Vincenz Clinics Paderborn GmbH, Paderborn, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDustin Schilawa
Department of General and Visceral Surgery, Katholisches Krankenhaus Dortmund West, Dortmund, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorPaul Magnus Schneider
Centre for Surgery Zurich, Hirslanden Medical Center, Zurich, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorThilo Schwandner
Department of General and Visceral Surgery, Asklepios Klinik Lich, Lich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMarco Siech
Department of Surgery I, Ostalb Klinikum Aalen, Aalen, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDaniel Steinemann
Clarunis, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorOliver Stöltzing
Elblandklinikum Riesa, Zentrum für Allgemein- und Viszeralchirurgie Riesa-Meißen, Meissen, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorElke von Haeften
Clinic for Visceral, Thoracic and Vascular Surgery, Klinikum Heidenheim, Heidenheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDominik Weihs
Department of Surgery, Krankenhaus St. Veit/Glan, St. Veit/Glan, Austria
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorArmin Wiegering
Klinik für Allgemein, Viszeral, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt am Main, Goethe Universität Frankfurt am Main, Frankfurt am Main, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorChristina Barbara Zielinski
Westpfalz-Klinikum Kaiserslautern, Kaiserslautern, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristoph Kowalski
Department of Health Services Research, German Cancer Society, Berlin, Germany
Contribution: Conceptualization, Writing - original draft, Writing - review & editing, Validation, Supervision, Project administration
Search for more papers by this authorCorresponding Author
Robert Siegel
Colorectal Cancer Center, Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany
Correspondence
Robert Siegel, Division of Colorectal Surgery, Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
Email: [email protected]
Contribution: Conceptualization, Investigation, Writing - original draft, Writing - review & editing, Validation, Supervision
Search for more papers by this authorNora Tabea Sibert
Department of Health Services Research, German Cancer Society, Berlin, Germany
Oncological Health Services Research, Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Dusseldorf, Germany
Contribution: Conceptualization, Writing - original draft, Methodology, Validation, Writing - review & editing, Formal analysis, Supervision
Search for more papers by this authorClara Breidenbach
Department of Health Services Research, German Cancer Society, Berlin, Germany
Contribution: Writing - review & editing, Validation
Search for more papers by this authorCihan Gani
Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
Contribution: Writing - review & editing, Validation, Supervision
Search for more papers by this authorPhilipp Alexander Neumann
Department of Surgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Contribution: Investigation, Conceptualization, Writing - review & editing, Validation
Search for more papers by this authorStefan Rolf Benz
Department of Surgery, Sindelfingen-Böblingen Hospital, Böblingen, Germany
Contribution: Supervision, Validation, Investigation, Writing - review & editing
Search for more papers by this authorStefan Post
Universitätsmedizin Mannheim, Mannheim, Germany
Contribution: Investigation, Validation, Writing - review & editing, Supervision
Search for more papers by this authorThomas Seufferlein
Department of Internal Medicine I, University of Ulm, Ulm, Germany
Contribution: Supervision, Validation, Writing - review & editing, Investigation
Search for more papers by this authorVanessa Kolb
ClarData GmbH, Neu-Ulm, Germany
Contribution: Writing - review & editing, Software, Data curation
Search for more papers by this authorMatthias Behrend
Department of Visceral, Thoracic and Vascular Surgery, DONAUISAR Klinikum Deggendorf, Deggendorf, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorRichard David Blossey
Allgemein-, Viszeral- und Onkologische Chirurgie und Koloproktologie, Vinzenkrankenhaus Hannover, Hanover, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorJörg Bunse
Department of General and Visceral Surgery, Sana Hospital Lichtenberg, Berlin, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorMarc Dahlke
Department of Surgery, Robert-Bosch-Hospital, Stuttgart, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorRicarda Diller
Department of General and Visceral Surgery, Brüderkrankenhaus St. Josef Paderborn, Paderborn, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorNikos Emmanouilidis
General, Visceral, Thoracic and Minimalinvasive Surgery, St. Elisabeth Hospital Gütersloh, Gütersloh, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorThomas J. Ettrich
Department of Internal Medicine I, University of Ulm, Ulm, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorJörg Fahlke
General and Visceral Surgery, Johanniter Hospital Stendal, Stendal, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorSven Flemming
Department of General, Visceral, Transplantation, Vascular and Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorBjörn Freitag
Department of General and Visceral Surgery, St. Josef-Hospital, Bochum, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMartin Fuchs
