Author: "Fredrik, Klevebro" - Searchworks@Jio Institute Digital Library Search Results

94 results on '"Fredrik, Klevebro"'

1. Postoperative complications after esophagectomy for cancer, neoadjuvant chemoradiotherapy compared to neoadjuvant chemotherapy: A single institutional cohort study

Author: Halla Sif Ólafsdóttir, Emmy Dalqvist, Eva Onjukka, Fredrik Klevebro, Magnus Nilsson, Giovanna Gagliardi, and Gabriella Alexandersson von Döbeln
Subjects: Esophageal neoplasm, Radiotherapy, Adverse effects, Postoperative complications, Esophagectomy, Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Background: Complications after esophagectomy are common and the possible increase in postoperative complications associated with neoadjuvant chemoradiotherapy is of concern. The aim of our study was to analyze if the addition of radiotherapy to neoadjuvant chemotherapy increases the incidence and severity of postoperative complications, including evaluation of the relation between radiation doses to the heart and lungs and postoperative complications. Methods: The study was based on an institutional surgical database for esophageal cancer. The study period was October 2008 to March 2020. Patients treated with neoadjuvant chemoradiotherapy were compared to patients treated with neoadjuvant chemotherapy and dose/volume parameters for the lungs and heart considered. The primary outcome was 30-day postoperative complications. Results: During the study period, 274 patients underwent surgery for esophageal cancer, 93 patients after neoadjuvant chemotherapy and 181 patients after neoadjuvant chemoradiotherapy. The median prescribed radiation dose to the planning target volume was 41.4 Gy, the median of the mean lung dose was 6.2 Gy, and the median of the mean heart dose was 20.3 Gy. The addition of radiotherapy to neoadjuvant chemotherapy did not increase the incidence of postoperative complications. Neither were radiation doses to the lungs and heart associated with postoperative complications. Taxane-based chemotherapy regimens were however associated with an increased incidence of postoperative complications. Conclusions: In our cohort, the addition of neoadjuvant radiotherapy to chemotherapy was not associated with postoperative complications. However, taxane-based chemotherapy regimens, with or without concomitant radiotherapy, were associated with postoperative complications.
Published: 2023
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2. Partial stomach-partitioning gastrojejunostomy for gastric outlet obstruction: A cohort study based on consecutive case series from a single center

Author: Biying Huang, Berit Sunde, Andrianos Tsekrekos, Masaru Hayami, Ioannis Rouvelas, Magnus Nilsson, Mats Lindblad, and Fredrik Klevebro
Subjects: Gastric outlet obstruction, Modified Devine exclusion, Partial stomach-partitioning gastrojejunostomy, Upper gastrointestinal cancer, Surgery, RD1-811
Abstract: Summary: Background/objective: Gastric outlet obstruction can have a large impact on quality of life for patients with upper gastrointestinal cancer or benign obstruction. Partial stomach-partitioning gastrojejunostomy has previously shown promising outcomes compared to conventional gastrojejunostomy in terms of reduced delayed gastric emptying. The objective of the current study was to present outcomes of partial stomach-partitioning gastrojejunostomy in a single high-volume center for upper gastrointestinal cancer. Methods: A retrospective cohort study including all consecutive patients who underwent partial stomach-partitioning gastrojejunostomy from 2013 to 2020. The primary outcome was oral intake tolerance. A subgroup analysis was performed in all patients with manifest gastric outlet obstruction comparing partial stomach-partitioning gastrojejunostomy to conventional gastrojejunostomy. Results: Partial stomach-partitioning gastrojejunostomy was performed in 32 patients and laparoscopic technique was used in 19 patients (59%). The procedure improved oral intake tolerance defined by gastric outlet obstruction scoring system by 0.63 points on average (P = 0.041). No postoperative complications related to the procedure were observed. Recurrence of gastric outlet obstruction developed in six patients (19%), four patients (13%) required endoscopic reintervention but no patient required surgical reintervention. A comparison between partial stomach-partitioning gastrojejunostomy and conventional gastrojejunostomy showed no statistically significant differences regarding postoperative nutritional status, length of hospital stay, recurrence or reintervention. Conclusion: The results of the study show that partial stomach-partitioning gastrojejunostomy can be an effective surgical treatment for patients suffering from gastric outlet obstruction and that the procedure can be safely performed with laparoscopic technique.
Published: 2022
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3. Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study

Author: Halla Sif Ólafsdóttir, Fredrik Klevebro, Nelson Ndegwa, and Gabriella Alexandersson von Döbeln
Subjects: Oesophageal neoplasm, Palliative care, Radiotherapy, Dose fractionation, Dysphagia, Medical physics. Medical radiology. Nuclear medicine, R895-920, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Common symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules. Methods We conducted a retrospective cohort study on palliative radiotherapy for oesophageal cancer given at Karolinska University Hospital. Patients included were treated with either short-course (20 Gy in 4 Gy fractions daily, 5 consecutive workdays) or long-course (30–39 Gy in 3 Gy fractions, 10–13 consecutive workdays) palliative external beam radiotherapy between January 2009 and December 2013. The primary endpoint was dysphagia relief and secondary endpoints were adverse events, re-interventions, and overall survival. Cox regression analyses were used to estimate the effect of treatment schedule on survival. Results A total of 128 patients received external beam radiotherapy under the study period, of these 75 (58.6%) received short-course radiotherapy and 53 (41.4%) long-course radiotherapy. Sixteen (30.8%) patients experienced dysphagia relief after short-course radiotherapy and 9 (22.0%) patients after long-course radiotherapy (p = 0.341). Acute toxicity was less frequent after short-course radiotherapy than after long-course radiotherapy, particularly oesophagitis (35.4% vs. 56.0%, p = 0.027) and nausea/emesis (18.5% vs. 36.0% p = 0.034). Re-interventions tended to be more common after short-course radiotherapy (32.0%) than after long-course radiotherapy (18.9%) (p = 0.098). There was no difference in overall survival between the two groups. Conclusions Short- and long-course palliative radiotherapy for oesophageal cancer were equally effective to relieve dysphagia and no difference was seen in overall survival. Acute toxicity was, however, more frequent and more severe after long-course radiotherapy. Our results suggest that short-course radiotherapy is better tolerated with equal palliative effects as long-course radiotherapy.
Published: 2021
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4. Minimally invasive surgical techniques for oesophageal cancer and nutritional recovery: a prospective population-based cohort study

Author: Joonas H Kauppila, Asif Johar, Kalle Mälberg, Pernilla Lagergren, Helen Rosenlund, Fredrik Klevebro, and Poorna Anandavadivelan
Subjects: Medicine
Abstract: Objectives To explore whether the minimally invasive oesophagectomy (MIE) or hybrid minimally invasive oesophagectomy (HMIE) are associated with better nutritional status and less weight loss 1 year after surgery, compared with open oesophagectomy (OE).Design Prospective cohort study.Setting All patients undergoing oesophagectomy for cancer in Sweden during 2013–2018.Participants A total of 424 patients alive at 1 year after surgery were eligible, and 281 completed the 1-year assessment. Of these, 239 had complete clinical data and were included in the analysis.Primary and secondary outcome measures The primary outcome was nutritional status at 1 year after surgery, assessed using the abbreviated Patient-Generated Subjective Global Assessment questionnaire. The secondary outcomes included postoperative weight loss at 6 months and 1 year after surgery.Results Of the included patients, 78 underwent MIE, 74 HMIE while 87 patients underwent OE. The MIE group had the highest prevalence of malnutrition (42% vs 22% after HMIE vs 25% after OE), reduced food intake (63% vs 45% after HMIE vs 39% after OE), symptoms reducing food intake (60% vs 45% after HMIE vs 60% after OE) and abnormal activities/function (45% vs 32% after HMIE vs 43% after OE). After adjustment for confounders, MIE was associated with a statistically significant increased risk of reduced food intake 1 year after surgery (OR 2.87, 95% CI 1.47 to 5.61), compared with OE. Other outcomes were not statistically significantly different between the groups. No statistically significant associations were observed between surgical techniques and weight loss up to 1 year after surgery.Conclusions MIE was statistically significantly associated with reduced food intake 1 year after surgery. However, no differences were observed in weight loss between the surgical techniques. Further studies on nutritional impact of surgical techniques in oesophageal cancer are needed.
Published: 2022
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5. Neoadjuvant Chemoradiotherapy and Surgery for Esophageal Squamous Cell Carcinoma Versus Definitive Chemoradiotherapy With Salvage Surgery as Needed: The Study Protocol for the Randomized Controlled NEEDS Trial

Author: Magnus Nilsson, Halla Olafsdottir, Gabriella Alexandersson von Döbeln, Fernanda Villegas, Giovanna Gagliardi, Mats Hellström, Qiao-Li Wang, Hemming Johansson, Val Gebski, Jakob Hedberg, Fredrik Klevebro, Sheraz Markar, Elizabeth Smyth, Pernilla Lagergren, Ghazwan Al-Haidari, Lars Cato Rekstad, Eirik Kjus Aahlin, Bengt Wallner, David Edholm, Jan Johansson, Eva Szabo, John V. Reynolds, CS Pramesh, Naveen Mummudi, Amit Joshi, Lorenzo Ferri, Rebecca KS Wong, Chris O’Callaghan, Jelena Lukovic, Kelvin KW Chan, Trevor Leong, Andrew Barbour, Mark Smithers, Yin Li, Xiaozheng Kang, Feng-Ming Kong, Yin-Kai Chao, Tom Crosby, Christiane Bruns, Hanneke van Laarhoven, Mark van Berge Henegouwen, Richard van Hillegersberg, Riccardo Rosati, Guillaume Piessen, Giovanni de Manzoni, and Florian Lordick
Subjects: esophageal squamous cell carcinoma, neoadjuvant chemoradiotherapy, definitive chemoradiotherapy, locoregional surveillance, salvage esophagectomy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: BackgroundThe globally dominant treatment with curative intent for locally advanced esophageal squamous cell carcinoma (ESCC) is neoadjuvant chemoradiotherapy (nCRT) with subsequent esophagectomy. This multimodal treatment leads to around 60% overall 5-year survival, yet with impaired post-surgical quality of life. Observational studies indicate that curatively intended chemoradiotherapy, so-called definitive chemoradiotherapy (dCRT) followed by surveillance of the primary tumor site and regional lymph node stations and surgery only when needed to ensure local tumor control, may lead to similar survival as nCRT with surgery, but with considerably less impairment of quality of life. This trial aims to demonstrate that dCRT, with selectively performed salvage esophagectomy only when needed to achieve locoregional tumor control, is non-inferior regarding overall survival, and superior regarding health-related quality of life (HRQOL), compared to nCRT followed by mandatory surgery, in patients with operable, locally advanced ESCC.MethodsThis is a pragmatic open-label, randomized controlled phase III, multicenter trial with non-inferiority design with regard to the primary endpoint overall survival and a superiority hypothesis for the experimental intervention dCRT with regard to the main secondary endpoint global HRQOL one year after randomization. The control intervention is nCRT followed by preplanned surgery and the experimental intervention is dCRT followed by surveillance and salvage esophagectomy only when needed to secure local tumor control. A target sample size of 1200 randomized patients is planned in order to reach 462 events (deaths) during follow-up.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT04460352.
Published: 2022
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6. Implementation of minimally invasive gastrectomy for gastric cancer in a western tertiary referral center

Author: Andrianos Tsekrekos, Tania Triantafyllou, Fredrik Klevebro, Masaru Hayami, Mats Lindblad, Magnus Nilsson, Lars Lundell, and Ioannis Rouvelas
Subjects: Gastric cancer, Minimally invasive surgery, Laparoscopic gastrectomy, Surgery, RD1-811
Abstract: Abstract Background Minimally invasive techniques have gradually come to take a leading position in the surgical treatment of gastrointestinal malignancies. In order to define an effective process for the implementation of similar techniques in the treatment of gastric cancer, patient caseload represents a pivotal factor for education and training, but is a prerequisite not fulfilled in most Western countries. Additionally, as opposed to the East, a variety of additional factors such as the usually advanced stage of the disease and differences in patient characteristics are prevailing and raise further obstacles. Hereby we report a strategy for a safe and effective process for the implementation of laparoscopic gastric cancer surgery in a Western tertiary referral center. Methods The present study describes the stepwise implementation of laparoscopic gastrectomy for the treatment of gastric cancer at a tertiary referral center, comprising the time period 2012–2019. This process was facilitated by a close collaboration with two high-volume centers in Japan, as well as exchanging fellowships and observerships between the Karolinska University Hospital and other European centers. From the initially strict selection of cases for laparoscopic surgery, laparoscopic gastrectomy has gradually become the preferred approach also in patients with locally advanced tumors. Results From January 1st 2010 until December 31st 2019, 249 patients were operated for gastric cancer, of whom 141 (56.6%) had an open and 108 (43.4%) a laparoscopic procedure. In the latter group, total gastrectomy was performed in 33.3% of the patients. While blood loss, operation time and length of stay decreased during the first years after implementation, these variables increased slightly during the last years of the study period, probably due to the higher proportion of advanced gastric cancer cases, as well as the higher rate of laparoscopic total gastrectomy with more extended lymphadenectomy. Conclusions Laparoscopic surgery is currently a valid therapeutic option for gastric cancer, which has expanded to also embrace total gastrectomy and locally advanced tumors. Collaboration between centers in the East and West, centralization to high-volume centers and application of enhanced recovery protocols are essential components in the implementation and further refinement of minimally invasive gastrectomy.
Published: 2020
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7. Risk factors for acute kidney injury after pancreatoduodenectomy, and association with postoperative complications and death

Author: Oskar Swartling, Marie Evans, Patrik Larsson, Stefan Gilg, Marcus Holmberg, Fredrik Klevebro, Matthias Löhr, Ernesto Sparrelid, and Poya Ghorbani
Subjects: Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology
Published: 2023

8. Improved survival after laparoscopic compared to open gastrectomy for advanced gastric cancer: a Swedish population-based cohort study

Author: Andrianos Tsekrekos, Laura E. Vossen, Lars Lundell, Martin Jeremiasen, Erik Johnsson, Jakob Hedberg, David Edholm, Fredrik Klevebro, Magnus Nilsson, and Ioannis Rouvelas
Subjects: Cancer och onkologi, Cancer Research, Oncology, Cancer and Oncology, Gastroenterology, General Medicine, Advanced gastric cancer, Laparoscopic gastrectomy, Minimally invasive surgery, Survival
Abstract: Background Laparoscopic gastrectomy is increasingly used for the treatment of locally advanced gastric cancer but concerns remain whether similar results can be obtained compared to open gastrectomy, especially in Western populations. This study compared the short-term postoperative, oncological and survival outcomes following laparoscopic versus open gastrectomy based on data from the Swedish National Register for Esophageal and Gastric Cancer. Methods Patients who underwent surgery with curative intent for adenocarcinoma of the stomach or gastroesophageal junction Siewert type III from 2015 to 2020 were identified, and 622 patients with cT2-4aN0-3M0 tumors were included. The impact of surgical approach on short-term outcomes was assessed using multivariable logistic regression. Long-term survival was compared using multivariable Cox regression. Results In total, 350 patients underwent open and 272 laparoscopic gastrectomy, of which 12.9% were converted to open surgery. The groups were similar regarding distribution of clinical disease stage (27.6% stage I, 46.0% stage II, and 26.4% stage III). Neoadjuvant chemotherapy was administered to 52.7% of the patients. There was no difference in the rate of postoperative complications, but laparoscopic approach was associated with lower 90 day mortality (1.8 vs 4.9%, p = 0.043). The median number of resected lymph nodes was higher after laparoscopic surgery (32 vs 26, p p Conclusions Laparoscopic gastrectomy can be safely preformed for advanced gastric cancer and is associated with improved overall survival compared to open surgery.
Published: 2023

9. Influence of postoperative complications following esophagectomy for cancer on quality of life: A European multicenter study

Author: N. Schuring, E. Jezerskyte, M.I. van Berge Henegouwen, M.A.G. Sprangers, P. Lagergren, A. Johar, S.R. Markar, S.S. Gisbertz, Sheraz R. Markar, Giovanni Zaninotto, Carlo Castoro, Asif Johar, Pernilla Lagergren, Jessie A. Elliott, Suzanne S. Gisbertz, Christophe Mariette, Rita Alfieri, Jeremy Huddy, Viknesh Sounderajah, Eleonora Pinto, Marco Scarpa, Fredrik Klevebro, Berit Sunde, Conor F. Murphy, Christine Greene, Narayanasamy Ravi, Guillaume Piessen, Hylke Brenkman, Jelle P. Ruurda, Richard Van Hillegersberg, Sjoerd Lagarde, Bas Wijnhoven, Manuel Pera, José Roig, Sandra Castro, Robert Matthijsen, John Findlay, Stefan Antonowicz, Nick Maynard, Orla McCormack, Arun Ariyarathenam, Grant Sanders, Edward Cheong, Shameen Jaunoo, William Allum, Jan Van Lanschot, Magnus Nilsson, John V. Reynolds, Mark I. van Berge Henegouwen, George B. Hanna, Surgery, Graduate School, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Imaging and biomarkers, Medical Psychology, APH - Aging & Later Life, APH - Mental Health, CCA - Cancer biology and immunology, and CCA - Cancer Treatment and quality of life
Subjects: Esophagectomy, Quality of life, Postoperative complications, SDG 3 - Good Health and Well-being, Oncology, Esophageal neoplasms, Surgery, General Medicine
Abstract: Introduction: Postoperative complications following major surgery have been shown to be associated with reduced health-related quality of life (HRQL), and severe complications may have profound negative effects. This study aimed to examine whether long-term HRQL differs with the occurrence and severity of complications in a European multicenter prospective dataset of patients following esophagectomy for cancer. Methods: Disease-free patients following esophagectomy for cancer between 2010 and 2016 from the LASER study were included. Patients completed the LASER, EORTC QLQ-C30 and EORTC QLQ-OG25 questionnaires >1 year following treatment. Long-term HRQL was compared between patients with and without postoperative complications, subgroup analysis was performed for severity of complications (no, minor [Clavien-Dindo I-II], severe [Clavien-Dindo ≥ III]), using univariable and multivariable regression. Results: 645 patients were included: 283 patients with no, 207 with minor and 155 with severe complications. Significantly more dyspnea (QLQ-C30) was reported by patients with compared to patients without complications (differenceinmeans 6.3). In subgroup analysis, patients with severe complications reported more dyspnea (difference in means 8.3) than patients with no complications. None of the differences were clinically relevant (difference in means ≥ 10 points). LASER-based low mood (OR2.3) was statistically different for minor versus severe complications. Conclusion: Comparable HRQL was found in patients with and without postoperative complications following esophagectomy for cancer, after a mean follow-up of 4.4 years. Furthermore, patients with different levels of severity of complications had comparable HRQL. The level of HRQL in esophageal cancer patients are more likely explained by the impact of the complex procedure of the esophagectomy itself.
Published: 2023

10. Impact of Early Jejunostomy Tube Feeding on Clinical Outcome and Parameters of Body Composition in Esophageal Cancer Patients Receiving Multimodal Therapy

Author: Piers R. Boshier, Fredrik Klevebro, Amy Schmidt, Shiwei Han, Wesley Jenq, Francesco Puccetti, Maarten F. J. Seesing, Vickie E. Baracos, and Donald E. Low
Subjects: Oncology, Surgery
Published: 2022

11. An International Multicenter Study Exploring Whether Surveillance After Esophageal Cancer Surgery Impacts Oncological and Quality of Life Outcomes (ENSURE)

Author: Jessie A, Elliott, Sheraz R, Markar, Fredrik, Klevebro, Asif, Johar, Lucas, Goense, Pernilla, Lagergren, Giovanni, Zaninotto, Richard, van Hillegersberg, Mark I, van Berge Henegouwen, Magnus, Nilsson, George B, Hanna, John V, Reynolds, and Nicolas, Demartines
Subjects: Surgery
Abstract: To determine the impact of surveillance on recurrence pattern, treatment, survival and health-related quality-of-life (HRQL) following curative-intent resection for esophageal cancer.Although therapies for recurrent esophageal cancer may impact survival and HRQL, surveillance protocols after primary curative treatment are varied and inconsistent, reflecting a lack of evidence.European iNvestigation of SUrveillance after Resection for Esophageal cancer was an international multicenter study of consecutive patients undergoing surgery for esophageal and esophagogastric junction cancers (2009-2015) across 20 centers (NCT03461341). Intensive surveillance (IS) was defined as annual computed tomography for 3 years postoperatively. The primary outcome measure was overall survival (OS), secondary outcomes included treatment, disease-specific survival, recurrence pattern, and HRQL. Multivariable linear, logistic, and Cox proportional hazards regression analyses were performed.Four thousand six hundred eighty-two patients were studied (72.6% adenocarcinoma, 69.1% neoadjuvant therapy, 45.5% IS). At median followup 60 months, 47.5% developed recurrence, oligometastatic in 39%. IS was associated with reduced symptomatic recurrence (OR 0.17 [0.12-0.25]) and increased tumor-directed therapy (OR 2.09 [1.58-2.77]). After adjusting for confounders, no OS benefit was observed among all patients (HR 1.01 [0.89-1.13]), but OS was improved following IS for those who underwent surgery alone (HR 0.60 [0.47-0.78]) and those with lower pathological (y)pT stages (Tis-2, HR 0.72 [0.58-0.89]). IS was associated with greater anxiety ( P =0.016), but similar overall HRQL.IS was associated with improved oncologic outcome in select cohorts, specifically patients with early-stage disease at presentation or favorable pathological stage post neoadjuvant therapy. This may inform guideline development, and enhance shared decision-making, at a time when therapeutic options for recurrence are expanding.
Published: 2022