Gastroenterology, Hepatology and Gastroenterological Oncology, München Klinik Bogenhausen, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorLars Haeder
Department of General and Visceral Surgery, Diakovere Henriettenstift, Hannover, Hanover, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorStephan Hollerbach
Department of Gastroenterology, Allgemeines Krankenhaus Celle, Celle, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJens Höppner
Department of Surgery, University Medical Center OWL – Campus Hospital LippeUniversity of Bielefeld, Detmold, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMia Kim
Clinic for Coloproctology, München Klinik Neuperlach, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristian Klink
Department of General and Visceral Surgery, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJürgen Knuth
Department of General, Visceral, Vascular and Thoracic Surgery, Hospital of Kempten, Kempten, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorStefan Koeppen
Clinic for Gastroenterology and Oncology, Helios Klinikum Hildesheim, Hildesheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJörg Köninger
Department of General, Visceral, Thorax and Transplantation Surgery, Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorErnst Wolfgang Kolbe
University Clinic of General, Abdominal and Thoracic Surgery, Hospital of Herford, Herford, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorFlorian Kühn
Department of General, Visceral and Transplant Surgery, University Hospital of Munich, Munich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorShueb Mussa
Department of General and Visceral Surgery, Ev. Diakonissenkrankenhaus Leipzig, Leipzig, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorRobert Oehring
Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Harzklinikum D.C. Erxleben, Quedlinburg, Germany
Department of Surgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum and Campus Charité Mitte, Berlin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorSebastian Petzoldt
Clinic for General, Visceral and Minimally Invasive Surgery DRK Kliniken Berlin Köpenick, Berlin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorPompiliu Piso
Department of General and Visceral Surgery, Krankenhaus Barmherzige Brüder, Regensburg, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristian Prause
Department of Gastroenterology, Hepatology, Hematology, Oncology, Palliative Medicine, Helios Park-Klinikum Leipzig, Leipzig, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorChristian Prinz
Clinic for Gastroenterology – Hepatology – Diabetology – Endocrinology, Helios Universitätsklinikum Wuppertal, Wuppertal, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristoph Reißfelder
Department of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMaren Riechmann
Department for General, Visceral and Thoratic Surgery, Sana Klinikum Hof, Hof, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJörg-Peter Ritz
Department for General and Visceral Surgery, Helios Klinikum Schwerin, Schwerin, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorJens Rolinger
Department of General and Visceral Surgery, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorRobert Rosenberg
Department of General and Visceral Surgery, Kantonsspital Basel, Basel, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorHubert Scheuerlein
Clinic for General, Visceral and Pediatric Surgery, St. Vincenz Clinics Paderborn GmbH, Paderborn, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDustin Schilawa
Department of General and Visceral Surgery, Katholisches Krankenhaus Dortmund West, Dortmund, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorPaul Magnus Schneider
Centre for Surgery Zurich, Hirslanden Medical Center, Zurich, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorThilo Schwandner
Department of General and Visceral Surgery, Asklepios Klinik Lich, Lich, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorMarco Siech
Department of Surgery I, Ostalb Klinikum Aalen, Aalen, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDaniel Steinemann
Clarunis, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorOliver Stöltzing
Elblandklinikum Riesa, Zentrum für Allgemein- und Viszeralchirurgie Riesa-Meißen, Meissen, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorElke von Haeften
Clinic for Visceral, Thoracic and Vascular Surgery, Klinikum Heidenheim, Heidenheim, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorDominik Weihs
Department of Surgery, Krankenhaus St. Veit/Glan, St. Veit/Glan, Austria
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorArmin Wiegering
Klinik für Allgemein, Viszeral, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt am Main, Goethe Universität Frankfurt am Main, Frankfurt am Main, Germany
Contribution: Writing - review & editing, Investigation
Search for more papers by this authorChristina Barbara Zielinski
Westpfalz-Klinikum Kaiserslautern, Kaiserslautern, Germany
Contribution: Investigation, Writing - review & editing
Search for more papers by this authorChristoph Kowalski
Department of Health Services Research, German Cancer Society, Berlin, Germany
Contribution: Conceptualization, Writing - original draft, Writing - review & editing, Validation, Supervision, Project administration
Search for more papers by this authorRobert Siegel and Nora Tabea Sibert have contributed equally to this manuscript and thus share first authorship.