12. Partial stomach-partitioning gastrojejunostomy for gastric outlet obstruction: A cohort study based on consecutive case series from a single center

Author: Magnus Nilsson, Mats Lindblad, Fredrik Klevebro, Andrianos Tsekrekos, B. Sunde, Masaru Hayami, Ioannis Rouvelas, and Biying Huang
Subjects: medicine.medical_specialty, RD1-811, Upper gastrointestinal cancer, Gastric Bypass, Subgroup analysis, Single Center, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Stomach Neoplasms, Humans, Medicine, Gastrointestinal Neoplasms, Retrospective Studies, Partial stomach-partitioning gastrojejunostomy, Gastric emptying, Gastric Outlet Obstruction, business.industry, Stomach, Palliative Care, Modified Devine exclusion, Retrospective cohort study, Gastric outlet obstruction, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Quality of Life, 030211 gastroenterology & hepatology, business, Cohort study
Abstract: Summary Background/objective Gastric outlet obstruction can have a large impact on quality of life for patients with upper gastrointestinal cancer or benign obstruction. Partial stomach-partitioning gastrojejunostomy has previously shown promising outcomes compared to conventional gastrojejunostomy in terms of reduced delayed gastric emptying. The objective of the current study was to present outcomes of partial stomach-partitioning gastrojejunostomy in a single high-volume center for upper gastrointestinal cancer. Methods A retrospective cohort study including all consecutive patients who underwent partial stomach-partitioning gastrojejunostomy from 2013 to 2020. The primary outcome was oral intake tolerance. A subgroup analysis was performed in all patients with manifest gastric outlet obstruction comparing partial stomach-partitioning gastrojejunostomy to conventional gastrojejunostomy. Results Partial stomach-partitioning gastrojejunostomy was performed in 32 patients and laparoscopic technique was used in 19 patients (59%). The procedure improved oral intake tolerance defined by gastric outlet obstruction scoring system by 0.63 points on average (P = 0.041). No postoperative complications related to the procedure were observed. Recurrence of gastric outlet obstruction developed in six patients (19%), four patients (13%) required endoscopic reintervention but no patient required surgical reintervention. A comparison between partial stomach-partitioning gastrojejunostomy and conventional gastrojejunostomy showed no statistically significant differences regarding postoperative nutritional status, length of hospital stay, recurrence or reintervention. Conclusion The results of the study show that partial stomach-partitioning gastrojejunostomy can be an effective surgical treatment for patients suffering from gastric outlet obstruction and that the procedure can be safely performed with laparoscopic technique.
Published: 2022

13. Frequency of blood lactate elevation following esophagectomy and its association to postoperative complications

Author: Henrik Linde, Vilhelmas Bartusevicius, Åke Norberg, Fredrik Klevebro, and Jonathan Grip
Subjects: Anesthesiology and Pain Medicine, General Medicine
Abstract: Esophagectomy is a major surgical intervention and a cornerstone in the treatment of esophageal cancer. There is clinical experience that blood lactate concentration often is elevated in the period following esophagectomy, but the incidence and clinical consequences are sparsely studied.We extracted data from all patients undergoing esophagectomy at Karolinska University Hospital 2016-2018, n = 153. Most were performed with minimally invasive technique, n = 130. Blood lactate values directly after surgery, highest value during the first night, and morning level on postoperative day one were recorded. Primary outcome was hospital length of stay and secondary outcome was a composite of postoperative infection, additional surgery, or intensive care during the hospital stay. Development of anastomotic leak was analyzed separately.Postoperative hyperlactatemia was common as 93% of patients had peak lactate concentration 1.6 mmol/L and 27%3.5 mmol/L in the first night following operation. Median hospital length of stay was 14 days. Blood lactate showed a weak correlation to hospital stay and intensive care the morning following surgery, but not at arrival to postoperative ward. There were no statistical differences between those with and without anastomotic leak at any of the time points. Elevated lactate in the first 12-16 h postoperatively was related to surgical factors (open technique, surgery time, and perioperative bleeding) but not to patient related factors (ASA-class, Charlson comorbidity index, sex, age) or cumulative fluid balance.In conclusion, elevated blood lactate in the immediate time following esophagectomy showed a weak association to intensive care and length of stay but not anastomotic leak.
Published: 2022

14. Limitations of reliance on metabolic markers following surgery

Author: Jonathan Grip, Åke Norberg, and Fredrik Klevebro
Subjects: Anesthesiology and Pain Medicine, General Medicine
Published: 2023

15. ERAS guidelines-driven upper gastrointestinal contrast study after esophagectomy

Author: Francesco Puccetti, Donald E. Low, MadhanKumar Kuppusamy, Fredrik Klevebro, Michal Hubka, Puccetti, F., Klevebro, F., Kuppusamy, M. K., Hubka, M., and Low, D. E.
Subjects: medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Anastomosis, Postoperative Complications, Internal medicine, Delayed Gastric emptying, medicine, Humans, Ivor lewis, Upper gastrointestinal, ERAS, Retrospective Studies, business.industry, Gastric conduit, Anastomosis, Surgical, Hepatology, Surgery, Esophagectomy, Jejunostomy, Enhanced Recovery After Surgery, business, Abdominal surgery
Abstract: Background: Early nasogastric tube (NGT) removal is a component of enhanced recovery after surgery (ERAS) protocol for esophagectomy. The aim of this study is to assess a protocol-driven application of UGI contrast study to facilitate early NGT removal and direct a standardized therapeutic response in patients with evidence for delayed gastric conduit emptying (DGCE). Methods: All patients undergoing esophagectomy between January 2017 and October 2019 were prospectively enrolled. Esophageal resections were performed through different surgical approaches involving gastric conduit reconstruction. A standardized clinical protocol (SCP) was systematically applied, which targeted a UGI contrast study on POD 2–3 to allow immediate NGT removal or initiate DGCE protocols. Results: This study enrolled 50 patients undergoing open Ivor Lewis (42%), left thoracoabdominal (46%), and three-field procedure (12%) with gastric conduit reconstruction and either upper thoracic (66%) or cervical (34%) anastomosis. Jejunostomy was routinely placed while pyloric procedures were not performed. Patients achieving targeted contrast study (86%) demonstrated significantly earlier NGT removal (p-value 0.010), oral protocol initiation (0.001), and decreased length of hospital stay (6 vs 10days, 0.024). Four patients (8%) presented with radiology signs of DCGE and underwent protocoled treatment, eventually achieving discharge similar to the overall study population (7 vs 8.5days). Conclusions: Protocol-driven UGI contrast study can effectively provide objective data facilitating early NGT removal and discharge. Patients with DGCE can successfully undergo intervention to improve conduit emptying and adhere to ERAS discharge goals.
Published: 2021

16. 397. NEOADJUVANT CHEMORADIOTHERAPY VERSUS NEOADJUVANT CHEMOTHERAPY AND POSTOPERATIVE COMPLICATIONS AFTER ESOPHAGECTOMY FOR CANCER

Author: Halla Olafsdottir, Emmy Dalqvist, Osama Hamida, Eva Onjukka, Fredrik Klevebro, Magnus Nilsson, Giovanna Gagliardi, and Gabriella Alexandersson von Döbeln
Subjects: Gastroenterology, General Medicine
Abstract: Postoperative complications after esophagectomy are common. Neoadjuvant chemotherapy or chemoradiotherapy in addition to surgery is the standard treatment with curative intent for patients with locally advanced esophageal cancer. The aims of our study were to analyze if the addition of neoadjuvant radiotherapy to chemotherapy and surgery increases the rate and severity of postoperative complications and to evaluate if radiotherapy doses to the heart and lungs were associated with postoperative complications. The study was based on a prospectively collected database of esophageal cancer patients that were operated on between October 2008 and March 2020. Patients treated with neoadjuvant chemoradiotherapy were compared to patients treated with neoadjuvant chemotherapy. All postoperative complications were graded according to the Clavien Dindo classification. The primary outcome was 30-day postoperative complications. Logistic regression was used to determine the effect of radiotherapy on complication rates. Several dose/volume parameters for the lungs and the heart were considered. During the study period esophagectomy was performed on 275 patients after neoadjuvant treatment (93 after chemotherapy and 182 after chemoradiotherapy). The median total radiation dose was 41.4 Gy, the median lung dose was 6.2 Gy and the median dose to the heart was 20.3 Gy. Neoadjuvant chemoradiotherapy compared to chemotherapy showed no association with postoperative complications of a Clavien Dindo score of ≥2 or severe postoperative complications (Clavien Dindo ≥3b). Taxane-containing chemotherapy had a statistically significant association with postoperative complications (table 1). The radiotherapy dose to the heart and lungs had no significant association with postoperative complications. In our cohort, the addition of preoperative radiotherapy to chemotherapy did not increase the rate of postoperative complications. However, an association between postoperative complications and taxane-containing chemotherapy regimens given with or without concomitant radiotherapy was noted.
Published: 2022

17. 336. IMPACT OF TIME TO SURGERY AFTER CHEMORADIOTHERAPY ON TUMOR REGRESSION AND SURVIVAL IN THE MULTICENTER RANDOMIZED CONTROLLED NEORES II TRIAL

Author: Klara Nilsson, Fredrik Klevebro, Berit Sunde, Ioannis Rouvelas, Mats Lindblad, Eva Szabo, Ingvar Halldestam, Ulrika Smedh, Bengt Wallner, Jan Johansson, David Borg, Gjermund Johnsen, Eirik Kjus Aalin, Hans-Olaf Johannessen, Gabriella Alexandersson von Döbeln, Geir Olav Hjortland, Ghazwan Al-Haidari, Alexander Quaas, Naining Wang, Isabel Bartella, Christiane Bruns, Wolfgang Schröder, and Magnus Nilsson
Subjects: Gastroenterology, General Medicine
Abstract: Time to surgery after termination of neoadjuvant chemoradiotherapy for esophageal cancer has traditionally been 4–6 weeks. Observational studies have suggested that delay of surgery for up to three months may lead to improved tumor regression and better outcomes. NeoRes II is the first randomized trial to address this in esophageal cancer. No difference in surgical morbidity or mortality between early and delayed surgery was reported in a previous publication from the trial. A multicenter clinical trial with randomized 1:1 allocation of standard time to surgery of 4–6 weeks, or delay of surgery to 10–12 weeks, after termination of chemoradiotherapy. The primary endpoint was complete histological tumor regression in patients with adenocarcinoma. Secondary endpoints included tumor regression grade, tumor free resection margins and overall survival in all patients, and stratified by histological subtype. In total 249 patients were randomized, 204 with adenocarcinoma and 45 with squamous cell carcinoma. There was no significant difference in histological complete response between adenocarcinoma patients allocated to standard time to surgery (20.6%) compared to delayed (25.6%) surgery (P = 0.18). Tumor free resection margin was achieved in 97.4% after standard time to surgery and 97.1% after delayed surgery (P = 1.0). The median follow-up time for survival was 51 months. Delayed time to surgery was associated with a 35% higher overall mortality, hazard ratio 1.35 (95% CI:0.94–1.95), (P = 0.11). No significant difference in complete histological tumor regression or tumor free resection margins comparing standard and delayed time to surgery after chemoradiotherapy was observed. There was a non-significant trend towards inferior overall survival after delayed surgery, suggesting caution in delaying surgery for more than 6 weeks after neoadjuvant chemoradiotherapy.
Published: 2022

18. 334. DEFINITION OF SEVERE BENIGN OESOPHAGEAL STRICTURES AND IDENTIFICATION OF ASSOCIATED RISK FACTORS

Author: Peter Elbe, Anna Boytsova, Mats Lindblad, Fredrik Klevebro, and Miroslav Vujasinovic
Subjects: Gastroenterology, General Medicine
Abstract: Benign oesophageal strictures (BES) are often easily treated but around 30% progress into recurrent or refractory benign oesophageal strictures (RBES), that need repetitive dilatations. Difficulties of RBES have been widely discussed in the literature, but there is not a well-established consensus regarding the definition of RBES. In this study we wanted to develop a simple definition in relation to aetiology and number of dilatation sessions per stricture. A retrospective study on 242 BES-patients treated with endoscopic dilatation was performed. The primary endpoint was need of further dilatation per procedure, based on total number of dilatation sessions performed and stricture ethology. Univariate and multivariable regression analysis were performed to assess risk factors for RBES. Among 242 patients, 76 had RBES. The need of further dilatation increases with 13% at fifth dilation session and keeps a continuous mean value at 81%. Investigating some aetiologies separately, the point where need increases does vary. The risk of having RBES decreased for distal (Odds Ratio (OR) 0,25 (Confidence interval (CI) 95% 0,09-0,65)) and middle (OR 0,35 (CI 95% 0,13-0,88)) location of the stricture compared to proximal strictures. We propose that a stricture can be defined as RBES when reaching the fifth dilatation session. At that point we also suggest that clinicians should consider additional treatment, in addition to dilatation, in order to resolve the stricture.
Published: 2022

19. 607. COMPARISON OF RECURRENCE PATTERNS AND SURVIVAL AFTER NEOADJUVANT CHEMORADIOTHERAPY VS. CHEMOTHERAPY FOR ESOPHAGEAL CANCER, A MULTI-CENTER EUROPEAN COHORT STUDY

Author: Fredrik Klevebro, Jessie Elliott, Styliani Montziari, Sheraz R Markar, Lucas Goense, Asif Johar, Pernilla Lagergren, Giovanni Zanninotto, Richard van Hillegersberg, Mark van Berge Henegouwen, Magnus Nilsson, George Hanna, Marcus Schäfer, and John Reynolds
Subjects: Gastroenterology, General Medicine
Abstract: Curative treatment for esophageal cancer requires local and systemic disease control. Neoadjuvant treatment increases long-term survival, but the evidence to date is insufficient to determine if neoadjuvant chemoradiotherapy (nCRT) with focus on local control or neoadjuvant chemotherapy (nCT) with focus on systemic control, is more beneficial. In this analysis of the ENSURE study we aimed to compare recurrence patterns and survival between nCRT and nCT in a large multicenter European cohort study. All patients treated with neoadjuvant therapy and esophagectomy for cancer from 2009-2015 in the ENSURE study (NCT03461341) were included. Univariable and multivariable logistic regression and Cox proportional hazard models were used to compare recurrence pattern, diseases-free, and overall survival. Results are shown as odds ratios (OR), hazard ratios (HR) and 95% confidence intervals (CI). The multivariable model was pre-specified and included age, sex, clinical tumor stage, and tumor histology. In total 3267/4682 (69.8%) patients were treated with neoadjuvant therapy and were included in the study. nCRT was given to 1798 (55.0%) patients, and nCT was given to 1496 (45.0%) patients. Median age for nCRT was 63 vs. 64 for nCRT, 65.5% in the nCRT group had adenocarcinoma vs. 81.4% in the nCT group. In the nCRT group 38.7% of patients had tumor stage III-IV compared to 61.3% in the nCT group. Multivariable adjusted OR for local recurrence comparing nCRT to nCT was 1.31 (95% CI: 1.08-1.59), distant recurrence OR 1.87 (95% CI: 1.57-2.22), and combined recurrence 1.49 (95% CI: 1.26-1.76). Adjusted HR for disease specific survival comparing nCRT to nCT was 1.38 (95% CI: 1.24-1.55), disease free survival: 1.39 (95% CI: 1.25-1.54), and for overall survival: 1.44 (95% CI: 1.30-1.60). The results of the study show significantly increased risk for recurrent disease and decreased survival after nCRT compared to nCT for esophageal cancer. nCRT is administered with a lower total dose of chemotherapy compared to nCT. Radiotherapy is given for local control, which is also achieved with adequate lymphadenectomy. The results indicate that effective systemic treatment with nCT might be beneficial compared to nCRT in curative intended treatment of esophageal cancer.
Published: 2022

20. 19. ERAS GUIDELINES-DRIVEN UPPER GASTROINTESTINAL CONTRAST STUDY AFTER ESOPHAGECTOMY CAN DETECT DELAYED GASTRIC CONDUIT EMPTYING AND IMPROVE OUTCOMES

Author: Fredrik Klevebro, Magnus Konradsson, Shiwein Han, Joanna Luttikhold, Magnus Nilsson, Mats Lindblad, Mats Andersson, and Donald E Low
Subjects: Gastroenterology, General Medicine
Abstract: Delayed gastric conduit emptying can occur after esophagectomy and has been shown to be associated with increased risk for postoperative complications. Application of a standardized clinical protocol after esophagectomy including an upper gastrointestinal contrast study has the potential to improve postoperative outcomes. Prospective cohort including all patients operated with esophagectomy at two high-volume centers for esophageal surgery. The standardized clinical protocol included an upper gastrointestinal contrast study on day 2 or 3 after surgery. All images were compiled and evaluated for the purpose of the study. Clinical data was collected in IRB approved institutional databases at the participating centers. The study included 119 patients of whom 112 (94.1%) completed an upper gastrointestinal contrast study. The results showed that 8 (7.1%) patients had no emptying of contrast from the gastric conduit, partial emptying was seen in in 34 (30.4%) patients, and 70 (62.5%) patients had complete conduit emptying. Complete or partial emptying was associated with significantly earlier nasogastric tube removal (3 vs. 6 days) and hospital discharge 8 vs. 17 days, P The results of the study demonstrate that postoperative upper gastrointestinal contrast studies can be used to assess the level of emptying of the gastric conduit after esophagectomy. Application of upper gastrointestinal contrast study in the ERAS guidelines-driven standardized clinical pathway after esophagectomy can improve postoperative outcomes.
Published: 2022

21. 580. EFFECTS OF NEOADJUVANT CHEMOTHERAPY ON PREOPERATIVE DISEASE SPECIFIC SYMPTOMS AND HEALTH RELATED QUALITY OF LIFE FOR PATIENTS WITH GASTROESOPHAGEAL CANCER

Author: Anders Holmén and Fredrik Klevebro
Subjects: Gastroenterology, General Medicine
Abstract: Guidelines promotes neoadjuvant chemotherapy in treating gastroesophageal cancer, but little is known concerning effects on disease specific symptoms and health-related quality of life. We therefore wished to study how preoperative neoadjuvant chemotherapy might affect disease specific symptoms and preoperative health-related quality of life in patients with gastroesophageal cancer. We performed a single center cohort study with prospectively collected data on patients with curative intended surgery due to gastroesophageal cancer between 2013 and 2020. Patients were asked to voluntarily assess their health-related quality of life prior to surgery and stratified with regards to neoadjuvant chemotherapy or surgery alone. Our primary endpoint was self-assessed health-related quality of life evaluated with validated quality of life questionnaires, transferred from a Likert scale to a 0-100 score according to scoring manuals. A multivariable adjusted model was constructed including for age, ASA-score, and clinical tumor T- and N-stage. In total 361 patients were included of which 239 were treated with neoadjuvant chemotherapy. Patients that received neoadjuvant chemotherapy were in median 10 years younger and included more males (77 vs 65). Patients treated with neoadjuvant chemotherapy reported better physical functioning (6.1, p=0.013), less pain (-10.9, p=0.004)), less insomnia (-12.6, p=0.004), and less trouble concerning eating restrictions (-11.9, p=0.005). Some symptoms were further reduced in patients with EC, such as dysphagia (-15.2, p=0.006), eating restrictions (-23.2, p= p With exception of sense of taste and hair loss, neoadjuvant chemotherapy may improve preoperative Health Related Quality of Life in patients with gastroesophageal cancer. This is even more clear concerning nutritional aspects and is more pronounced for patients with esophageal cancer.
Published: 2022

22. Patient-reported outcomes after oesophagectomy in the multicentre LASER study

Author: Conor F. Murphy, J Roigg, Marco Scarpa, Bas P. L. Wijnhoven, Carlo Castoro, Jeremy R Huddy, Christine Greene, Giovanni Zaninotto, O McCormack, Nick Maynard, S S Gisbertz, Miguel Pera, John V. Reynolds, B. Sunde, Fredrik Klevebro, Edward Cheong, R Matthijsen, Viknesh Sounderajah, Christophe Mariette, George B. Hanna, Magnus Nilsson, Pernilla Lagergren, Sjoerd M. Lagarde, Sheraz R. Markar, Asif Johar, M. I. van Berge Henegouwen, Guillaume Piessen, Arun Ariyarathenam, H Brenkman, John M. Findlay, Jelle P. Ruurda, Jessie A Elliott, J. J. B. van Lanschot, Rita Alfieri, Eleonora Pinto, S Jaunoo, S Antonowicz, William H. Allum, Grant Sanders, S Castro, R. van Hillegersberg, N Ravi, Surgery, CCA - Cancer biology and immunology, CCA - Cancer Treatment and Quality of Life, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Male, medicine.medical_specialty, Time Factors, Esophageal Neoplasms, medicine.medical_treatment, 030230 surgery, 03 medical and health sciences, Lethargy, Postoperative Complications, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Swallowing, Quality of life, Internal medicine, Humans, Medicine, Patient Reported Outcome Measures, Aged, Retrospective Studies, business.industry, Incidence, Heartburn, Middle Aged, Esophageal cancer, medicine.disease, Esophagectomy, Europe, Cross-Sectional Studies, Treatment Outcome, 030220 oncology & carcinogenesis, Quality of Life, Vomiting, Female, Surgery, medicine.symptom, business, Follow-Up Studies, Cohort study
Abstract: Background Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life. Methods This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models. Results Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms. Conclusion A long-term symptom burden is common after oesophageal cancer surgery.
Published: 2021

23. Analysis of Compliance with Enhanced Recovery After Surgery (ERAS) Protocol for Esophagectomy

Author: Francesco Puccetti, Fredrik Klevebro, MadhanKumar Kuppusamy, Shiwei Han, Richard E. Fagley, Donald E. Low, and Michal Hubka
Subjects: Esophagectomy, Postoperative Complications, Esophageal Neoplasms, Humans, Surgery, Length of Stay, Enhanced Recovery After Surgery, Retrospective Studies
Abstract: ERAS guidelines have provided an effective recovery approach for esophagectomy. This study aimed to identify the relationship between the length of hospital stay (LOS) and compliance with clinical benchmarks of an established institutional ERAS program.A single-center prospective database of esophageal cancer patients was retrospectively analyzed between January 2016 and January 2020. All patients underwent surgery within a standardized ERAS pathway for esophagectomy. Compliance with individual ERAS benchmarks and postoperative outcomes were evaluated according to patient's LOS; accelerated (≤ 6 days, AR), targeted (7-8 days, TR), and delayed recovery (≥ 9 days, DR).The study included 100 consecutive patients undergoing esophagectomy with a median LOS of 7 (3.8-40.8) days, and a 30-day readmission rate of 12.6%. LOS was not affected by comorbidities, tumor type or stage, neoadjuvant therapy, operative approach or anastomotic leak. Postoperative complications were 49.5%, and 90-day mortality was 3.8%. AR, TR, and DL were achieved by 45%, 31%, and 24% of patients, respectively. Postoperative morbidity differed significantly among groups, impacting LOS (p 0.001). Overall compliance with ERAS protocol was 82.7% and adherence to specific benchmarks was initially ( 48 h) high, but significantly affected by postoperative complications afterwards.Adherence to recovery benchmarks in patients undergoing esophagectomy is most commonly impacted by postoperative complications. In esophageal cancer surgery, the adherence to ERAS benchmarks after esophagectomy should be regularly audited. Modification to ERAS protocols to increase application in patients with complications should be considered.
Published: 2022

24. Nutritional jejunostomy in esophagectomy for cancer, a national register-based cohort study of associations with postoperative outcomes and survival

Author: Anders Holmén, Thorhallur Agustsson, Ioannis Rouvelas, Eva Szabo, Fredrik Klevebro, and Masaru Hayami
Subjects: medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Esophageal cancer, Jejunostomy, Feeding jejunostomy, Lower risk, Cohort Studies, Postoperative complications, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, medicine, Humans, Anastomotic leak, business.industry, Odds ratio, medicine.disease, Surgery, Esophagectomy, Treatment Outcome, Parenteral nutrition, 030220 oncology & carcinogenesis, Original Article, 030211 gastroenterology & hepatology, business, Abdominal surgery, Cohort study
Abstract: Purpose Insertion of a nutritional jejunostomy in conjunction with esophagectomy is performed with the intention to decrease the risk for postoperative malnutrition and improve recovery without adding significant catheter-related complications. However, previous research has shown no clear benefit and there is currently no consensus of practice. Methods All patients treated with esophagectomy due to cancer during the period 2006–2017 reported in the Swedish National Register for Esophageal and Gastric Cancer were included in this register-based cohort study from a national database. Patients were stratified into two groups: esophagectomy alone and esophagectomy with jejunostomy. Results A total of 847 patients (45.27%) had no jejunostomy inserted while 1024 patients (54.73%) were treated with jejunostomy. The groups were comparable, but some differences were seen in histological tumor type and tumor stage between the groups. No significant differences in length of hospital stay, postoperative surgical complications, Clavien-Dindo score, or 90-day mortality rate were seen. There was no evidence of increased risk for significant jejunostomy-related complications. Patients in the jejunostomy group with anastomotic leaks had a statistically significant lower risk for severe morbidity defined as Clavien-Dindo score ≥ IIIb (adjusted odds ratio 0.19, 95% CI: 0.04–0.94, P = 0.041) compared to patients with anastomotic leaks and no jejunostomy. Conclusion A nutritional jejunostomy is a safe method for early postoperative enteral nutrition which might decrease the risk for severe outcomes in patients with anastomotic leaks. Nutritional jejunostomy should be considered for patients undergoing curative intended surgery for esophageal and gastro-esophageal junction cancer.
Published: 2020

25. A 68Ga-FAPI-46 PET/CT Imaging Pitfall in Assessing Residual Gastric Cancer Early After Chemotherapy

Author: Siri af Burén, Thuy A. Tran, Fredrik Klevebro, Maria Holstensson, and Rimma Axelsson
Subjects: Neoplasm, Residual, Gelatinases, Stomach Neoplasms, Positron Emission Tomography Computed Tomography, Serine Endopeptidases, Quinolines, Humans, Membrane Proteins, Radiology, Nuclear Medicine and imaging, General Medicine
Abstract: After neoadjuvant chemotherapy, preoperative imaging with 68Ga-FAPI-46 PET/CT showed a similar level of tracer uptake at the location of the primary tumors in 2 patients with gastric cancer. Postoperative histopathology revealed residual malignant cells only in one of the patients, whereas the elevated FAPI uptake in the other patient correlated to an inflammatory reaction and fibrosis. With this case, we would like to highlight that an increased FAPI uptake in inflammatory and fibrotic tissue early after chemotherapy may represent a potential interpretation pitfall. Further studies evaluating the clinical application of FAPI-PET in assessing residual cancer tissue are warranted.
Published: 2022

26. Lasting Symptoms After Esophageal Resection (LASER):European Multicenter Cross-sectional Study

Author: Fredrik Klevebro, Robert Matthijsen, Jelle P. Ruurda, Richard van Hillegersberg, Sjoerd M. Lagarde, Arun Ariyarathenam, John V. Reynolds, Guillaume Piessen, Edward Cheong, Viknesh Sounderajah, Carlo Castoro, Bas P. L. Wijnhoven, Shameen Jaunoo, Eleonora Pinto, Christophe Mariette, George B. Hanna, Narayanasamy Ravi, Grant Sanders, Christine Greene, Suzanne S. Gisbertz, José Roig, Magnus Nilsson, Sandra Castro, John M. Findlay, Nick Maynard, Pernilla Lagergren, J. Jan B. van Lanschot, B. Sunde, Jeremy R Huddy, Stefan Antonowicz, Mark I. van Berge Henegouwen, Manuel Pera, Giovanni Zaninotto, Sheraz R. Markar, Hylke J. F. Brenkman, Marco Scarpa, William H. Allum, Rita Alfieri, Asif Johar, Jessie A Elliott, O McCormack, Conor F. Murphy, Surgery, CCA - Cancer Treatment and quality of life, CCA - Cancer Treatment and Quality of Life, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Male, medicine.medical_specialty, Esophageal Neoplasms, Cross-sectional study, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Quality of life, SDG 3 - Good Health and Well-being, Weight loss, Internal medicine, medicine, Humans, esophageal cancer, Aged, Response rate (survey), business.industry, Odds ratio, Esophageal cancer, Middle Aged, medicine.disease, humanities, Esophagectomy, Europe, Mood, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Quality of Life, symptoms, 030211 gastroenterology & hepatology, Surgery, Female, Self Report, medicine.symptom, Symptom Assessment, business, survivorship
Abstract: Objective To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors. Background Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood. Patients and methods Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires. Specific symptom questionnaire items that were associated with poor HRQOL as identified by EORTC QLQ-C30 and QLQ-OG25 were identified by multivariable regression analysis and combined to form a tool. Results A total of 876 of 1081 invited patients responded to the questionnaire, giving a response rate of 81%. Of these, 66.9% stated in the last 6 months they had symptoms associated with their esophagectomy. Ongoing weight loss was reported by 10.4% of patients, and only 13.8% returned to work with the same activities.Three LASER symptoms were correlated with poor HRQOL on multivariable analysis; pain on scars on chest (odds ratio (OR) 1.27; 95% CI 0.97-1.65), low mood (OR 1.42; 95% CI 1.15-1.77) and reduced energy or activity tolerance (OR 1.37; 95% CI 1.18-1.59). The areas under the curves for the development and validation datasets were 0.81 ± 0.02 and 0.82 ± 0.09 respectively. Conclusion Two-thirds of patients experience significant symptoms more than 1 year after surgery. The 3 key symptoms associated with poor HRQOL identified in this study should be further validated, and could be used in clinical practice to identify patients who require increased support.
Published: 2022

27. Laparoscopic Versus Open Gastrectomy for Cancer: A Western Center Cohort Study

Author: Lars Lundell, Mats Lindblad, Magnus Nilsson, Andrianos Tsekrekos, Satoshi Kamiya, Masaru Hayami, Fredrik Klevebro, and Ioannis Rouvelas
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Blood Loss, Surgical, Anastomosis, Severity of Illness Index, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Blood loss, Gastrectomy, Stomach Neoplasms, medicine, Humans, Hospital Mortality, Leak rate, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Surgical outcomes, Cancer, Laparoscopic gastrectomy, Length of Stay, Middle Aged, medicine.disease, Conversion to Open Surgery, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Lymph Node Excision, Female, Laparoscopy, 030211 gastroenterology & hepatology, Gastric cancer, business, Cohort study
Abstract: Background Laparoscopic gastrectomy (LG) for cancer has been introduced in institutions worldwide in an effort to minimize surgical trauma, while aiming to provide comparable oncological outcomes to conventional open gastrectomy (OG). The aim of this study was to present our results during the period of implementation of the laparoscopic technique. Materials and methods In 2012, LG for the treatment of gastric cancer was introduced at our institution. The results presented are based on a retrospective analysis of data from a cohort of all patients treated with curative intent over the period 2010-2018. Results During the study period, 206 patients underwent surgery for gastric cancer: 129 patients (62.6%) had an OG and 77 patients (37.4%) an LG. The conversion rate due to technical reasons was 2.6%. LG was associated with significantly less intraoperative blood loss [mean (mL), OG 544 versus LG 176] and shorter hospital stay than OG [mean (d), OG 12 versus LG 8], fewer severe complications (Clavien-Dindo grade ≥ IIIb) [OG 29 (22.5%) versus LG 9 (11.7%), P = 0.081], significantly lower anastomotic leak rate [OG 18 (14.0%) versus LG 1 (1.3%)] and no 90-day mortality. The percentage of R0 resections was similar between the two groups (OG 82.2% versus LG 85.7%, P = 0.507), while the mean number of resected lymph nodes was significantly higher in the laparoscopic group [OG 34 versus LG 39, P = 0.030]. Conclusions Our data suggest that similar and, in some aspects, better short-term outcomes can be achieved with LG with maintained oncological quality.
Published: 2020

28. Assessment of Health Related Quality of Life and Digestive Symptoms in Long-term, Disease Free Survivors After Esophagectomy

Author: Katerina V Savva, Anabelle Waller, L. Hage, Piers R. Boshier, Fredrik Klevebro, Donald E. Low, and George B. Hanna
Subjects: Response rate (survey), medicine.medical_specialty, education.field_of_study, business.industry, medicine.medical_treatment, Population, Heartburn, Esophageal cancer, medicine.disease, Dysphagia, humanities, 03 medical and health sciences, 0302 clinical medicine, Esophagectomy, Weight loss, 030220 oncology & carcinogenesis, Internal medicine, Cohort, medicine, 030211 gastroenterology & hepatology, Surgery, medicine.symptom, education, business
Abstract: Objective The aim of this study was to investigate long-term HRQOL and symptom evolution in disease free patients up to 20 years after esophagectomy. Background Esophagectomy has been associated with decreased HRQOL and persistent gastrointestinal symptoms. Methods The study cohort was identified from 2 high volume centers for the management of esophageal cancer. Patients completed HRQOL and symptom questionnaires, including: Digestive Symptom Questionnaire, EORTC QLQ-C30, EORTC QLQ-OG25 Euro QoL 5D, and SF36. Patients were assessed in 3 cohorts: 5 years after surgery. Results In total 171 of 222 patients who underwent esophagectomy between 1991 and 2017 who met inclusion criteria and were contactable, responded to the questionnaires, corresponding to a response rate of 77%. Median age was 66.2 years, and median time from operation to survey was 5.6 years (range 0.3-23.1). Early satiety was the most commonly reported symptom in all patients irrespective of timeframe (87.4%; range 82%-92%). Dysphagia was seen to decrease over time (58% at 5 years; P = 0.013). Weight loss scores demonstrated nonstatistical improvement over time. All other symptom scores including heartburn, regurgitation, respiratory symptoms, and pain scores remained constant over time. Average HRQOL did not improve from levels 1 year after surgery compared to patients up to 23 years after esophagectomy. Conclusion With the exception of dysphagia, which improved over time, esophagectomy was associated with decreased HRQOL and lasting gastrointestinal symptoms up to 20 years after surgery. Pertinently however long-term survivors after oesophagectomy demonstrated comparable to improved HRQOL compared to the general population. The impact of esophagectomy on gastrointestinal symptoms and long-term HRQOL should be considered when counseling and caring for patients undergoing esophagectomy.
Published: 2020

29. Preoperative heart disease and risk for postoperative complications after pancreatoduodenectomy

Author: Patrik Larsson, Kari Feldt, Marcus Holmberg, Oskar Swartling, Ernesto Sparrelid, Fredrik Klevebro, and Poya Ghorbani
Subjects: Adult, Heart Failure, Postoperative Complications, Hepatology, Adolescent, Risk Factors, Atrial Fibrillation, Gastroenterology, Humans, Pancreaticoduodenectomy
Abstract: Comorbidities increase the risk for postoperative complications after pancreatoduodenectomy. The importance of different categories of heart disease on postoperative outcomes has not been thoroughly studied.Patients aged ≥18 years undergoing pancreatoduodenectomy between 2008 and 2019 at Karolinska University Hospital, Sweden were included. Heart disease was defined as a preoperatively established diagnosis, and subcategorized into ischaemic, valvular, heart failure and atrial fibrillation. Postoperative outcome was analysed by multivariable regression.Out of 971 patients, 225 (23.3%) had heart disease. Heart disease was associated with an increased risk for complications; Clavien-Dindo score ≥ IIIa (Odds Ratio [OR] 1.53, 95% confidence interval [CI] 1.07-2.18; p = 0.019), intensive care unit admissions (OR 3.20, 95% CI 1.81-5.66; p 0.001) and longer hospitalizations (median 14 vs. 11 days; p 0.001). Although heart disease was not associated with 90-day mortality, it conferred a shorter median overall survival (22 vs. 32 months; p 0.001). Atrial fibrillation and heart failure were each associated with increased risk for postoperative complications, whereas ischaemic and valvular heart disease were not.Atrial fibrillation and heart failure were independently associated with increased risk for postoperative complications. Despite no association with early postoperative mortality, heart disease negatively affected long-term survival.
Published: 2021

30. Impact of Early Jejunostomy Tube Feeding on Clinical Outcome and Parameters of Body Composition in Esophageal Cancer Patients Receiving Multimodal Therapy

Author: Piers R, Boshier, Fredrik, Klevebro, Amy, Schmidt, Shiwei, Han, Wesley, Jenq, Francesco, Puccetti, Maarten F J, Seesing, Vickie E, Baracos, and Donald E, Low
Subjects: Esophagectomy, Enteral Nutrition, Treatment Outcome, Esophageal Neoplasms, Malnutrition, Weight Loss, Body Composition, Jejunostomy, Humans, Neoadjuvant Therapy, Retrospective Studies
Abstract: Malnutrition commonly affects patients with esophageal cancer and has the potential to negatively influence treatment outcomes. The aim of this study was to investigate the impact of early (preoperative) jejunostomy tube feeding (JTF) in nutritionally 'high risk' patients receiving multimodal therapy for esophageal cancer.Patients were selected to undergo early JTF during neoadjuvant chemoradiotherapy (nCRT) in accordance with European Society for Clinical Nutrition and Metabolism (ESPEN) and Enhanced Recovery after Surgery (ERASIn total, 81 patients received early JTF and 91 patients received routine JTF. Patients who received early JTF had lower body mass index (BMI; 26.1 ± 4.6 vs. 28.4 ± 4.9; p = 0.002), greater weight loss, and worse performance status at diagnosis. Groups were otherwise well-matched for baseline characteristics. Rate of re-intubation (8.8% vs. 1.1%; p = 0.027), pulmonary embolism (5.0% vs. 0.0%; p = 0.046), and 90-day mortality (10.0% vs. 1.1%; p = 0.010) were worse in the early JTF group; however, overall survival was equivalent for both the early and routine JTF groups (p = 0.053). Wide variation in the degree of preoperative muscle loss and total adipose tissue loss was observed across the entire study cohort. Relative preoperative muscle and adipose tissue loss in patients with early and routine JTF was equivalent.In patients determined to be at 'high risk' of malnutrition, early JTF may prevent excess morbidity after esophagectomy with an associated relative preservation of parameters of body composition.
Published: 2021

31. 664 BURDEN OF IN-HOSPITAL CARE IN OESOPHAGEAL CANCER: A NATIONAL POPULATION-BASED STUDY

Author: Fredrik Klevebro, Jan Johansson, Mats Lindblad, Jakob Hedberg, David Edholm, and Gustav Linder
Subjects: Population based study, medicine.medical_specialty, business.industry, Family medicine, Gastroenterology, medicine, Cancer, General Medicine, medicine.disease, business, Hospital care
Abstract: Oesophageal cancer management requires extensive in-hospital care. This cohort study aimed to quantify in-hospital care for esophageal cancer patients in relation to intended treatment and to analyze factors associated with risk of spending a large proportion of survival time in hospital. Methods All patients with oesophageal cancer in three nationwide registers over a ten-year period, were included. In-hospital care during the first year after diagnosis was evaluated and the proportion of survival time spent in hospital, stratified for intended treatment (curative, palliative or best supportive care) calculated. Associations of relevant factors to a greater proportion of survival time in hospital was analyzed by multivariable logistic regression. Results In-hospital care was provided for a median time of 39, 26 and 15 days the first year after diagnosis of oesophageal cancer for curative, palliative and best supportive care groups respectively. Patients receiving curatively intended treatment spent a median of 12% of their survival time in hospital during the first year after diagnosis, while palliative or best supportive care patients spent 19% and 23% respectively. Factors associated with more in-hospital care included higher age, female sex, being unmarried and chronic obstructive pulmonary disease (COPD). Conclusion The burden of in-hospital care during the first year after diagnosis of oesophageal cancer was substantial. Important clinical and socioeconomic factors were identified that predisposed to a greater proportion of survival time spent in hospital.
Published: 2021

32. 627 PL11.02 ENSURE: AN INTERNATIONAL MULTICENTRE STUDY EXPLORING WHETHER SURVEILLANCE AFTER ESOPHAGEAL CANCER SURGERY IMPACTS ONCOLOGICAL AND QUALITY OF LIFE OUTCOMES

Author: Fredrik Klevebro, Lucas Goense, John V. Reynolds, George B. Hanna, Sheraz R. Markar, Magnus Nilsson, Asif Johar, Richard van Hillegersberg, Jessie A Elliott, Giovanni Zaninotto, and Pernilla Lagergren
Subjects: medicine.medical_specialty, Quality of life (healthcare), business.industry, Gastroenterology, medicine, General Medicine, Esophageal cancer, medicine.disease, business, Intensive care medicine
Abstract: Although established and emerging therapies for recurrent esophageal cancer (EC) may impact on survival and health related quality of life (HR-QL), surveillance protocols after the primary curative treatment of EC are varied and inconsistent, reflecting a limited evidence-base to guide an optimum approach. Specifically, whether advantages exist for an intensive surveillance protocol is unknown and was the focus of this study. Methods ENSURE was an international multicentre observational study of consecutive patients undergoing surgery with curative intent for esophageal and junctional cancers (2009–2015) across 20 European and North American centers (NCT03461341). Intensive surveillance (IS) was defined as routine annual CT/PET-CT during the first three postoperative years, and compared with standard surveillance (SS) with investigation as clinically indicated. The primary outcome measure was overall survival (OS), secondary outcomes included treatment, disease-specific survival (DSS), disease-free survival (DFS), recurrence pattern, and HR-QL. Multivariable linear, logistic and Cox proportional hazards regression analyses were performed to determine the independent impact of surveillance on oncologic outcomes and HR-QL. Results 4,682 patients were studied, 45.5% underwent IS. At median follow-up of 60 months, 47.5% developed recurrence; oligometastatic in 39% of cases, with 31% receiving best supportive care, 60% chemotherapy and/or radiation, and 8% surgical resection. IS was associated with reduced symptomatic recurrence (OR0.17 [0.12–0.25]), increased tumor-directed therapy (OR2.09 [1.58–2.77]), and improved OS (HR0.90 [0.82–0.98], 5-year OS 47.9 ± 1.2% versus 43.2 ± 1.1%). On multivariable analysis, significantly improved OS with IS was maintained for patients who underwent surgery alone (HR0.60 [0.47–0.78]) and in those with lower pathological (y)pT stages (Tis-2, HR0.72 [0.58–0.89]). IS was associated with greater anxiety (P = 0.016), but similar overall HR-QL. Conclusion These data suggest that IS may improve oncologic outcomes, particularly in patients with early stage disease at presentation or with a favorable pathological stage post induction therapy. This may be relevant to guideline development and provide a framework and rationale for RCTs. It may also inform shared decision-making with patients at a time where therapeutic options for recurrence are expanding.
Published: 2021

33. 464 IS OPEN LEFT THORACO-ABDOMINAL ESOPHAGECTOMY A VIABLE OPTION IN THE ERA OF MINIMALLY INVASIVE ESOPHAGECTOMY?