Meeting presentation: Parts of the study results were presented at the 50th German Coloproctology Congress 2024.
Abstract
Aim
To prospectively evaluate the effect of preoperative radiotherapy followed by surgery versus surgery alone on patient-reported outcomes (PROs) 1 year after surgery.
Method
Prospective observational cohort study in 127 colorectal cancer centres. Patients with rectal cancer completed European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC-QLQ-C30) and Colorectal module (-CR29) questionnaires (thus providing PROs) before initialization of treatment [baseline (T0)] and at 12 months after surgery [follow up (T1)]. The PRO data together with sociodemographic information were linked to clinical data. Relevant confounders were identified using directed acyclic graphs. The effect of preoperative radiotherapy on selected PROs 12 months after surgery was estimated using adjusted tobit regression models.
Results
Of 1635 patients with rectal cancer for whom both baseline and follow-up PROs were available, 565 (35%) received preoperative radiotherapy. Twelve months after surgery, patients with surgery alone reported better scores for global health status/Quality of Life, urinary incontinence, faecal incontinence (patients without stoma), dyspareunia (female patients) and impotence (male patients) than did patients receiving preoperative radiotherapy. The statistically significant effects ranged between 33.20 (p < 0.001, R2 = 0.19) for impotence and 39.01 (p = 0.001, R2 = 0.10) for dyspareunia. For global health status/QoL and urinary incontinence, no statistically significant effect could be found.
Conclusion
Radiotherapy in addition to surgery negatively affects selected PROs 1 year after surgery in patients with rectal cancer. Compared with surgery alone, patients report profoundly impaired bowel and sexual function after preoperative radiotherapy. However, global health status/QoL was not affected statistically significantly. These results are an important argument for limiting preoperative radiotherapy to patients with a high risk of recurrence of rectal cancer and may facilitate informed decision-making.
Trial Registration
German Clinical Trial Registry Number DRKS00008724 (https://drks.de/search/de/trial/DRKS00008724).
CONFLICT OF INTEREST STATEMENT
Sibert, Kowalski and Breidenbach are employees of the German Cancer Society. Outside the submitted work, Siegel reports receiving travel support from Intuitive for robotic surgery. Bunse reports receiving payments from Coloplast for an educational event, as well as receiving support for travel and meetings from Intuitive for robotic surgery. Diller reports receiving payments for expert testimony from the Ärztkammer Westfalen Lippe. Ettrich reports receiving consultancy payments from MSD, Roche, Sanofi, BMS, AstraZeneca, Merck Serono, Sevier, Ipsen, AbbVie, Takeda, grants from Lilly and Servier, payments for lectures from Lilly and BMS, and travel expenses payments from Merck Serono. Flemming reports receiving consultancy payments from MyOn Care. Höppner reports receiving payments for lectures from Oncology News, China, and travel expenses payments from Intuitive Surgical. Neumann reports receiving payments for presentations/lectures from Johnson&Johnson and Dr. Falk Pharma International, support payments for attending meetings from Johnson & Johnson and payment for participating at advisory boards from Johnson&Johnson and Takeda. Ritz reports receiving payments for lectures from Intuitive Surgery and Medtronic. All other authors have nothing to declare.
Open Research
DATA AVAILABILITY STATEMENT
For legal reasons, patient-specific data cannot be shared. Aggregated data can be requested from Nora Tabea Sibert ([email protected]).
Supporting Information
| Filename | Description |
|---|---|
| codi70158-sup-0001-AppendixS1.docxWord 2007 document , 13.4 KB |
Appendix S1. |
| codi70158-sup-0002-AppendixS2.docxWord 2007 document , 25.9 KB |
Appendix S2. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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