Author: Fredrik Klevebro, Piers R Boshier, Carmen Mueller, Jonathan Cools-Lartigue, Lorenzo Ferri, and Donald E Low
Subjects: Gastroenterology, General Medicine
Abstract: The aim of the study was to evaluate short-term and oncological outcomes of left thoracoabdominal esophagectomy (LTE) compared to minimally invasive esophagectomy for cancer of the esophagus and gastroesophageal junction. LTE facilitates complete resection of esophageal cancer particularly for bulky tumors, but there are concerns that this approach is associated with significant morbidity. Methods Prospectively entered esophagectomy databases from two high volume North American centers were reviewed for patients undergoing LTE or MIE in the 2012–2018. Patient demographics, tumour characteristics, operative outcomes, postoperative outcomes, and pathologic surrogates of oncologic efficacy (R0 resection rate, and number of resected lymph nodes) were compared. In total 247 patients were included in the study, LTE was applied in 170 (68.8%) patients, and MIE in 77 (31.2%) patients. Results LTE patients had more neoadjuvant treatment (LTE = 78.2%, MIE = 34.2%, P 2—LTE = 26.1%, MIE17.0%, P = 0.184), pulmonary complications (LTE = 31.9%, MIE = 20.0%, P = 0.085), pneumonia (LTE = 15.2%, MIE = 13.6%, P = 0.768), anastomotic leak (LTE = 7%, MIE = 10%, P = 0.396), or postoperative mortality (LTE = 0%, MIE = 1.3%, P = 0.140). Median length of stay was 7 days in both groups. R0 resection rate was 93.8% and 95.5% respectively (P = 0.631). Median number of resected lymph nodes was 24 for LTE and 22 for MIE (P = 0.226). LTE had more stage II-IV tumors (LTE = 67.8%, MIE = 40.7%, P Conclusion LTE was used for larger tumors with greater lymph node burden in patients that were more likely to have received neoadjuvant treatment compared to MIE. Despite this the postoperative morbidity was equal to that of MIE, with no difference in short-term or oncological results in this cohort.
Published: 2021

34. 546 INTENSIVE SURVEILLANCE AFTER CURATIVE INTENT SURGERY FOR ESOPHAGEAL CANCER: INITIAL RESULTS OF THE ENSURE STUDY

Author: Giovanni Zaninotto, George B. Hanna, Fredrik Klevebro, Magnus Nilsson, John V. Reynolds, Jessie A Elliott, Sheraz R. Markar, and Melody Ni
Subjects: Curative intent, medicine.medical_specialty, business.industry, General surgery, Gastroenterology, medicine, General Medicine, Esophageal cancer, business, medicine.disease
Abstract: Emerging data demonstrate long-term survival after salvage interventions for local or oligometastatic recurrence after planned curative resection for esophageal cancer, providing rationale for postoperative surveillance. However, the impact of intensive surveillance on oncologic outcome is unknown. This multicenter collaborative study aimed to characterize oncologic surveillance protocols across esophageal cancer centers internationally and determine the independent effect of intensive surveillance on oncologic outcome. Methods The ENSURE international multicenter study included consecutive patients who underwent surgery with curative intent for cTxNxM0 esophageal cancer from June 2009 to June 2015. Intensive surveillance was defined as use of cross-sectional imaging, at least annually, during the first three postoperative years. The estimated sample size of 4425 provided 90% power to detect a 5% increase in 5-year overall survival (OS, primary outcome measure). Secondary outcome measures included disease-free (DFS) and disease-specific survival (DSS), surveillance strategies, incidence of oligometastatic recurrence, treatment strategies, and HRQOL. The study was registered on ClinicalTrials.gov (NCT03461341). Results 4597 patients were included. The participating 27 centres undertook mean(SD) 52.3(17.1) esophageal cancer resections annually between 3.5 ± 1.3 attending surgeons. 37%, 11% and 19% centers utilized postoperative surveillance CT, PET-CT and endoscopy, respectively. Among all patients, intensive surveillance was associated with improved OS (HR0.92 [0.85–0.99]) but not DSS (HR0.93 [0.85–1.01]) or DFS (HR0.97 [0.90–1.04]), and on multivariable analysis, intensive surveillance did not provide oncologic benefit (OS HR1.10 [0.99–1.22], DSS HR1.12 [1.00–1.25]), but reduced observed DFS (HR1.19 [1.08–1.31]). Evaluating surveillance modalities, neither surveillance endoscopy nor laboratory tests improved oncologic outcome, however flexible nasolaryngoscopy was associated with improved OS (HR0.84 [0.69–1.0]). Conclusion ENSURE, the first study powered to assess the impact of postoperative surveillance protocols on oncologic outcome in esophageal cancer, demonstrated no overall survival benefit following intensive imaging surveillance, with reduced observed disease-free survival time. However, routine assessment for secondary aerodigestive malignancies may be of oncologic benefit. The present data do not support the use of intensive imaging surveillance among all patients following esophageal cancer surgery. Further reports detailing subgroup analyses and HRQOL impact are anticipated.
Published: 2021

35. 691 IS OPEN LEFT THORACO-ABDOMINAL ESOPHAGECTOMY A VIABLE OPTION IN THE ERA OF MINIMALLY INVASIVE ESOPHAGECTOMY?

Author: Fredrik Klevebro, Shiwei Han, Stephen Ash, C Mueller, Jonathan Cools-Lartigue, Nick Maynard, Lorenzo Ferri, and Donald Low
Subjects: medicine.medical_specialty, business.industry, Esophagectomy, medicine.medical_treatment, Invasive esophagectomy, Gastroenterology, Medicine, General Medicine, business, Surgery
Abstract: Left thoracoabdominal esophagectomy (LTE) facilitates complete resection of esophageal cancer particularly for bulky tumors, but there are concerns that this approach is associated with significant morbidity. The aim of the current study was to evaluate short-term and oncological outcomes of left thoracoabdominal esophagectomy compared to minimally invasive esophagectomy for cancer of the esophagus and gastroesophageal junction. Methods Prospectively entered esophagectomy databases from three high volume centers were reviewed for patients undergoing LTE or MIE 2012–2018. Patient demographics, tumour characteristics, operative outcomes, postoperative outcomes, and pathologic surrogates of oncologic efficacy (R0 resection rate, and number of resected lymph nodes) were compared. In total 844 patients were included in the study, LTE was applied in 654 (77.5%) patients, and MIE in 190 (22.5%) patients. Results LTE patients had more neoadjuvant treatment (LTE = 74.5%, MIE = 64.9%, P = 0.027). There was no difference in overall postoperative complications (LTE = 61.9%, MIE = 64.6%, P = 0.517), severe complications (Clavien Dindo >IIIa (LTE = 26.6%, MIE 26.5%, P = 0.982), pneumonia (LTE = 29.8%, MIE = 26.3%, P = 0.349), anastomotic leak (LTE = 7.7%, MIE = 9.9%, P = 0.348), or in-hospital mortality (LTE = 1.5%, MIE = 2.1%, P = 0.584). Median length of stay was 11 days after LTE vs. 8 days after MIE (P Conclusion LTE was used for tumors with greater lymph node burden in patients that were more likely to have received neoadjuvant treatment compared to MIE. MIE was associated with significantly shorter length of hospital stay, however postoperative morbidity and Clavien-Dindo scores were equal to that of MIE in this cohort.
Published: 2021

36. Short-course compared to long-course palliative radiotherapy for oesophageal cancer: a single centre observational cohort study

Author: Fredrik Klevebro, Nelson Ndegwa, Halla Sif Ólafsdóttir, and Gabriella Alexandersson von Döbeln
Subjects: Adult, Male, medicine.medical_specialty, Palliative care, Time Factors, Esophageal Neoplasms, Nausea, medicine.medical_treatment, R895-920, Medical physics. Medical radiology. Nuclear medicine, Clinical endpoint, Medicine, Humans, Radiology, Nuclear Medicine and imaging, External beam radiotherapy, Dose fractionation, RC254-282, Aged, Retrospective Studies, Aged, 80 and over, Radiotherapy, business.industry, Research, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Retrospective cohort study, Radiotherapy Dosage, Dysphagia, Middle Aged, Prognosis, Surgery, Radiation therapy, Survival Rate, Oncology, Female, Radiotherapy, Intensity-Modulated, medicine.symptom, business, Cohort study, Follow-Up Studies, Oesophageal neoplasm
Abstract: BackgroundCommon symptoms of oesophageal cancer are dysphagia, pain, and bleeding. These symptoms can be relieved with palliative radiotherapy. The aim of this study was to analyse the outcome of two different palliative radiotherapy schedules.MethodsWe conducted a retrospective cohort study on palliative radiotherapy for oesophageal cancer given at Karolinska University Hospital. Patients included were treated with either short-course (20 Gy in 4 Gy fractions daily, 5 consecutive workdays) or long-course (30–39 Gy in 3 Gy fractions, 10–13 consecutive workdays) palliative external beam radiotherapy between January 2009 and December 2013. The primary endpoint was dysphagia relief and secondary endpoints were adverse events, re-interventions, and overall survival. Cox regression analyses were used to estimate the effect of treatment schedule on survival.ResultsA total of 128 patients received external beam radiotherapy under the study period, of these 75 (58.6%) received short-course radiotherapy and 53 (41.4%) long-course radiotherapy. Sixteen (30.8%) patients experienced dysphagia relief after short-course radiotherapy and 9 (22.0%) patients after long-course radiotherapy (p = 0.341). Acute toxicity was less frequent after short-course radiotherapy than after long-course radiotherapy, particularly oesophagitis (35.4% vs. 56.0%,p = 0.027) and nausea/emesis (18.5% vs. 36.0%p = 0.034). Re-interventions tended to be more common after short-course radiotherapy (32.0%) than after long-course radiotherapy (18.9%) (p = 0.098). There was no difference in overall survival between the two groups.ConclusionsShort- and long-course palliative radiotherapy for oesophageal cancer were equally effective to relieve dysphagia and no difference was seen in overall survival. Acute toxicity was, however, more frequent and more severe after long-course radiotherapy. Our results suggest that short-course radiotherapy is better tolerated with equal palliative effects as long-course radiotherapy.
Published: 2021

37. ASO Visual Abstract: Impact of Early Jejunostomy Tube Feeding on Clinical Outcome and Parameters of Body Composition in Esophageal Cancer Patients Receiving Multimodal Therapy

Author: Piers R. Boshier, Fredrik Klevebro, Amy Schmidt, Shiwei Han, Wesley Jenq, Francesco Puccetti, Maarten F. J. Seesing, Vickie E. Baracos, and Donald E. Low
Subjects: Oncology, Surgery
Published: 2022

38. Reply to Comment on Health-related quality of life following total minimally invasive, hybrid minimally invasive or open oesophagectomy: a population-based cohort study by Li et al

Author: Fredrik Klevebro, Pernilla Lagergren, and Asif Johar
Subjects: Health related quality of life, medicine.medical_specialty, Esophageal Neoplasms, business.industry, MEDLINE, Cohort Studies, Esophagectomy, Population based cohort, Quality of Life, Medicine, Humans, Surgery, Laparoscopy, business, Intensive care medicine
Published: 2021

39. Tumor regression grading after neoadjuvant treatment of esophageal and gastroesophageal junction adenocarcinoma: results of an international Delphi consensus survey

Author: Michael Vieth, Kateřina Kamarádová, Rhonda K. Yantiss, E. Sabo, N. Wang, James Conner, Donald E. Low, Jean-François Fléjou, Robert H. Riddell, Sönke Detlefsen, Luca Mastracci, Lars Lundell, G. Saliba, Fredrik Klevebro, H. Hahn, Kieran Sheahan, R. Dorer, Sybren L. Meijer, Fátima Carneiro, and Pathology
Subjects: 0301 basic medicine, medicine.medical_specialty, Neoadjuvant treatment, Consensus, Delphi Technique, Esophageal Neoplasms, education, Esophageal cancer, Adenocarcinoma, Gastroesophageal Junction Adenocarcinoma, Gastroesophageal junction cancer, Delphi, Specimen Handling, Pathology and Forensic Medicine, Gross examination, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Esophagus, Grading (education), Lymph node, business.industry, medicine.disease, Histopathologic tumor regression grade, Primary tumor, Neoadjuvant Therapy, Treatment Outcome, 030104 developmental biology, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Esophagogastric Junction, Radiology, Neoplasm Grading, business
Abstract: Summary Complete histopathologic tumor regression after neoadjuvant treatment is a well-known prognostic factor for survival among patients with adenocarcinomas of the esophagus and gastroesophageal junction. The aim of this international Delphi survey was to reach a consensus regarding the most useful tumor regression grading (TRG) system that could represent an international standard for histopathologic TRG grading of gastroesophageal carcinomas. Fifteen pathologists with special interest in esophageal and gastric pathology participated in the online survey. The initial questionnaire contained of 43 statements that addressed the following topics: (1) specimen processing, (2) gross examination, (3) cross sectioning, (4) staining, (5) Barrett's esophagus, (6) TRG systems, and (7) TRG in lymph node (LN). Participants rated the items using a 5-point Likert style scale and were encouraged to write comments for each statement. The expert panel recommended a 4-tiered TRG system for assessing the primary tumor: grade 1: No residual tumor (complete histopathologic tumor regression), grade 2: less than 10% residual tumor (near-complete regression), grade 3: 10%–50% residual tumor (partial regression), grade 4: greater than 50% residual tumor (minimal/no regression), combined with a 3-tiered system for grading therapeutic response in metastatic LNs: grade a: no residual tumor (complete histopathologic TRG), grade b: partial regression (tumor cells and regression), grade c: no regression (no sign of tumor response). This TRG grading system can be recommended as an international standard for histopathologic TRG grading in esophageal and gastroesophageal junction adenocarcinoma.
Published: 2021

40. ENSURE: An International Multicentre Study Exploring Whether Surveillance after Oesophageal Cancer Surgery Impacts Oncological and Quality of Life Outcomes

Author: Jessie A. Elliott, Sheraz R. Markar, Fredrik Klevebro, Asif Johar, Lucas Goense, Pernilla Lagergren, Giovanni Zaninotto, Richard van Hillegersberg, M Nilsson, George B. Hanna, John V. Reynolds, and ENSURE Study Group
Published: 2021

41. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Tamás, Mersich, Dániel, Wettstein, Gabriele, Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud, Mozafari, Ahmed, Hilmi, Helen, Mohan, Oded, Zmora, Gaetano, Gallo, Francesco, Pata, Gianluca, Pellino, Yuki, Fujimoto, Naoto, Kuroda, Mohamad, K Abou Chaar, Faris, Ayasra, Ildar, Fakhradiyev, Intisar Hisham Said Hamdun, Jang, Jin-Young, Mohammad, Jamal, Lina, Karout, Aiste, Gulla, Fanjandrainy, Rasoaherinomenjanahary, Luc Hervé Samison, Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura, Martinez, María José Martínez, Alejandra, Nayen, Antonio Ramos-De la Medina, Jade, Nunez, Pueya Rashid Nashidengo, Rakesh, Shah, Ashish Lal Shrestha, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Deborah, Wright, Lukman, Abdur-Rahman, Adesoji, Ademuyiwa, Adewale, Adisa, Babatunde, Osinaike, Justina, Seyi-Olajide, Omolara, Williams, Emmanuel, Williams, Sofija, Pejkova, Zainab Al Balushi, Raza, Sayyed, Mustafa Abo Mohsen, Sadi, A Abukhalaf, Moises, Cukier, Hugo, Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr, Major, José, Azevedo, Miguel, F Cunha, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Viktor, Kochetkov, Andrey, Litvin, Jc Allen Ingabire, Georges, Bucyibaruta, Ntirenganya, Faustin, Sosthene, Habumuremyi, Alphonsine, Imanishimwe, Haragirimana Jean de Dieu, Emmanuel, Munyaneza, Isaie, Ncogoza, Abdourahmane, Ndong, Dejan, Radenkovic, Min Hoe Chew, Frederick, Koh, James, Ngu, Arpád, Panyko, Uros, Bele, Jurij Aleš Košir, Hassan, Daoud, Ana Maria Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin, Rutegård, Malin, Sund, Michel, Adamina, Eleftherios, Gialamas, Karoline, Horisberger, Muhammad, Alshaar, Abel, Huang, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Hervé Monka Lekuya, Slava, Kopetskyi, Hayder, Alsaadi, Sattar, Alshryda, Osaid, Alser, Brittany, Bankhead-Kendall, Kerry, Breen, Hassan, Mashbari, Fernando Bonilla Cal, Hamza, Al-Naggar, Mayaba, Maimbo, Dennis, Mazingi, Tom, Abbott, Melika, Akhbari, Ruth, Benson, Shivam, Bhanderi, Bruce, Biccard, Edward, Caruana, Sohini, Chakrabortee, Reema, Chapatwala, Ainhoa, Costas-Chavarri, Andreas, K Demetriades, Anant, Desai, Salomone Di Saverio, Thomas, Drake, John, Edwards, Jonathan, Evans, Marco, Fiore, Samuel, Ford, Christina, Fotopoulou, Alexander, Fowler, Kaori, Futaba, Ian, Ganly, Harelimana Grace James, Ewen, Griffiths, Alessandro, Gronchi, Peter, Hutchinson, Gabriella Yael Hyman, Joseph, Incorvia, Ritu, Jain, Michael, Jenkinson, Tabassum, Khan, Stephen Richard Knight, Angelos, Kolias, Søren, Kudsk-Iversen, Tsun Yu Kwan, Elaine, Leung, Julio, Mayol, Siobhan, Mckay, John, G Meara, Emily, Mills, Susan, Moug, Akshay, Patel, Roberto, Perinotti, Henry, E Rice, Keith, Roberts, Andrew, Schache, Richard, Shaw, Neil, Smart, Matthew, Stephens, Grant, D Stewart, Ella, Teasdale, Peter, Vaughan-Shaw, Raghavan, Vidya, Naomi, Wright, Natalie, Zimmelman, Ervis, Agastra, Dariel, Thereska, Sergio Martin Lucchini, Veronica, Laudani, Carina, Chwat, Ivana Ines Pedraza Salazar, Diana Alejandra Pantoja Pachajoa, Agustin, Duro, José Alfredo Calderón Arancibia, Giuliana, D'Aulerio, Nagendra, Dudi-Venkata, Natasha, Egoroff, Shebani, Farik, Natalie, Lott, Jana-Lee, Moss, Sarah, Rennie, Lorwai, Tan, Uyen Giao Vo, David, Watson, David, Watters, Tim, Bright, Paul, Hollington, Xuanyu, Zhou, Hidde, M Kroon, Anthony, Farfus, John, Barker, Eleanor, Watson, Sean, Stevens, Haider, Latif, Amanda Caroline Dawson, Alwin, Chuan, Vijayaragavan, Muralidharan, Enoch, Wong, Travis, Ackermann, Maurizio, Pacilli, Russell, Hodgson, Alexander, Heriot, Peter, Choong, Wendy, Brown, Surjit, Lidder, Justin, Yeung, Luke, Traeger, Guillermo, Regalo, Ralph, Gourlay, Sarit, Badiani, Cherry, Koh, Soni, Putnis, Fayza, Haider, Ashrarur Rahman Mitul, Niels, Komen, Bert, Dhondt, Serge, Cappeliez, Manon, Pigeolet, Martijn, Schoneveld, Jasper, Stijns, Wouter, Oosterlinck, Nicolas, Flamey, Cyrille, Kpangon, Mouhamed, Agbadebo, Sèmèvo Romaric Tobome, Aldo Vieira Barros, Samuel Aguiar Júnior, Heloisa Galvão do Amaral Campos, Jefferson, Gross, Felipe José Fernandez Coimbra, Luiz Paulo Kowalski, Fabiana, Makdissi, Suely, Nakagawa, Joao Pedreira Duprat Neto, Jose Guilherme Vartanian, Guilherme, Yazbek, Stenio, C Zequi, Ronald, Flumignan, Natalia, Jaworska, Angela, Dell, Harsha, Shanthanna, Abdollah, Behzadi, Carolyn, Nessim, Michelle, Mozel, Pascal, St-Germain, Crispin, Russell, Gary, Groot, Najib, Safieddine, Duminda, Wijeysundera, Antoine, Eskander, Sami, Chadi, Shawn, Mackenzie, Alana, Flexman, Fernando, Heredia, Julio, Villanueva, Sofia, Waissbluth, Roberto, Macchiavello, Mario, I Escudero, Tyare, Fuentes, Ximena, Mimica, Dinimo Bolivar Saenz, Lina, Caicedo, Juan Pablo Alzate, Joaquin, Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Juliana, Rodriguez, Liliana, Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián, Balanta-Melo, Rafael, Figueroa-Casanova, Oscar-Julián, García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Emileth, Montenegro, Julia, Rodriguez-Abreu, Dolores, Mejía, Galal, Abouelnagah, Sameh, Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy, A Hassan, Mahmoud, M Saad, Mohamed Reda Loaloa, Badr, Mostafa, Mohamed, Qassem, Mohamed, Fahmy, Hesham, Abozied, Ahmed, Y Azzam, Sherief, Ghozy, Asser, Sallam, Ahmed, Shehta, Mohamed, Abdelkhalek, Rehab, Samaka, Amr, Morsy, Ahmed Elshawadfy Sherif, Abraham, Negussie, Tigist, Fisseha, Kibruyisfaw, Shumbash, Metasebia, Abebe, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe, Megersa, Teshome, Tefera, Melatework, Assefa, Bahru, Atnafu, Bereket, Tsegaye, Yoseph Solomon Bezabih, Silamlak, Sisay, Kebebe, Bekele, Moa, Jira, Habtamu, Derilo, Eyueal, Degefa, Anteneh, Tadesse, Melkamu, Nidaw, Elise, Sarjanoja, Sylvie, Testelin, Sophie, Boucher, Lionel, Jouffret, Zaher, Lakkis, Alban Zarzavadjian Le Bian, Luke, Harper, Marc Danguy des Déserts, Benoît, André, Karem, Slim, Romain, Verhaeghe, Andrea, Police, Edouard, Girard, Alexandre, Chebaro, Armande Subayi Nkembi, Laurent, Arnalsteen, Quentin, Ballouhey, Diane, Mege, Clement, Jeandel, Emilie, Duchalais, Pierre-Alban, Bouche, Gilles, Manceau, Célia, Crétolle, Erik, Hervieux, Noémie, Girard, Agathe, Seguin-Givelet, Sebastien, Gaujoux, Belinda De Simone, Matthieu, Boisson, Damien, Bergeat, Fabien, Fredon, Francesco, Nappi, Radwan, Kassir, Aurélien, Scalabre, Federico, Migliorelli, Anne-Cecile, Ezanno, Barbara, Seeliger, Charlotte, Vaysse, Helene, Charbonneau, Vincent, Misrai, Olivier, Abbo, Martina Aida Angeles, Laurent, Brunaud, Ali, Modabber, Sebastian, Wolf, Carsten, Kamphues, Philipp, Höhn, Tim, R Glowka, Alexander Christopher Rokohl, Ulrich, Bork, Georg, Fluegen, Raymund, E Horch, Andrea, Schmedding, Andreas, Schnitzbauer, Helge, Eberbach, Daniel, Schlager, Fritz, Spelsberg, Lena, Keppler, Andreas, Hecker, Susanne, Wolfer, Ulrich, Ronellenfitsch, Christine, Nitschke, Christian, Peiper, Ibrahim, Hakami, Stefan, Welter, Karine, Nikolaieva, Andreas, Roth, Judith, Lindert, Konstantinos, Gousias, Anke, Rissmann, Valerie Catherine Linz, Nuh, Rahbari, Marie-Claire, Rassweiler-Seyfried, Anna Eleonora Gut, Jens, Gempt, Daniel, Reim, Arthur, Wagner, Alexander, M Keppler, Mircea Gabriel Stoleriu, Tim, Saier, Josef, Stadler, Julia Christina Kaiser, Stefan, M Brunner, Karin, Pfister, Jonas, Herzberg, Kai, Nowak, Tobias, Reinhard, Gregor, A Stavrou, Alfred, Königsrainer, Christian, Konrads, Markus, Quante, Simon, Laban, Silke von Pusch, Markus, Hirschburger, Johannes, Doerner, Armin, Wiegering, Ekaterini Christina Tampaki, Alitza Gutiérrez Ruiz, Alejandra, Rodas, Ana Lucía Portilla, Jacqueline, Carrera, Amalia Barrios Duarte, Megan, Lowey, Sabrina, Barillas, Atul, Suroy, Dhaivat, Vaishnav, Raghunandan Gorantlu Chowdappa, Irappa, Madabhavi, Dhananjaya, Bhat, Sunil Kumar Venkatappa, Sumit, Thakar, Kavitha, Jain, Aruna, Kumar, Manoj, Nagar, Tushar, Mishra, Arunkumar, Sekar, Anand, Gupta, Lileswar, Kaman, Madhivanan, Karthigeyan, Manjul, Tripathi, Ashwin, Rammohan, Sudheer Othiyil Vayoth, Anupama, Rajanbabu, Anbukkani, Subbian, Rahul, Gupta, Monish, Raut, Nissi, Evelyn, R Lavanya Kannaiyan, Anil, Matai, Sanjeev, Misra, Vishal, Bhende, Sathish, Muthu, Indranil, Ghosh, Abhishek, Sharma, Ankur, Bajaj, Shiv, Rajan, Gaurav, Agarwal, Pranay, Pawar, Philip, Alexander, M Vijayakumar Vijayakumar, Zeeshan, Hameed, Badareesh, L, Navneet Kumar Chaudhry, Lipika, Baliarsing, Satish, Dharap, Amruta, Kulkarni, Yuvaraja, Thyavihally, Rahul Deo Sharma, S Pramesh, C, Rajesh, Soni, Surya Kumar Dube, Shilpa, Sharma, Harvinder, Singh, Lovenish, Bains, Rahul, Ghodke, Ashwani, Kumar, Vivek, Sodhai, Suvendu, Maji, Somprakas, Basu, Chandrashekhar, Mahakalkar, Ravi, Kannan, Asif, Mehraj, Ranganath, N, Ashish, Phadnis, Yadev, I, Alfie, Kavalakat, Rohin, Mittal, Karthik Chandra Vallam, Hamed, Akhavizadegan, Esmaeil Rezghi Maleki, Naser Yousefzadeh Kandevani, Hilary, Ikele, Catherine, Mcnestry, Christina, Fleming, Stephen, O'Brien, Sami Abd Elwahab, Niall, Davis, Mohsen, Javadpour, Brendan, Mcdonnell, Clare, O Connor, Jarlath, Bolger, Cillian, Clancy, Stefanie, M Croghan, Noel, Donlon, Carolyn, Cullinane, Ben, Creavin, Muheilan, Muheilan, Helen, Earley, Syed Mohammad Umar Kabir, Muhammad, Fahadullah, Éanna, Ryan, Tara, Connelly, Daisuke, Hashimoto, Majdi Ali Alqudah, Amer, Alajalen, Rand, Y Omari, Abdulrahman, Qasem, Yazan, Alawneh, Amer, Ahmad, Omar, Aladawi, Bourhan, Alrayes, Hanan, Haidar, Shatha, Husain, Faisal, Qassem, Adnan, Sumadi, Ala'a Abu Salhiyeh, Balqees Mahmoud Al-Manaseer, Zaid, Alsunna, Hazim, Ra'Ed, Faten Reyad Bani Hamad, Amro, Abuleil, Elmi Ahmed Mohamed Jimaale, Marah, Abu-Mehsen, Noor, Olaywah, Omar, Wafi, Hazim, Ababneh, Luai, Abu-Ismail, Almu'Atasim, Khamees, Ahmad, Alkhatib, Raikhan, Bolatbekova, Mukhtar, Kulimbet, Talgat, Nurgozhin, Timur, Saliev, Baurzhan, Zhussupov, Ydyrys, Almabayev, Dilyara, Kaidarova, Khalil, Tamoos, Ahmed, Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah, Alkadeeki, Milad, Gahwagi, Wafa, Aldressi, Mohamed, Amnaina, Arowa Hassan Abdulrahman Alansari, Akram, Alkaseek, Ghozlan, Yagoub, Anass Ben Amer, Marwa, Salem, Ayman, Almugaddami, Dania, Burgan, Mohammed, Abdelkabir, Khayriyah, Alshareef, Rayet Al Islam Ben Jouira, Ayman, Meelad, Ahmad, Bouhuwaish, Sumayya Essayah Dwaga, Houda, Khalifa, Bushray, Almiqlash, Taha, Suliaman, Mohammed, Alawami, Fras, Elhajdawe, Hajir, Aboazamazem, Ibrahim, Ellojli, Ahmed, Msherghi, Ismail Ali Saleh, Mohammed, Alayan, Marcel Didier Ndayishyigikiye, Akutu, Munyika, Philipp, Plarre, David, W Borowski, Cameron, Wells, Rebecca, Teague, Brodie, Elliott, David, Kieser, Omar, Mohyieldin, Nick, Mcintosh, Cheyaanthan, Haran, Jasmin, King, Jeong, Ha, Matthew James McGuinness, Opeoluwa, Adesanya, Julius, Olaogun, Akinola, Akinmade, Kefas, Bwala, Peter, Agbonrofo, Akinwale, Afolabi, Usang, Usang, Sebastian, Ekenze, Samson, Olori, Taiwo Akeem Lawal, Abiodun, Okunlola, Stephen, Kache, Danjuma, Sale, Lofty-John, Anyanwu, Chukwuma, Okereke, Musliu Adetola Tolani, Venko, Filipce, Lazar, Todorovic, Sotir, Stavridis, John George Massoud, Sareyah, Alsibai, Rizwan, Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya, Aziz, Asad Ali Kerawala, Lajpat, Rai, Mariyah, Anwer, Aiman, Tariq, Bushra, Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila, Talat, Muhammad, Asif, Muhammad Hamid Chaudhary, Umer, Farooq, Siddique, Ahmad, Waleed, Mabood, Syed Imran Bukhari, Muhammad, Tariq, Eesha, Yaqoob, Saad, Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar 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Mohammed Shadrul Alam, Akm Khairul Basher, Shahnoor, Islam, M Nazmul Islam, S, Sabbir, Karim, Muntasir, Faisel, Sadia, Khan, Iftekhar Ibne Mannan, Nawshin, Nazia, Malissa, Bentham, Sasha, Corbin, Alex, Doyle, Asha, Eastmond, Amelia, Haynes, Margaret, O'Shea, Emil, Phillips, Keisha, Walkes, Evgeniy, L Artyushkov, Mark, L Kaplan, Vladislav, Straltsov, Yauheniya, Litvina, Alexei, Lyzikov, Victor, E Tihmanovich, Mafalda, Borges, Tim, Brits, Nicolas De Hous, Stefan De Wachter, Tomas, Menovsky, Xavier, Mortiers, Dorien, Vermeulen, Nils, Vleminckx, Dirk, Ysebaert, Julie, Bontinck, Danny, Bulthé, Ricky, Rasschaert, Anne-Sophie Van Haver, Koen Van Belle, Laurence, Verstraeten, Manon, Vounckx, Sébastien, D'Ulisse, Yasmine De Bruyne, Badih El Nakadi, Tessely, Heloise, Matteo, Luisetto, Sotirios, Marinakis, Maxime, Maton, Claire, Viste, Elke Van Daele, Mathieu, Vandeputte, Marc, Duinslaeger, Daniel, Jacobs-Tulleneers-Thevissen, Yanina, Jansen, Ward, Janssens, Rastislav, Kunda, Nouredin, Messaoudi, Michael, Ruyssers, Ellen Van Eetvelde, Marian, Vanhoeij, Jef Van den Eynde, Raf Van den Eynde, Ahmed, M Chaoui, Marcellin, Akpla, Souliath, Lawani, Hermann, Agossou, Hulrich Aouagbe Behanzin, Covalic, Bokossa, Hubert, Dewanon, Hugues, Yome, Alassan, Boukari, Oswald, Gbehade, Labissi Francois Amossou, Francis, Dossou, Tatjana, Barišić, Miran, Boras, Zdrinko, Brekalo, Ivana Čuljak Blagojević, Ana, Damjanović, Vedran, Dragisic, Ana Dugandžić Šimić, Filip, Gunaric, Martin, Kajic, Darko, Knežević, Tanja, Krešić, Valentina, Lasić, Ludvig, Letica, Vlatka, Martinovic, Iva, Mikulic, Josip, Miskovic, Hrvoje, Pehar, Pejana, Rastović, Irena, Sesar, Violeta, Šetka-Čuljak, Martina, Soljic, Dejan, Tiric, Vajdana, Tomić, Anja, Vasilj, Igor, Hudic, Renato Aguera Oliver, Felipe Azenha Lamonica, Jorge De Medeiros, Henrique Donizetti Bianchi Florindo, Rodolfo Jose Favaretto Filho, Fernanda Costa Pereira, Rodrigo, Rodrigues, Antonio Antunes Rodrigues Junior, Fernanda Ruiz de Andrade, Maisa, Salvetti, Débora Schalge Campioto, Mayra Tuboi Lamonica, Gustavo, Urbano, Ricardo Villela Prado, Nivaldo, Alonso, Carlos Ferreira Dos Santos, Cristiano, Tonello, Robinson Esteves Pires, Ricardo Fernandes Rezende, Igor, Reis, Fernando Augusto Lima Marson, Erick Pires Ferreira, Camila Vantini Capasso Palamim, Marcelo, Brandao, Tiago Henrique de Souza, Rebecca, Maunsell, Alfeu Accorsi Neto, Guilherme, Accorsi, Murilo Francisco Fernandes, Camila, Machareth, Barbara Viegas Moura, Vanessa, Dias, Luciano, Guarienti, Lia Regina de Sampaio, Cristiano, Vendrame, Tatiane Amorim Coelho, Karin, Becker, Andre, Dias, Camila Girardi Fachin, Monica Maria Gomes-da-Silva, Isabela, Moraes, Amanda, Pinto, Adriano Seikiti Stychnicki, Nathalia Siqueira Julio, José Mauro Dos Santos, Humberto Fenner Lyra Junior, João Carlos Costa de Oliveira, Tiago Rafael Onzi, Marlus Tavares Gerber, Filipe Osni Coelho, Janaína Carla da Silva, Carolina, Panis, Daniel, Rech, Melissa, Avelino, Lais, Botacin, Mateus Capuzzo Gonçalves, Amanda Lira Dos Santos Leite, Laercio, Pol-Fachin, Tainá Santos Bezerra, Alcimar Lavareda Dos Santos Junior Alcimar, Robson, Amorim, Maria Eduarda Bellotti Leão, João José Corrêa Bergamasco, Cintia Cardoso Pinheiro, Rubem Alves Da Silva Neto, Elaine Francisca De Araújo, Lilian, Guimaraes, Tatiana, Liborio-Kimura, Isabelle Melo da Camara, Victor Ripardo Siqueira, Juan, Rodriguez, Jeancarllo, Silva, Rubem Alves Silva Junior, Cláudio, Cardoso, Andre, Guimaraes, Wislene Sarajane Moreira Alves, Agna Soares Da Silva Menezes, Marcelo, Araujo, Kattiucy, Brito, Josie Marcelle Lira Albuquerque, Jairo Alberto Dussan-Sarria, Andressa, Souza, Andre Ricardo Stüker, Tiago, Bresciani, Luciana Cadore Stefani, Leandro Totti Cavazzola, Tainá, Costa, Matheus, Dasqueve, Gustavo De Bacco Marangon, Otávio Ritter Silveira Martins, Josy, Rodrigues, Guilherme Roloff Cardoso, Brasil Silva Neto, Tilaê, Soares, Aline, Zanella, Lucas Torelly Filippi, Enilde Eloena Guerra, Ricardo Pedrini Cruz, Antonio Nocchi Kalil, Gustavo, Laporte, Moacyr, Salem, Murilo de Lima Brazan, Caio Antonio de Campos Prado, Elaine Christine Dantas Moises, Hilda Satie Suto, Alice Gadotti Yasuda, Ana Carolina Tagliatti Zani, Roberto Cardoso Cardoso Dos Santos, Geraldo, Duarte, Edwaldo Edner Joviliano, Carolina Lourenço Gomes Dos Santos, Silvana Maria Quintana, Edwin, Tamashiro, Fabiana Cardoso Pereira Valera, Marília Veccechi Bijos Zaccaro, Isis, Andreotti, Leonardo, Lima, Wilson Salgado Jr, Alonço da Cunha Viana Júnior, Lana, Moutinho, Cora Pichler de Oliveira, Isabela Trindade Martins, Isabela Vieira Toledo, Marco Antonio Correa Guimaraes-Filho, Rodrigo, Arrivabeno, Claudio Bovolenta Murta, Danniel Frade Said, Jose Pontes Junior, Felipe Guimarães Pugliesi, Paulo, Gregorio, Alessandro, Mariani, Fabio, Minamoto, Juliana Lourenço da Silva, Bruno, Muller, Caio, Zanon, Vladimir, C Carvalho, Ana Lucia Munhoz Lima, Priscila, R Oliveira, Jorge Dos Santos Silva, Mariana Faccini Teixeira, Marco, Kulcsar, Leandro, Matos, Kamilla 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Volpe, Arthur, Gatti, Caroline, Nardi, Ramon, Oliva, Layze Braz de Oliveira, Herica Emilia Félix de Carvalho, Ivonizete Pires Ribeiro, Gabriel Renan Soares Rodrigues, Álvaro Francisco Lopes de Sousa, Michel, Chebel, Paulo Henrique de Sousa Fernandes, Marcelo Augusto Faria Freitas, Juliano Rodrigues da Cunha, Zeenia, Ather, Dobromir, Dimitrov, Emil, Filipov, Elitsa, Gyokova, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Vasil, Neykov, Boyko, Atanasov, Nikolay, Belev, Paolina, Kamenova, Kaloyan, Tonev, Tsanko, Yotsov, Evguenia, Hristova, Kolyo, Spassov, Tsanko, Tsankov, Dragomir, Dardanov, Petar, Gribnev, Manol, Sokolov, James, Brown, John, Tanyi, Heather, Hurdle, Anthony, Maclean, Michael, Sander, Salim Al Riyami, Krittika, Bali, David, Bigam, Khaled, Dajani, Mehran, Anvari, Rafik, Bolis, David, Choi, Susan, Ellis, Michael, Gupta, Wael, Hanna, Dennis, Hong, Cynthia, Horner, Lea, Luketic, Peter, Moisiuk, Yaron, Shargall, Hilda, Alfaro, Nawar, Alkhamesi, Laura, Allen, Muriel, Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, Labrecque, Eve-Lyne, Langlais, Audrey, Larouche, Andréane, Lavallée, Madeleine, Lemyre, Sarah, Maheux-Lacroix, Melissa, Marien, Patrick, Marin, Julie, Mauger, Genevieve, Milot, Sylvie, Nadeau, Sebastien, Nguyen, Mélinda, Paris, Stéphane, Pelet, Marie, Plante, Carole, Plante, Frederic, Pouliot, Marie Claude Renaud, Mathilde, Sarlabous, Isabelle, Schmit, Raphaël, St-Germain, Brian, Johnston, Nicole, Labine, Amit, Persad, Hong, Pham, Melissa, Wood, Riordan, Azam, Amit, Atrey, Andrew, Beckett, Daniel, Cohen, Sunit, Das, Julian, Daza, Cheryl, Dunkerton, Yosef, Ellenbogen, Ciara, Hanley, Sorcha, Kellett, Amir, Khoshbin, Karim, Ladha, Amanda, Mcfarlan, Spencer, Montgomery, Janneth, Pazmino-Canizares, Hrishikesh, Suresh, Ravleen, Vasdev, Maira, Ahmed, Fred, Gentili, Aristotelis, Kalyvas, Matthias, Millesi, Can, Sarica, Taariq, Shaikh, Leslie, St, Jacques, Raha, Tabasinejad, Gelareh, Zadeh, Marvin, Hsiao, Nicole, Jedrzejko, Peter, Black, Claire, Broe, Charlotte, Dandurand, Rebecca, Grey, 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Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, 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Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez 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Andrea Carolina Perea Serna, July, Ríos, Gabriel, Ríos-Samper, Juan David Rivera Garcia, Juan Camilo Salcedo Moreno, John, Sandoval, Guillermo Alberto Sarmiento Ramirez, Paola Andrea Tabares Romero, Ricardo, Urzola, Iliana Maria Valdes-Duque, Miguel, Velasquez, Lina Maria Villegas, James, Zapata-Copete, José Omar Zorrilla Lara, Mauricio Zuluaga Zuluaga, Alejandra Echeverri Moreno, Juan Sebastian Figueroa, Adolfo Enrique Gómez Ortiz, Maria Fernanda Gonzalez Mosos, Alejandro, González-Orozco, Juan Jose Jaramillo Roncancio, María Camila Leyva Martínez, Monica, Mosos, Juan Sebastian Ramirez, Henry Andrés Rodríguez, Juan David Saavedra Henao, María Alejandra Torrado Varón, Leidy Natalia Idarraga Ramírez, Lorena, Ocampo, Monica Cardona Marin, Ana Maria Marin Gonzalez, David Alejandro Mejia, Luis Emiro Vanegas, Yicel Alvarez Martinez, Sandra Aruachan Vesga, Dayana Vanessa Baron Fuentes, Alejandra Caballero Salas, Gustavo Antonio Martinez Estrada, Kelly Viloria Campo, Juan Antonio Corralez Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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Abdelgadir, Youssef, Al-Mukhaizeem, Fiachra, Cooke, Clare, Crowley, Ivor, Cullen, Michael, Flanagan, Amy, Fogarty, Orna, Glynn, Claudia Guerrero Martinez, Mohamed Alfatih Hamza, Mekki, Hassan, Ibrahim, Hegazy, Rhodri, Hill, Amr, Kazim, Azriny Shaziela Khalid, Muhammad Abdullah Khalid, Zubair, Majeed, Aidan, Manning, Peter, Mccullough, Seamus, Murphy, Peter, Neary, Anthony, Noone, Gerrard, O'Donoghue, John, O'Kelly, Eddie, Odonnell, Elaf, Osman, Jessica, Ryan, Rafeh, Saeed, Ahmad Abo Arar, Arsan Abu Abed, Daniel, Dykman, Ahmad, Elnassasra, Inbar, Gatot, Haim, Gavriel, Ruthie, Gold-Deutch, Nadav, Haim, Jonathan, Hammerschlag, Yehuda, Hershkovitz, Ahmad, Jaber, Adi, Kenoshi, Ron, Lavy, Omar, Majadla, Limor, Muallem-Kalmovich, Hilli, Nativ, Igor, Rabin, Yael, Sandler, Osnat, Zmora, Miklosh, Bala, Yonatan Avraham Demma, Yuri, Fishman, Gad, Marom, Naor, Avni, Ofra, Carmel, Amicur, Farkas, Michael Ron Freund, Lior, Gonen, Yaacov, Gozal, Dmitry, Greenman, Stanislav, Kocherov, Nevo, Margalit, Orit Nahtomi Shick, Israel Alexander Ostrovsky, Rivka, Pardes, Michal, Perets, Tal, Shahar, Henry, Shapiro, James, Tankel, David, Teren, Reuven, Yahud, Shlomo, Yellinek, Paolo, Balercia, Lisa, Catarzi, Giuseppe, Consorti, Pasquale, Cianci, Domenico, Gattulli, Marina, Minafra, Enrico, Restini, Enrico, Andolfi, Filippo, Annino, Frezza, Barbara, Alessia, Biancafarina, Edoardo, Bussolin, Marco De Prizio, Ulpjana, Gjondedaj, Marilena, Gubbiotti, Gianni, Mura, Giuseppe Antonino Pellicano, Giacomo Maria Pirola, Rezart, Sulce, Gennaro, Martines, Vincenzo, Papagni, Arcangelo, Picciariello, Stefano, Magnone, Michele, Pisano, Elia, Poiasina, Laura, Alberici, Filippo, Antonacci, Alessandro, Arena, Angela, Belvedere, Fabio, Bernagozzi, Paolo, Bernante, Pietro, Bertoglio, Lorenzo, Bianchi, Maria, Bisulli, Barbara, Bonfanti, Safia, Boussedra, Jury, Brandolini, Crescenzo, Cacciapuoti, Stefano, Cardelli, Riccardo, Casadei, Matteo, Cescon, Alessandro, Cipolli, Riccardo, Cipriani, Luca, Contu, Francesco, Costa, Niccolo, Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero, Dolci, Giulia, Dondi, Matteo, Droghetti, Sergio Nicola Forti Parri, Elena, Garelli, Chiara, Gelati, Giuliana, Germinario, Federico, A Giorgini, Carlo, Ingaldi, Elio, Jovine, Kenji, Kawamukai, Antonio Lanci Lanci, Raffaele, Lombardi, Maria Elisa Lozano Miralles, Claudio, Marchetti, Michele, Masetti, Francesco, Minni, Daniele, Morezzi, Daniele, Parlanti, Alice, Pellegrini, Anna Myriam Perrone, Anna Paola Pezzuto, Marco, Pignatti, Gianluigi, Pilu, Valentina, Pinto, Gilberto, Poggioli, Silvana Bernadetta Puglisi, Diego, Raimondo, Matteo, Ravaioli, Claudio, Ricci, Sara, Ricciardi, Francesco, Ricotta, Roberta, Rizzo, Angela, Romano, Matteo, Rottoli, Riccardo, Schiavina, Renato, Seracchioli, Matteo, Serenari, Margherita, Serra, Piergiorgio, Solli, Gioia, Sorbi, Mario, Taffurelli, Marta, Tanzanu, Achille, Tarsitano, Marco, Tesei, Gabriele, Vago, Tommaso, 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Giuseppe, Esposito, Federica, Frongia, Adolfo, Pisanu, Mauro, Podda, Nicola, Cillara, Alessandro Cannavera Putzu, Raffaele, Sechi, Emmanuele, Abate, Massimiliano, Casati, Letizia, Laface, Marcello, Schiavo, Fabio, Marino, Fabrizio, Perrone, Paolo, Annicchiarico, Alessandro, Cappellani, Matteo, Cavallo, Alessia, Giaquinta, Rossella, Gioco, Massimiliano, Veroux, Pierfrancesco, Veroux, Antonino, Zanghì, Antonio, Cianci, Arturo Lo Giudice, Maria Grazia Matarazzo, Giorgio Ivan Russo, Giuseppe, Sarpietro, Carmen Emanuela Scandura, Ida, Barca, Adriano, Carnevali, Antonio, Carpino, Maria Giulia Cristofaro, Gilda De Paola, Giuseppe, Giannaccare, Daniela, Novembre, Giuseppe, Sammarco, Vincenzo, Scorcia, Angeli Christy Yu, Marcello, D'Andrea, Lorenzo, Mongardi, Luigino, Tosatto, Mirko, Barone, Felice, Mucilli, Angelo, Muraglia, Ottavia, Caserini, Domenico Benvenuto Giuliani, Marco, Monti, Alessia, Morello, Edoardo, Segalini, Felice, Borghi, Desiree, Cianflocca, Alberto, Daniele, Danilo, Donati, Enrico, Gelarda, Giorgio, Giraudo, Maria Carmela Giuffrida, Alessandra, Marano, Elena, Olearo, Vincenzo Pruiti Ciarello, Andrea, Puppo, Valentina, Testa, Marco, Giacometti, Sandro, Zonta, Eleonora, Monti, Andrea, Porta, Daniele, Sambucci, Arianna, Birindelli, Barbara, Carrara, Bruno, Compagnoni, Roberto Del Giudice, Sara Elisabetta Dester, Daniele, Lomiento, Silvia, Ruggiero, Lucio, Taglietti, Fabio, Viotti, Domenico, Lacavalla, Savino, Occhionorelli, Michele, Rubbini, Massimiliano, Bernabei, Nicolò, Fabbri, Marta, Fazzin, Carlo, V Feo, Marco, Torchiaro, Renato, Costi, Edoardo, Virgilio, Lorenzo, Arlia, Giuseppe, Barbato, Ilenia, Bartolini, Andrea, Bottari, Chiara, Bruno, Alessandro, Bruscino, Carlotta, Checcucci, Fabio, Cianchi, Francesco, Coratti, Rosita De Vincenti, Annamaria Di Bella, Massimiliano, Fambrini, Laura, Fortuna, Oreste, Gallo, Giacomo, Gigliucci, Luca Giovanni Locatello, Gherardo, Maltinti, Jacopo, Martellucci, Paolo, Prosperi, Maria Novella Ringressi, Flavia, Sorbi, Fabio, Staderini, Antonio, Taddei, Alessandro, Anastasi, Giuseppe, Canonico, Emiliano, Chisci, Linda, Gabellini, Fabrizio, Masciello, Stefano, Michelagnoli, Tommaso, Nelli, Luca, Tirloni, Giovanni, Alemanno, Armando, Arminio, Renata, Beck, Carlo, Bergamini, Antonella, Cotoia, Vincenzo, Lizzi, Giuseppe, Maccagnano, Vito, Pesce, Antonio Luciano Sarni, Nicola, Tartaglia, Fernanda, Vovola, Andrea, Avanzolini, Antonio, Bocchino, Raffaele, Bova, Davide, Cavaliere, Fabrizio, D'Acapito, Giorgio, Ercolani, Francesca, Fappiano, Carlo Alberto Pacilio, Leonardo, Solaini, Giancarlo, D'Andrea, Laura, Lavalle, Veronica, Picotti, Andrea, Barberis, Marco, Filauro, Matteo, Santoliquido, Alessandra, Aprile, Fabio, Barra, Raffaele De Rosa, Raquel, Diaz, Simone, Ferrero, Piero, Fregatti, Claudio, Gustavino, Michele, Iester, Chiara, Kratochwila, Andrea, Massobrio, Davide, Pertile, Stefano, Scabini, Umberto, Scovazzi, Domenico, Soriero, Marco, Sparavigna, Carlo, Traverso, Aldo, Vagge, Denise, Gambardella, 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Virgilio, Matteo Di Bari, Fabio, Ferreli, Francesca, Gaino, Marco, Gramellini, Carlotta La Raja, Luca, Malvezzi, Salvatore, Marano, Giuseppe, Mercante, Flavio, Milana, Gennaro, Nappo, Georgios, Peros, Francesca, Pirola, Vanessa, Rossi, Elena, Russo, Giuseppe, Spriano, Sara, Tamburello, Alessandro, Zerbi, Alberto, Aiolfi, Davide, Bona, Andrea, Sozzi, Laura, Adamoli, Mohssen, Ansarin, Luca, Bertolaccini, Sabine, Cenciarelli, Francesco, Chu, Rita De Berardinis, Uberto Fumagalli Romario, Giacomo, Pietrobon, Giulia, Sedda, Lorenzo, Spaggiari, Marta, Tagliabue, Antonella, Ardito, Maria, Caputo, Paola, Cellerino, Valentina, D'Alessandro, Elisa, Galfrascoli, Maria Paola Giusti, Marco, Lotti, Roberto, Santambrogio, Marco Antonio Zappa, Andrea, Bondurri, Alessandro Michele Bonomi, Francesco, Colombo, Michele Achille Crespi, Piergiorgio, Danelli, Angelo Gabriele Epifani, Luca, Ferrario, Alice, Frontali, Claudio, Guerci, Anna, Maffioli, Francesco, Ferrara, Luca Antonio Aldrighetti, Domenico, Baccellieri, Luca, Bertoglio, Giulia, Bonavina, Massimo, Candiani, Giorgio, Candotti, Arianna, Casiraghi, Laura Mariangela Castellano, Paolo Ivo Cavoretto, Roberto, Chiesa, Federica, Cipriani, Paola De Nardi, Guido, Fiorentini, Filippo, Gagliardi, Alessandro, Galdini, Alessandro, Grandi, Elena, Marotta, Simonetta, Massaron, Andrea, Melloni, Pietro, Mortini, Gianluca, Nocera, Martina, Piloni, Mirko, Pozzoni, Francesca, Ratti, Riccardo, Rosati, Alessandro Ferdinando Ruffolo, Pierpaolo, Sileri, Alfio, Spina, Andrea, Vignali, Cristina, Barberio, Luigi, Beretta, Francesca, Cavenago, Nora Di Tomasso, Stefano, Fresilli, Giovanni, Landoni, Stefano, Lazzari, Gaetano, Lombardi, Marilena, Marmiere, Fabrizio, Monaco, Gabriele, Todaro, Stefano, Turi, Alberto, Zangrillo, Francesca, Bertolina, Giorgio, Bogani, Stefano, Bonomi, Pierfrancesco, Cadenelli, Valentina, Chiappa, Stefano Piero Bernardo Cioffi, Davide, Citterio, Lara Valentina Comini, Umberto, Cortinovis, Maurizio, Cosimelli, Antonino, Ditto, Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, Dalila Loredana Lo Bue, Gaetano, Luglio, Gianluca, Pagano, Roberto, Peltrini, Nello, Pirozzi, Francesca Paola Tropeano, Alessia, Aversano, Andrea, Belli, Maria, D'Amico, Paolo, Delrio, Francesco, Izzo, Renato, Patrone, Daniela, Rega, Pietro, Maida, Ester, Marra, Gianpaolo, Marte, Andrea, Tufo, Francesco, Bianco, Antonio, Cappiello, Simona, Gili, Paola, Incollingo, Alessandra, Novi, Giulia, Bagaglini, Claudio, Iovino, Francesco Menegon Tasselli, Maria Paola Menna, Francesco Maria Romano, Settimio, Rossi, Guido, Sciaudone, Francesco, Selvaggi, Lucio, Selvaggi, Francesca, Simonelli, Guido, Coretti, Mario, Pannullo, Adolfo, Renzi, Francesca, Ascari, Giuliano, Barugola, Giacomo, Ruffo, Paolo, Baroffio, Paolo, Bellora, Laura Enrica Benedetti, Cristina, Cerri, Giordana, D'Aloisio, Maurizio, Ferrari, Elisa, Francone, Sergio, Gentilli, Herald, Nikaj, Antonella, Chessa, Alessandro, Fiorini, Luca, Campagnaro, Franco, Chioffi, Pietro, Ciccarino, Roberto, Colasanti, Francesco de Falco, Fotios, Kalfas, Gioacchino, Mattisi, Giulia, Nezi, Matteo, Palma, Angelica, Rizzoli, Domenico, Rossi, Davide, Russo, Renato, Salvador, Francesco, Volpin, Guido, Bissolotti, Stefano, Fusetti, Francesco, Lemma, Vito, Chiantera, Mariano Catello Di Donna, Giulio, Sozzi, Emanuele, Cammarata, Sofia, Campanella, Daniela, Canzonieri, Adriana, Cordova, Federico De Michele, Ettore, Dinoto, Mara, Franza, Leo, Licari, Daniele, Matta, Domenico, Mirabella, Felice, Pecoraro, Roberto, Pirrello, Pierfrancesco, Pugliese, Fernando, Rosatti, Giuseppe, Salamone, Francesca, Toia, Massimiliano, Tripoli, Cosimo, Callari, Dario Di Miceli, Alfredo, Annicchiarico, Luca, Bellanti, Michela, Bergonzani, Roberto, Berretta, Elisa, Cabrini, Vito Andrea Capozzi, Fausto, Catena, Federico, Cozzani, Paolo Del Rio, Marco, Domenichini, Anna, Fornasari, Antonio, Freyrie, Tiziana, Frusca, Mario, Giuffrida, Gennaro, Perrone, Giulia, Rossi, Matteo, Rossini, Andrea, Varazzani, Vittorio, Arici, Antonio, Bozzani, Lorenzo, Cobianchi, Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, Pedrazzani, Tommaso, Pollini, Simone, Rattizzato, Andrea, Ruzzenente, Roberto, Salvia, Giulia, Turri, Matilde, Bacchion, Giovanni, Butturini, Andrea, Casaril, Alessandro, Giardino, Harmony, Impellizzeri, Marco, Inama, Frigerio, Isabella, Gianluigi, Moretto, Marco De Zuanni, Enrica, Deiana, Mario, Guglielmo, Alessandro, Broglia, Claudia, Casarini, Caterina Costanza Zingaretti, Marta, Bonaldi, Giovanni, Cesana, Francesco, Mastriale, Stefano, Olmi, Matteo Uccelli Yasuyuki Fukami, Takuya, Saito, Tsuyoshi, Sano, Naoki, Hirai, Kazuyoshi, Hirota, Tetsuya, Kushikata, Tasuku, Oyama, Junichi, Saito, Katsuhiko, Ishibashi, Mizue, Kamiyama, Kyongsuk, Son, Kentaroh, Tarao, Takayuki, Yamada, Toshiya, Shiga, Chisaki, Aze, Yoshihiko, Deguchi, Hirotoshi, Hasegawa, Tatsuki, Hoshino, Yasushi, Innami, Hiroyuki, Inoue, Shingo, Ito, Takeshi, Nomura, Tomomi, Ogihara, Reina, Okada, Takashi, Ouchi, Yuri, Sekiya, Keikoku, Tachibana, Emi, Takano, Masae, Yamamoto, Shuko, Matsuda, Yuka, Matsuki, Kenji, Shigemi, Teruyuki, Hiraki, Yui, Inoue, Shosaburo, Jotaki, Tatsuro, Abe, Masatoshi, Eto, Junichi, Inokuchi, Eiji, Kashiwagi, Fumio, Kinoshita, Satoshi, Kobayashi, Ken, Lee, Takashi, Matsumoto, Keisuke, Monji, Hidekazu, Naganuma, Masaki, Shiota, Ario, Takeuchi, Shinju, Obara, Saori, Takatsuki, Saori, Tanaka, Koji, Iida, Kota, Kagawa, Shuichiro, Neshige, Tomohiro, Chaki, Naoyuki, Hirata, Satoshi, Kazuma, Motonobu, Kimizuka, Sho, Kumita, Noriaki, Nishihara, Sato, Satoshi, Atsushi, Sawada, Shunsuke, Tachibana, Michiaki, Yamakage, Yuta, Nakamura, Kozo, Sato, Tomoya, Irie, Tomoko, Irisawa, Eiki, Kanemaru, Yuko, Koga, Yoshihiko, Chiba, Jun, Makino, Shinnosuke, Ohama, Shinichiro, Okada, Kano, Teruaki, Tatsuya, Kida, Tomohide, Takei, Kazuhiro, Hanazaki, Hiroyuki, Kitagawa, Tsutomu, Namikawa, Toshiyuki, Mizota, Chikashi, Takeda, Shintaro, Yagi, Hiroshi, Imai, Makoto, Ishitobi, Manabu, Kato, Kouhei, Nishikawa, Takeshi, Sasaki, Hiroshi, Yonekura, Akihiro, Kanaya, Daisuke, Irimada, Haruka, Ishikawa, Kaiho, Yu, Mitsuru, Ida, Masahiko, Kawaguchi, Kenji, Kawamura, Munehiro, Ogawa, Hiroshi, Okada, Shunji, Endo, Yoshinori, Fujiwara, Masaharu, Higashida, Hisako, Kubota, Toshimasa, Okada, Hironori, Tanaka, Tomio, Ueno, Kazuhiko, Yoshimatsu, Motohiro, Kikukawa, Akira, Kuriyama, Susumu, Matsushime, Hishikawa, Hidehiko, Haruaki, Hino, Yoji, Hisamatsu, Akio, Kamiya, Hidefumi, Kinoshita, Masato, Kita, Toshinori, Kobayashi, Taku, Michiura, Hirokazu, Miki, Tomohiro, Murakawa, Hidetaka, Okada, Tomohito, Saito, Ryoichi, Saito, Motohiko, Sugi, Genichiro, Sumi, Yamaki, So, Tomohisa, Yamamoto, Aya, Yoshida, Tatsuya, Kambara, Sayaka, Kanematsu, Okazaki, Satoshi, Takeshi, Hijikawa, Hiroaki, Kitade, Hidesuke, Yanagida, Tomoyuki, Fujita, Satsuki, Fukushima, Naoki, Tadokoro, Taku, Furukawa, Yusuke, Iizuka, Yuji, Otsuka, Masamitsu, Sanui, Ikumi, Sawada, Hideki, Iwahashi, Morikazu, Miyamoto, Masashi, Takano, Tsutomu, Mieda, Chihiro, Ando, Tetsuro, Isada, Taku, Ishizaki, Qaed Bani Amer, Sachi, Ishida, Yasuma, Kobayashi, Norifumi, Kuratani, Tomoe, Sakurai, Misa, Takada, Yutaka, Iba, Junji, Tsukagoshi, Akira, Yamada, Yuki, Amano, Kentaro, Fumoto, Shusaku, Noro, Ayataka, Fujimoto, Kyoichi, Tomoto, Yukiyasu, Okamura, Teiichi, Sugiura, Katshuhiko, Uesaka, Natsuki, Takemura, Kento, Kuroda, Megumi, Hayashi, Satoi, Kaneko, Izumi, Kawagoe, Tsukasa, Kochiyama, Yamaguchi, Ai, Nobutsugu, Abe, Tadao, Ando, Mieko, Chinzei, Kouichi, Hirano, Yoichi, Kobayashi, Ryota, Matsuki, Hironori, Matsumoto, Akira, Motoyasu, Harumasa, Nakazawa, Hikari, Noguchi, Kaio, Okamura, Motoaki, Ono, Hiroyuki, Seki, Eiji, Sunami, Atsushi, Tajima, Shinji, Tanigaki, Kohji, Uzawa, Hidenobu, Watanabe, Yukari, Furuhata, Satoshi, Toyama, Tokujiro, Uchida, Yutaka, Enomoto, Yuri, Furukawa, Yoko, Hasumi, Jinso, Hirota, Katsuyuki, Iida, Shingo, Ikeda, Tatsuhiko, Ikeda, Natsuko, Kawamata, Yosuke, Kawasaki, Minako, Koizumi, Yoshiharu, Kono, Shigeki, Kuzuhara, Junichi, Maeda, Mai, Moriyama, Shoichi, Nagamoto, Rinako, Nakanishi, Michio, Noda, Atsushi, Seichi, Shintaro, Takahashi, Kobayashi, Takashi, Misuzu, Takeda, Kenta, Tanakura, Katsuyuki, Terajima, Munechika, Tsuji, Chiharu, Ueshima, Naoya, Yamamoto, Mari, Yamamoto, Toshiya, Yokota, Yuki, Yoshioka, Sakoh, Yuri, Shintaro, Iwata, Akira, Kawai, Shuhei, Osaki, Masashi, Ishikawa, Masae, Iwasaki, Tomonori, Morita, Reina, Hirooka, Yoshinori, Nakata, Shigehito, Sawamura, Yusuke, Ishida, Aya, Kawachi, Takayuki, Kobayashi, Fumiaki, Nagashima, Naoki, Suzuki, Kohei, Ando, Noriko, Miyazawa, Yukio, Tanaka, Khatab, Abuissa, Alaa, Aljabali, Amal, Almasri, Mera, Alrabadi, Rana, Alshara, Yasmeen, Alzghoul, Ahmed, Alzughoul, Ali, Freihat, Emran, Jeitan, Qais, Owais, Aseel, Smadi, Mahmoud, Abukhadra, Huthifa, Abunawas, Abdallah Ahmed Mezel Al-Azzam, Ammar, Aladaileh, Ismail, Albadawi, Mohammad, Alhawatmeh, Mohannad Yaser Alkhaza'leh, Roaa Salem Jwaid Alneimat, Saba, Alwahedy, Abdel Rahman Mohannad Ahmad Alwardat, Slsabela, Dhoon, Khaled, El-Qawaqzeh, Tarteel, Hrerat, Enas, Jaradat, Teeba, Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, Sereen, Khader, Mariam, Khalil, Omar, Mansour, Ahmad, Othman, Haitham, Qandeel, Mohammad, Saleem, Fouad, Souri, Ahmad, Tahboub, Raed, Tayyem, Munir, Abdallah, Ibrahim, Abdel-Hafez, Hamza Abu Obead, Hadeel, Abudari, Ehab, Abuhamour, Samer, Abusadah, Nimer, Al-Azzeh, Sofian, Al-Adwan, Ali, Al-Darabah, Mohammad, Al-Qannas, Basil, Albaba, Qutaiba, Alradawneh, Mohammad, Amaireh, Subhi, Ashour, Reem, Chabaan, Ammar, Eskander, Ahmad, Fawzi, Manal, Haij, Hisham, Hamad, Haya, Hamdan, Ahmed, Hamss, Esraa, Hassouneh, Ayah, Hyasat, Zainab, Ibrahim, Saja, Jamaliah, Mohammed, Khalil, Anas, Massad, Ishak, Mohamed, Mahmoud, Qandeel, Dalia, Qasrawi, Mahmoud, Raggad, Ebaa, Rifai, Nedal, Semreen, Reham, Shehada, Marwan, Shorman, Abdallah, Al-Shibi, Shatha, Alsa'Afin, Morad, Bani-Hani, Bahaa, Nimer, Sandra, Nofal, Layth, Qaraqe, Mohammed, Salameh, Ma'Moun, Saleh, Ghaidaa, Sanjuq, Alaa, Sharabi, Alaa, Sweiti, Jamal, Yaghmour, Sabri, Zaza, Rahaf, Alhindi, Eman, Baninasr, Mahmoud, Al-Masri, Hani, Al-Najjar, Fade, Alawneh, Motasem, Al-Latayfeh, Abdel-Ellah, Al-Shudifat, Abd Almonem Shaikh Ahmad, Abdelkarim, Abdeljalil, Haneen, Abdelrahman, Abdulmalek, Abdulmalek, Lina, Abedalqader, Laith Abu Abed, Omar Al Smadi, Salameh, Alarood, Mohammad, Allouzi, Maha, Almansour, Sari, Almi'Ani, Abdulhakim, Alsaiad, Khaled, Alshaikh, Farah, Androus, Mirna, Awbakh, Belal, Azzam, Hammam Bany Yasin, Maher, Daoud, Lujain, Dawod, Omar, Dawod, Reem, Elmusa, Saba, Fadli, Farah, Hammad, Majd, Hunaiti, Mahmoud, Muhtaseb, Rawan, Owaimer, Zaki, Qulaghassi, Saleh, Romman, Rawand, Saket, Said, Sharawi, Alaa, Tawalbeh, Mohammed, Al-Howthi, Laila, Ababneh, Roba, Ababneh, Faris Jamal Abu Za'nouneh, Sajedah Al Dhoun, Ahmad Al Khassawneh, Ahmed Al Sharie, Ayah Ahmad Al Shraideh, Tawfik, Al-Dabaa, Salsabeel, Al-Jarrah, Hothaifa, Al-Jarrah, Hadeel, Al-Othman, Zuhair, Alaradi, Qutaiba, Alshannaq, Rima, Alsulaiman, Motasem, Alzaqh, Yazan, Alzu'Bi, Ziad, Audat, Mohammad, Bahhour, Saja, Bdour, Roa, Khatatbeh, Fares, Marji, Tagleb, Mazahreh, Dina, Nail, Amjad, Nuseir, Asmaa, Rabab'Ah, Taher, Sawadi, Ghina, Zidan, Dima Abu Muhfouz, Abdullah, Nael, Ahmad, Qasim, Amar, Al-Jarrah, Faisal, Rawagah, Dima, Y Abu Ismail, Wedad, Al-Dolat, Mai, Alzoubi, Malak, Alzoubi, Mu'Taz, Alzu'Bi, Ruba, Asha, Ali, Guboug, Hasan, Hussein, Shireen, Rawashdeh, Mohammad, Sanwar, Adnan, Ababneh, Basil, Abu-Eisheh, Haneen Ahmad Alhami, Saif Aldeen Al Dwairi, Hana' Al Shurman, Zakaria Al Yahya, Hussam, Al-Atiyah, Hasan, Al-Balas, Anas, Aljaiuossi, Shatha, Alqawasmi, Sadeel, Alqudah, Mahmoud, Alshourman, Abdulsalam Bani Hamad, Anas Bany Issa, Raed, Ennab, Sara, Hamdoni, Zaid, Hijazi, Ali, Khafaja, Mohamed, Mraiyan, Riyad, Obeidat, Dina, Olaywah, Mohamad, Qudah, Mhamdd, Talal, Askar, Aidarov, Aisulu, Sarmenova, Almat, Kodasbaev, Orazbek, Sakhov, Shynar, Tanabayeva, Sultan, Amrayev, Berik, Dzhumabekov, Maulen, Malgazhdarov, Kanat, Tezekbaev, Yerlan, Kukubassov, Alima, Satanova, Michael, Mwachiro, Robert, Parker, Ian, Simel, Shamshuddin, Mohammedali, Claude, Mwaria, Ralph, Obure, Sayed Shah Nur Hussein Shah, Chetan, Hirani, Muthoni, Kibunyi, Claire, Mailu, Victor, Mwangi, Roy, Ogenya, Lydia, Osea, Davies, Cheruiyot, Omar, Hirsi, Carolyne, Muiru, Samuel, Wanjara, Chang Woo Kim, Suk Hwan Lee, Ahmad, Almulla, Mustafa, Dashti, Omar, Elghany, Abdullah, Sultan, Husain, Al-Mahmeed, Jasim, Alabbad, Ibtisam, Albader, Shuaib, Aldalal, Mahdi, Baba, Fareed, Abdulsalam, Naser, Alhajri, Athari, Alwael, Brook, Ayele, Hatem, Marie, Ahmed, Zaitoun, Ahmad, M AlAli, Ahmed, Alkhamis, Ous, Alozairi, Sulaiman, Almazeedi, Salman, Alsabah, Mostafa, Abdelkarim, Asmaa Al Rashed, Saud Al Subaie, Tariq, Al-Shaiji, Abdullatif, Al-Terki, Omar, Alhunaidi, Ali, Aljewaied, Khaled, Alzamel, Ahmed, Farag, Hussein, Hayati, Salah, Termos, Sarah, Wood, Maha, Al-Gilani, Mutlaq, Al-Sihan, Haifa, Alotaibi, Dmitrijs, Lobovs, Andrejs, Pcolkins, Armands, Sivins, Ingus Arnolds Apse, Annija Evelīna Berga, Anna, Ivanova, Jevgenijs, Demicevs, Igors, Ivanovs, Aleksejs, Kaminskis, Janis, Opincans, Jānis, Pāvulāns, Agris, Rudzāts, Anna, Udre, Samer, Dbouk, Imadeddine, Farfour, Mohamad, Rakka, Ingrid, Antonios, Joe El Hage, Stephanie, Hage, Lea, Haiby, Hiba, Kahi, Anthony, Lichaa, Rita Milan Moussa, Michel, Salameh, Riad, Sarkis, Obey, Albaini, Tony, Haykal, Bassem, Safadi, Hussein, Abou-Abbass, Reem Al Makari, Zeina Al Zein, Mariam, Baidoun, Rania, Itani, Mustafa, Owiedat, Ali, H Abdel Sater, Michel, Akl, Nour, Badran, Sara El Mustapha, Fathallah, Fatouh, Youssef, Ghoussoub, Nader, Saad, Fatima, Serhan, Bassem, Souleiman, Walid, Alame, Peter, Ghiya, Firas, Ibrahim, Rasha, Abdallah, Mohamad, B Kassab, Samar, Karout, Aya Abdul Al, Hilal, Chaaban, Ghinwa, Fakih, Huzifa, Haj-Ibrahim, Rabih, Awad, Hadi El Assaad, Ahmed, Alfeqeeh, Hosam, Muftah, Taha, Abdulrahman, Naeimah, Ahseen, Hayat Omar Abunaaja, Abdulmuez, Abdulmalik, Abd El Jawad Al Gasi, Sara, Alsaeiti, Fatimah, Elkhafeefi, Nasre, Elrefai, Rofida, Ahmad, Tarek, Alhouni, Safya, Alkarky, Hana, Alkeelani, Rauoof, Alkuwafi, Rema, Benhariz, Nagat, Bettamer, Musa, Busarira, Hassan, Bushaala, Tariq, Diryaq, Osama, Elbargathe, Tarik, Eldarat, Mustafa, Elfadli, Jamael, Elfitori, Asma, Elmahgoub, Reem, Elsahti, Yosef, Hassan, Fathi, Hussain, Taha, Mirsal, Marwa, Mohammed, Ebtesam, Saad, Haifaa Il Hadad, Mostafa, Mosabha, Awatif, Alhaje, Aaya, Haron, Suhir, Alsuwiyah, Mona, Hamed, Samer, Khel, Sana, Omar, Rowaida, Yousef, Abubaker, Abdelmalik, Yahya, Abosnaina, Ma'Aly, Abuhlaiga, Ahmed Omar Abushahma, Alhosen Saleh, M Aldelensi Alzubi, Asma, Aljanfi, Mohamed Alnaser Alnehum, Ahmad, Alzedam, Malik, Delhen, Galia, Maderi, Faisel, Matoug, Burooj, Mohammed, Mohamed, Sawalem, Alhadi, Jahan, Abdussalam, Jahan, Basma, Alazabi, Bahauldin, Alezabi, Mona Masaud Amro Alazabi, Amin Salem Ahmed Egdeer, Fatma, Sefi, Elhusain, Kamoka, Abdulrauf, Salamah, Alya, Abdalhadi, Saedah, Abdeewi, Marwah, Alhadad, Ahmed, Awrayit, Mabroka, Eshnaf, Mohammad, Yahmad, Abdulhafid, Abudher, Faisl, Elamin, Farah, Abojeila, Mohamed, Aliwa, Sana, Shagour, Ahmed, Altobal, Omar, Aljuroushi, Hadeel, Almadani, Hajer, Attia, Amal Sharif Eljali, Ayyah, Emran, Mabruka, Omar, Radhwan, Salim, Ashraf, Samer, Nayrouz Abdullah Abulshuwashi, Emadeddin T, M Ben Khalifa, Hdaya Abdalla, S Benabdalla, Hatem, Elnageh, Ali, Hammad, Duha Milad Abdullah, Marwa, Abusalem, Esraa Ben Esmael, Fatma, Benmasoud, Laila, Debri, Randa, Elmokhtar, Manal Ezeddin Kamel Sheta, Bushra Sayeh Mohamed Elhabashi, Balkees, Younis, Amna, Elmabrouk, Ahmed, Momen, Abdalrahem Essied Alzubi Alzoubi, Kusay, Ayad, Ameerah Mahdi Abraheem Hasan, Fawzie, Musrati, Malek, Abusannoga, Ans, Malek, Hatem, Ajaj, Eman, Abdulwahed, Mohammed, Aboubeirah, Aya, Alqurpaa, Entisar, Alshareea, Sarra, Aribi, Tomather, Aribi, Marwa, Biala, Reem, Ghamgh, Mohannned, Issa, Amani Hamid Lamari, Mohammed, Mufth, Omar Sudig Abboud, Muad Fathi Khalleefah Abu Hallalah, Saleh, Abumahara, Sarah, Aburima, Mohammed, Adrees, Abdurahman, Ahtash, Asmaa Al Shukri, Hind, Alameen, Rehab, Alarabi, Alarabi, Alarabi, Aisha, Alelwany, Abdulkarim, Alesmail, Noran, Algadi, Khuloud, Almaqrahi, Hadel, Alosta, Mohamed, Alsharedi, Rasha, Bashir, Mahmoud Ben Ghrema, Sari Bin Nour, Sofian, Elbarouni, Ahmed, Elhadi, Abdulmohimen, A Elkhadar, Esraa, Elkouba, Nabiha, Elmsherghi, Abdulmohimen, Gammoudi, Abdulraouf, Ghariba, Fatima Zayed Gjam, Arwa, Haidar, Hala, Helal, Mohammed, Huwaysh, Ahmed Khalid Alhadheeri, Eslam, Kriem, Halim, Osman, Mohamed Ali Ossman, Marwah, Shilfeet, Laila, Turshani, Nouran, Albishty, Abdulmueti, Alhadi, Salem, Ali, Manal Ahmed Altoumi, Sumayyah Ghayth Bahroun, Eman, Younes, Hana, Atarabulsi, Mohamed, Elshaibi, Abdullmujeeb, Othman, Hayat Ben Hasan, Najat Shaban Ben Hasan, Rabab Shaban Ben Hasan, Vidmantas, Barauskas, Edvinas, Dainius, Zilvinas, Dambrauskas, Albertas, Dauksa, Inga, Dekeryte, Rita, Gudaityte, Kristijonas, Jasaitis, Akvilė, Koženiauskaitė, Virgilijus, Krasauskas, Ausra, Lukosiute-Urboniene, Almantas, Maleckas, Romualdas, Riauka, Vygintas, Šlenfuktas, Saulius, Svagzdys, Kestutis, Urbonas, Tomas, Vanagas, Linas, Venclauskas, Donatas, Venskutonis, Justas, Zilinskas, Marijus, Ambrazevicius, Vilius, Syminas, Oleg, Aliosin, Agne, Cizauskaite, Vitalijus, Eismontas, Jonas, Jurgaitis, Vytenis, Mikutaitis, Donatas, Petrauskas, Narimantas Evaldas Samalavicius, Dainius, Simcikas, Algirdas, Slepavicius, Albinas, Tamosiunas, Vaidotas, Turskis, Bernardas, Vasiliauskas, Laura, Aniukstyte, Audrius, Dulskas, Gediminas, Januška, Justas, Kuliavas, Margarita, Montrimaite, Albertas, Cekauskas, Azuolas Algimantas Kaminskas, Sarunas, Kozenevskis, Tomas, Poskus, Kestutis, Strupas, Arunas, Zelvys, Georges, Decker, Audrey, Noël, Maheriandrianina Fanambinana Voahary Rajaonarivony, Randimbinirina Zakarimanana Lucas, Herimampionona, E Andriantsoa, Mamisoa, B Rasamoelina, Rakotonarivo Aina Andrianina Vatosoa, Liantsoa, Andriamanana, Casimir Fp Rahantasoa Finaritra, Aristide Romain Raherison, Tsirimalala, Rajaobelison, Haritiana, Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José 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Sanja, Zahorjanski, Adrian, Chiow, Jun Xian Hing, Lip Seng Lee, Sey Kiat Terence Lim, Chi Wei Mok, Su-Ming, Tan, Hiang Jin Tan, Hana, Arbab, Candy, Choo, Doris Mae Dimatatac, Yee, Low, Hui Wen Chua, Tousif, Kabir, Sabrina, Ngaserin, Lester, Ong, Kiat Tee Benita Tan, Alvin, Tan, Wei-Wen, Ang, Yew-Lam, Chong, Jeffrey, J Leow, Biquan, Liu, Ming Ngan Aloysius Tan, Ern Yu Tan, Kar Yong Wong, Sharon, Yeo, Ladislav, Czako, Branislav, Gális, Kristián, Šimko, Radoslav, Morochovič, Martin, Paulo, Marián, Sedlák, Jan, Grosek, Ales, Tomazic, Leyla Al Mahdawi, Nuhi, Arslani, Andrej, Avsenak, Andrej, Bergauer, Krešimir, Blažević, Dejan, Bratus, Dalibor, Cankoski, Andrej, Cokan, Bojana, Crnobrnja, Andraz, Dovnik, Vojko, Flis, Samo, Fokter, Urska, Gajsek, Minja, Gregorič, Marko, Hazabent, Tomaz, Jagric, Niko, Kavčič, Jure, Knez, Nina, Kobilica, Rok, Kovačič, Lara, Lukman, Urska, Marolt, Jan, Mlakar, Tamara, Mohorko, Andrej, Moličnik, Ivan, Perić, Stojan, Potrč, Milena Senica Verbic, Mateja, Sirše, Jerneja, Vidmar, Adnan Sayid Abdo, Abdifatah Dahir Ali, Abdilaahi Ahmed Hayir, Sadiq, Ibrahim, Afnan, Nuh, Kadra, Omar, Ridwan, Saeed, Nikita, Blake, Cassandra, Ferreira, Corne, Nel, Colin, Noel, Marcel de Kock, Nathan, Kaplan, Emile, Kayombo, Paballo Clinton Khaeane, Asha, Malan, Wikus Wessel Mulder, Daylen, Rutledge, Cornel, Steyn, Gert, Steyn, Naser, Almgla, Mohamed, Daoub, Hammaad, Gamieldien, Thomas, Hilton, Nazmie, Kariem, Maahir, Kariem, Christo, Kloppers, Maritz, Laubscher, Wanga, Mtimkulu, Walid, Mugla, Daniel, Nel, Ferhana, Gool, Timothy, Hardcastle, Wasim, Mahomed, Nivashen, Pillay, Kayla, Rossini, Stephanie Van Straten, Annamart, Laubscher, Adelaide, Lee, Mohammed Yusuf Parker, Sinead, Quirke, Therese Du Preez, Adeline, Jacobs, Reinier, Swart, Modise Zacharia Koto, Neha, Kumar, Imraan, Sardiwalla, Mapuor, Areu, Juan Campos Garcia, Paula, Ferrara, Christoph José Klein Zampaña, Raquel, Lopez, Hernan, Sandoval, Guillermo, Carreño, German Mínguez Ruiz, Conrado Andrés Ros, Raquel Angulo Artal, Luis, Barbier, Guillermo, García-Operé, Marta, Jiménez-Jiménez, Héctor, Marín, Mikel, Oñate, Luis Antonio Pascua-Gómez, María Alexandra Pesántez Peralta, Ibabe Villalabeitia Ateca, Ladislao Cayetano Paniagua, Joan, Camí, Pablo, Collera, Martínez, David, Carlos Javier Gómez Díaz, Jordi Querolt Coll, M Dolors Rosines Cubells, Cristina Soto Montesinos, Guillermo, Triana, Marina, Xicola, Alfonso, Alias, Albert, Baduell, Mariano, Balaguer-Castro, María Pilar Camacho Carrasco, Marina Cámara Vallejo, Borja Campuzano Bitterling, Guillem, Claret, Francisco, J Cuesta-González, Alberto Di Somma, Joaquim Enseñat Nora, Neus, Fabregas, Ada Ferrer Fuertes, Abel, Ferrés, Cesar, Ginesta, Jose Juan Gonzalez Sanchez, Isabel, Gracia, Jhon Alexander Hoyos Castro, Montsant, Jornet-Gibert, Xavier, Morales, Alejandra, Mosteiro-Cadaval, Leire, Pedrosa, José Poblete Carrizo, Marina, Renau-Cerrillo, Luis Alberto Reyes Figueroa, Pedro Roldan Ramos, Jordi Rumià Arboix, Marta, Sabater-Martos, Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, David Bosch Garcia, Berta, Escudero, Carlos Garcia Cardona, Sergi, Bellmunt-Montoya, Javier de la Torre, Úrsula, Acosta, Iago Alvarez Saez, Eva Andreu Riobello, Fernando Ascanio Gosling, Jose, Bagan, Irene, Brana, Bartomeu, Caimari, Marta Cicuendez López Ocaña, Anna, Conesa, Alba de Pablo García-Cuenca, Natalija, Dediulia, Francesc, Duran-Valles, Jordi Giralt López de Sagredo, Maria Jose Gomez-Jurado, Ernesto, Guerra-Farfan, Juan Sebastian Guillén, María Guisasola Rabés, Viviana Andrea Hernández Angel, Maria Jurado Ruiz, Yuri, Loaiza, Manuel, Lopez, Susana, Manrique, Maria Dolores Mateo Arzo, Joan, Minguell-Monyart, Enric Miret Alomar, Sonia Monreal Clua, Víctor Morales Ariza, Clara Morales Comas, Judith, Murillo, Jose Maria Nieto Rodriguez, Elena Vilardell Ortiz, Jorge, Pamias, Montserrat Pascual Pascual Arellano, Remei Perera Sarri, Aleix Pons Bartroli, Nil, Prat, Alfredo Pueyo Ferrer, Rosa Pujol Pina, Jordi, Raurich-Leandro, Maria José Reche Padilla, Joaquín Rivero Déniz, Natalia, Rodriguez, Manuel Saez Barba, Vanessa Sanchez Torrents, Berta, Serrano, María Sol Siliato Robles, Christian Siso Raber, Iñigo, Soler, Maria Carmen Suescun López, Jordi Teixidor Serra, Cristina, Tello-Díaz, Marta Utrilla Pérez, Ramon, Vilallonga, Irene Vives Roselló, Vázquez García César, Mireia, Gili-Bueno, Carlos Gomez Roig, Gloria, González, Aamer, Malik, Maria Del Mar Martí-Ejarque, Mario Rafael Medina Hernández, Carolina, Pozo, Laura, Ruiz-Villa, Nuria, Sierra, Antonio, Valle, Susana, Velasquez, Mirentxu, Arrieta, Daniel, Escobar, Arkaitz, Lara, Alicia, Rojo, Idoia, Villamor, Javier Aitor Zabala Lopez-Maturana, Begoña, Estraviz, Laura Fernández Gómez Cruzado, Melania González de Miguel, David, Lecumberri, Victor Luis Gomez Corujo, Silvia, Bleda, Joaquin De Haro, Carlos, Martínez-Pinedo, David, Padilla-Valverde, Rafael Picón Rodríguez, Francisco Javier Redondo Calvo, Daniel, Sanchez-Pelaez, Alfonso Espinosa Ruiz, Eduardo, Rodriguez, Ignacio Alcalá Rueda, Gonzalo Díaz Tapia, Alvaro Sanchez Barrueco, Maria Dieguez López, Isabel López García, Pilar López-Toribio López, Marina, Bosch, Carolina Curtis Martínez, Alba Fernández Candela, Sandra Lario Pérez, Cristina Lillo García, Clara López de Lerma Martínez de Carneros, Francisco López Rodríguez-Arias, Inmaculada, Oller, Saray, Quinto, Luis, Sánchez-Guillén, Antonio Sanchís López, Álvaro, Soler-Silva, Daniel Triguero Cánovas, Victoria Garcia Peces, Estefania, Hernández-García, Guillermo, Plaza, Rafael Abad Alonso, Francisca Aranda Lozano, Marta Calvo Fernández, Eneko Del Pozo Andres, Josune Etxabe Gurrutxaga, Francisco Javier Fernández Pablos, Francisco Javier Ibáñez-Aguirre, Begoña Ochoa Villalabeitia, Natalia, Ortega, Amaia Sanz Larrainzar, Irune Vicente Rodriguez, Javier Jimenez Miramón, Jose, M Jover, Tamara, Llamero, Jose Luis Ramos Rodriguez, Ainhoa Valle Rubio, Maria Teresa Albiol, Codina, Antonio, Clara, Codony, Ramon Farres Coll, Cristina Farrés Pla, Nuria Gomez Romeu, Santiago, Lopez-Ben, Marcel, Pujadas, Berta, Tió, Francesc, Tuca, Elizabeth, Bárcena, Esther Brea Gómez, Antonio Francisco Guisado Calderón, Elisabeth Fernandez Castro, Montserrat Mairal Fraile, Oscar, Pastor, Cristina García Amador, Raquel Latorre Fragua, Marta, Allue, Pablo, Colsa, Teresa Gimenez Maurel, Raúl Latorre Tomey, Luis Francisco Martín Anoro, Luca, Ponchietti, Alejandra Utrilla Fornals, Carlo, Brugiotti, Carlos Jiménez Viñas, Fátima, Sena-Ruiz, Julio, Plata-Bello, Octavio, Arencibia, Daniel Gonzalez Garcia-Cano, Maria, Laseca, Antonio, Navarro-Sánchez, David Ortiz López, Maria, Pelloni, Sara, Berrocal, Elima Pilar Cagigal Ortega, Jorge, Calvera, Iria, Cervera, Patricia Díaz Peña, Silvia Verónica Domínguez Ovejas, Francisco, Donis, Patricia Fernández Bernabé, Gema, Fraga, Raúl Garcés García, Antonio, García, Elena Garcia De Castro, Antonio García Domínguez, Miguel Angel García García, Judit, Gonzalez, Carles Heredia Llinàs, Inés, Hernández, Norberto Herrera Merino, Carmen Lucero León Gámez, Ana Luis Siles, Maria Marqueta De Salas, Paula Martinez Pascual, Almudena Ortiz Simón, Laura, Osuna, Marta Perez Gonzalez, Antonio Ramos Bonilla, Lorena Rodríguez Gómez, Jose Luis Uquillas, Miguel Angel Alonso Prieto, Marta, Ballesteros-Pomar, Sara Busto Suarez, Mario, Castaño, Laura Castillo Pardo, Mario De Arriba Alonso, Fernando Diez Burón, Anna Farrés Rabanal, Diego Fernández-Samos Fernández, David, Garcia, Cristina García Pérez, Miguel García Sanz, Cesar, Gracia, Javier, Gualis, Gonzalo Gutiérrez Carrillo, Mateo, Hevia, Eva Higuera Miguélez, Gregorio, Laguna, Cristina Lombardia Gonzalez de Lera, Pablo López Martínez, Pasquale, Maiorano, Sergio Marcos Contreras, Elio Martín Gutiérrez, Marta, Molina, Irene, Perez, Teresa Renedo Villar, Luis Angel Suarez Gonzalez, Eva Alvarez Torres, Luz Bueno Rey, Zulay Adriana Calderon Barajas, Ana, M Castaño-Leon, Aida, Fernández, Pablo Garcia Pimentel, Luis, Jimenez-Roldan, Meta, Levstek, Rosalia Navarro Casado, Claudia Olea Vielba, Ana Maria Parada Rodriguez, Igor, Paredes, Patricia, Pascual-Cambero, Miguel Saiz Sánchez-Buitrago, Claudia Sarrais Polo, Victor Zarza Fernandez de Alegria, Mireya, Bonet, Alberto Encinas Vicente, Jose Miguel Villacampa Auba, Maria Dolores Burgueño, Patricia Serrano Méndez, Thomas, W Jorgensen, Mercedes, Martin, Mónica, Huecas, Felipe, Velasco, Verónica Alen Villamayor, Santiago Alonso Bartolomé, Miguel Alonso Juarranz, Luis Felipe Ávila-Ramírez, Javier Buendia Pérez, Barbara, Burgos-Blasco, Enrique Camarero Rodríguez, Paula Campelos Fernández, Claudia, Celotti, Marco Ciappara Paniagua, Ignacio, Cristobal, Alejandro Encinas Bascones, Elena, Fernandez-Martin, Inés Gil Prados, Jesus Gimeno Hernandez, Maria Alejandra Giraldo, Manuel Gomez Cervantes, Noemi Guemes Villahoz, Araceli Hernández Ramos, Maria Cruz Iglesias Moreno, Bibiana Lasses Martínez, Francisco Leyva Rodríguez, Leyre López Antoñanzas, Javier Martín Monterrubio, Jose Maria Martinez-de-la-Casa, Lourdes Montero Cruces, Jesús Moreno Sierra, Jose Maria Muguerza, Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, Fuentes, Lucia Gil Cidoncha, Sofía Herrero Gámiz, Eva Iglesias Garcia, Jose Luis Lucena De La Poza, Mª Eugenia Marín Martínez, Pilar Martín Rodrigo, Joaquin Manuel Muñoz Rodríguez, Verónica, Polaino, Alberto Pueyo Rabanal, Xabier Remirez Arriaga, Xiana, Rial, Miguel Sánchez Suárez, Maria Eugenia Torguet Muñoz, Borja Bazán Inostroza, Lara Blanco Terés, Alba Correa Bonito, Angela de la Hoz, Gustavo, Eisenberg, Javier Garcia Septiem, Jose Maria Lopesino, Rocio, Maqueda, Elena, Martin-Perez, Jose Luis Muñoz de Nova, Julia Revuelta Ramírez, Ana Rodríguez Sánchez, Álvaro Valdés de Anca, Laura Colao García, David Díaz Pérez, Enrique Esteban Agustí, Pablo Galindo Jara, Ana Belén Gallardo, Cesar, Garcia, Maria Gutierrez Samaniego, Miguel Angel Hernandez Bartolome, Lorenzo, Rabadan, Barriga Sánchez Raquel, Beatriz, Diéguez, Miguel, Hernández-García, Carolina Alfonso Carrillo, María Belén Alonso Bartolomé, Estibaliz, Alvarez, Mario, Alvarez-Gallego, Paula, Aragón-Ramos, Pablo Cesar Arteaga Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad 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Vossler, Michael, Weyant, Franklin, Wright, Erika, Bengtson, Mary, Bokenkamp, Hannah, Chacon, W Drew Fielder, Alex, Haynes, Charlotte, Heron, Charles, Hill, Cole, Holan, Hannah, Kay, Brian, Kelley, Sabino, Lara, Kathryn, Mcelhinney, E Charles Osterberg, Sharmila, Paul, Christopher, Riley, Ayane, Rossano, Romil, Shah, Ifeoluwa, Shoyombo, Pooja, Srikanth, Pedro, Teixeira, Marc, Trust, Marian, Williams-Brown, Benjamin, Bigelow, Ijezie, Ikwuezunma, Amit, Jain, Harsha, Malapati, Ivy, Mannoh, Adam, Margalit, Sarah, Rapaport, Srikrishna Vangipuram Suresh, Dominique, Vervoort, Lekha, Yesantharao, Zhang, Bo, Hossam, Abdou, Megan, Anders, Jose, Diaz, Michael, Mazzeffi, Peter, Rock, Salim, Afshar, Andrea, Balthazar, Laura, Carlson, Karen, Carver, Michael, Kurtz, Craig, D McClain, Meena, Nathan, Caleb, Nelson, Nathalie, Roy, Rachel, Saunders, Amir, Taghinia, Vivian, Williams, Allison, Brown, Zara, Cooper, Joshua, Jolissaint, David, Mahvi, Barbara, Okafor, Chandrajit, Raut, Vanessa, Roxo, Ciersten, Burks, Allen, Zhou, Djanira, Fernandes, Maha, Haqqani, Nicolette, Jabbour, David, Novikov, Joseph, Sabra, Paul, Tornetta, Lauren, Tracy, Keianna, Vogel, Joanna, Wang, Shawn, Wang, Shaun, Wason, Emily, Berner, Ander Dorken Gallastegi, Mohamad El Moheb, Anthony, Gebran, Marilyn, Heng, Santiago Lozano Calderon, Michael, Mctague, Christopher, Melnic, Andy, Park, Anna, Goldenberg-Sandau, Rebecca, Platoff, Lisa, Shea, Debra, Manning, Romeeka, Perkins, Samuel, Ross, Kyle, Thompson, Grace, Chang, Dustin, Dehart, Jared, Ourieff, Rosalinda, Alvarado, Anuradha, Bhama, Daniel, Deziel, Amir, Dorafshar, Henry, Govekar, Brian, Gulack, Dana, Hayden, George, Kokosis, Andrea, Madrigrano, Keith, Millikan, Jonathan, Myers, Cristina, O'Donoghue, Philip, Omotosho, Sam, Pappas, Srikumar, Pillai, Thea, Price, Scott, Schimpke, Ami, Shah, Deana, Shenaq, Nicole, Siparsky, Alfonso, Torquati, Peter, Tsambarlis, Srinivas, Vourganti, Al-Faraaz, Kassam, Ralph, Quillin, Mauro, Bravo, Elyad, Ekrami, Kai, Li, Alparslan, Turan, Cassie, Decker, Elizabeth, A Hennessy, Thomas, Schroeppel, Zachery, Stillman, Gary, Schwartz, Salah, Aoun, James, Caruso, Clay, Burlew, Julie, Clark, Kendyll, Gartrelle, David, Kwon, Kristin, Colling, Andrew, Barbas, Raquel, Bartz, Sarah, K Dotters-Katz, Tressa, Ellett, Etienne, Flamant, Hesham, Gabr, Dilraj, Grewal, George, Kasotakis, David, Kerr, Vijay, Krishnamoorthy, Alexander, Lazarides, Justin, Ma, Sachin, Mehta, Lucy, Meyer, Courtney, Mitchell, Demetrios, Moris, Diego, Schaps, Zohal, Ghulam-Jelani, Motasem, Refaat, Torre, Soderlund, Amna, Ali, Airi, Katoh, Krista, Kaups, Leigh Ann O'Banion, Yazen, Qumsiyeh, Jessica, Simpkins-Fresno, Murad, Almasri, Gauri, Kulkarni, Hisham, Marwan, Mohammad, Mehdi, Rasaq, Olaosebikan, Camilo, Velasquez, Rodrigo, Arrangoiz, Jeronimo Garcialopez De Llano, Adrian, Legaspi, Maria Fernanda Mijares Olivo, Amit, Sastry, Vanitha, Vasudevan, Hector, Garcia-Chavez, Atif, Iqbal, Yesenia, Rojas-Khalil, Malke, Asaad, Charles, Butler, Cameron, Gaskill, Patrick, Hensley, Jose, Karam, Matthew, Katz, Huan, Nguyen, Alberto, Pieretti, Christina, L Roland, Perel, Baral, D David Beahm, German, Berbel, Andres, Bur, Shea, Carver, Austin, Findley, Christopher, A Guidry, Megan, Hedlund, Corey, Hounschell, Sean, Kumer, Kelsey, E Larson, Derek, Marlor, Madhuri, Reddy, Scott, Turner, Alissa, Urich, Alexander, Cavalea, Brian, Daley, Bailey, Humphreys, Rachel, Savoy, Mary, Leech, Andrew, Loehrer, Kari, Rosenkranz, Avi, Bhavaraju, Nolan, Bruce, Lyle, Burdine, Kyle, Kalkwarf, Mary, Kimbrough, Garrett, Klutts, Joseph, Margolick, Tamara, Osborn, Anna, Privratsky, Matthew, Roberts, Jennifer, Baker, Peyman, Benharash, Ronald, W Busuttil, Robert, B Cameron, Joseph, Dinorcia, Joseph, Hadaya, Farnaz, Haji, Lien, Hua-Feng, Catherine, Juillard, Minna, Lee, Garrett, Salzman, Gregory, Senofsky, Richard, J Shemin, Jeannie, Shen, Carlie, Thompson, Areti, Tillou, Elizabeth, Bruenderman, Samuel, Carson, Clayton, Ellis, Farid, Kehdy, Robert C, G Martin 2nd, Tyler, Mouw, Amy, Wise, Linda, Britton-Zier, Julie, Dunn, Benjamin, Massey, Chathurika Samudani Dhanasekara, Thomas, Wyatt, Daniel, Abbott, Eugene, Foley, Stephanie, Savage, Patrick, Schwartz, Syed Nabeel Zafar, Lauren, Camp, Ruth, A Lewit, Alessia, Cioci, Amber, Collier, Gareth, Gilna, Neha, Goel, Joshua, Kronenfeld, Rebecca, Saberi, Eva, Urrechaga, Juan, Figueroa, Basil, Karam, Rachel, Morris, Christopher, J LaRocca, Archana, Ramaswamy, Steven, Waisbren, Jacob, Ankeny, Rahel, Ghebre, Jane Yuet Ching Hui, Eric, Jensen, Jordan, Mattson, Rachel, Vogel, Emily, Colonna, Frederick, Endorf, Rachel, M Nygaard, Alva, Bethurum, Rohan, Bhalla, David, Bichell, Christopher, Bonfield, Silky, Chotai, Michael, Dewan, Alexander, Hawkins, Aimal, Khan, J Matthew Kynes, Alexandra, Mata, Christopher, Wallis, Camila, Walters, Alice, Wang, Irving, Zamora, Lindsey, Zamora, Marah, Maayah, Melanie, Sion, Sarah, Ullrich, Dalia, Alqunaibit, Kiah, Andrews, Danielle, Friedman, John, Mcnelis, Yasmin, Abedin, Brian, Batko, Anthony, Colon, Sofia, Gabrilovich, Carma, Goldstein, Christina, Gory, Janmejay, Hingu, Brian, Leoce, Anh, Nguyen, Guergana, Panayotova, Ruchi, Ram, Deviney, Rattigan, Jerette, Schultz, Sara, Solar, John, Stein, Grace, Tsui, Elizabeth, Warnack, Apostolos, Gaitanidis, Leon, Naar, Robert, Sinyard, Sophia, Angelides, Laura, Fitzmaurice, Alexander, Himstead, Mehraneh, Jafari, Zeljka, Jutric, Kari, Kansal, Lydia, Kirillova, Isabella, Kuo, Kapila, Patel, Erika Linmey Tay Lasso, Maki, Yamamoto, Maleeha, Ahmad, Steven, Chang, Gary Alan Bass, Benjamin, Braslow, Daniel, Dempsey, Caoimhe, Duffy, Daniel, Holena, Jonathan, Imran, John, Keogh, Cara, Lorenzi, Niels, Martin, Mark, Seamon, Lauren, Huckaby, Katrina, Morgan, Caroline, Rieser, Lauren, Rosenblum, Cindy, Teng, J Michael DiMaio, Mohanad, Hamandi, Mary, Hoffman, Allison, T Lanfear, Michael, Connolly, Benjamin, Hall, Tareq, Kheirbek, Elizabeth, Renaud, Kevin, Behm, Judy, Boughey, Kristin Cardiel Nunez, Sean, Cleary, Mihai, Dumbrava, Travis, Grotz, James, Jakub, Rahul, Kanade, David, Larson, Sherief, Shawki, Dennis, Wigle, Haradeen, Dhillon, Avni, Suri, Leonardo Weber Graeff, Ahmed, Elshabrawy, Grace Ihsiu Todd, Mark, Davies, Yan, Qi, Walter, Biffl, Kathryn, Schaffer, Sarah, Averbach, Terry, Curry, Alexandra, Schwartz, Mary Kathryn Abel, Veronica, Andaya, Kristina, Benirschke, Katherine, Bigay, Marissa, Boeck, Lee-Lynn, Chen, Lee-May, Chen, Huey-Lan, Chern, Amanda, Compadre, Patricia, Conroy, Alexa, Glencer, Patrick, Ha, Barbara Cs Hamilton, Johannes, R Kratz, Rondall, Lane, Rex, H Lee, Brenda, Nunez-Garcia, Richard, O'Donnell, Doruk, Ozgediz, Paul, Park, Ankit, Sarin, Ipsit, Shah, Bonnie, Sheu, Madhulika, Varma, Katherine, Wai, Rosanna, Wustrack, Mary Jue Xu, Melissa, Zimel, Pedro, Escobar, Meredid Maldonado Santiago, Mohammad, Azam, Asad, Choudhry, Eric, Hammond, William, Marx, Jihad, Abbas, Somya, Al-Embideen, Carol, Angel, Bailea, Bobich, Raul, Bosio, Gregory, Georgiadis, Tahir, Jamil, Maria, Kenner, Meghan, Lark, Tamara, Maghathe, Sonia, Masih, Gabriel, Naimy, Kristin, O'Mara-Gardner, Emily, Rady, Roberta, Redfern, Jack, Sample, Joseph, Sferra, Kaitlyn, Sharp, Jessica, Shoemaker, Stephen, Stanek, John, Stengle, Hibba, Sumra, Jeffrey, M Sutton, Faris, Azar, Anne, Fischer, Jaymie, Henry, Lawrence, Lottenberg, Mario, Rueda, Sasha, Thiel, Adel, Bozorgzadeh, John, Kelly, Armando Salim Munoz Abraham, Erin, Scott, Camila, Haro, Andrés, Pouy, Gastón, Acuña, Sofia, Álvarez, Ana Carmen Carbajal, Fabiola, Castedo, Diego, Pereiranuñez, Helena, Sobrero, Josefina, Tarigo, Rafat, Al-Saban, Fatima, Al-Eryani, Siham Al Maqtari, Sahar, Al-Maqtari, Mahmmoud, Abdualqader, Majed, Aeed, Ghadeer Al Sanany, Anwaar Al Dhafif, Buthina Al Jarmozi, Saba, Al-Ameri, Awsan, Al-Dhaheri, Dhyia Alhuq Al-Surimi, Amira, Alakhdury, Sabreen, Alashmali, Zainab, Alattas, Manar, Alduba'Ai, Hamdan, Aldumaini, Wafa, Alhaddad, Abdelrahman, Alharazi, Nawal, Alhemyari, Adnan, Alhumaida, Maniee, Aljabri, Hassan, Almarashi, Zuhoor, Almohanady, Marwa, Alodine, Nooraldin, Alqasemi, Basma, Alqudaimi, Ansam Mohammed Ghaleb Alrobaiee, Mohammed, Alsabri, Radfan, Alsalal, Ramzi, Alsayadi, Musaed, Alsayadi, Reem, Alshaipani, Ebrahim, Alsharabi, Nora, Atiah, Hadeel, Bajjah, Muhib, Esmael, Asma, Ghallab, Rana, Ghannam, Adwa'A, Hamid, Lina, Hashem, Sara, Saif, Shaima, Sayad, Nawras, Shaban, Amatallah Hadi Shamsan, Sarah, Shream, Amal, Shukri, Shahd, Zeid, Nabila, Abdullah, Abdulrahman Faisal Al-Garadi, Ahmed, M Ali Al-Radhi, Norhan, Naji, Shaima'A, Nasser, Areej Taha Al Anaib, Ebrahim, Abdurab, Fadhl Al Muhtadi, Amer, Al-Hebbah, Ahmed, Al-Madhrahi, Shehab, Al-Mahdi, Sakhr Abdulhakeem Al-Maswari, Ayman, Al-Oqabi, Zakarya Abdullah Al-Zaazaai, Karim, Al-Zazay, Ali, Alafif, Asem, Albzzaz, Lina, Alqalisi, Mohammed, Alrezami, Haneen, Alshargabi, Mokhtar, Alshargabi, Hossam, Ghanem, Kareem, Saeed, Rasheed, Shalabi, Fareed, Showqi, Miriam, Maimbo, Catherine, Mkandawire, Mulaya, Mubambe, Theresa, Nkole, Vanessa, Savopoulos, Patricia, Shinondo, Chabwera, Shumba, Penias, Tembo, Shelton, Chivanga, Ngqabutho, Dube, Handsome, Dube, Daniel, Dzinotyiwei, Ronald, Makanda, Moses, Mangena, Partson, Maphosa, Derek, Matsika, Proud, Mawere, Nkosikhona, Moyo, Assel, Moyo, Arnold, Muguwu, Simbarashe, Mungazi, Garikai, Mwale, Gamuchirai, Ndabvonga, Mambote Crispin Olivier Ntoto, Hardlife, Ranganai, Ernesto Sánchez Castillo, Oltah, Tshuma, Grace, Gwini, Vimbai Moyana Muguto, Gilbert, Moyo, Trust, Mushawarima, Tinashe, Shoko, Rorisang, Jamela, Marvellous, Machiri, Eric, Shumba, Antony, Chengahomwe, Yemurai, Bikwa, Maxwell, Chimhina, Jeremy, Marume, Kudzayi, Munanzvi, Precious G, T Mutambanengwe, Federico, Ferrari, Marco, Fontanella, Franco, Odicino, Romano, Vito, Nepogodiev D, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Felice Pecoraro, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

42. Endoscopic vacuum therapy for anastomotic leak after esophagectomy: a single-center’s early experience

Author: Andrianos Tsekrekos, Fredrik Klevebro, Mats Lindblad, Satoshi Kamiya, Masaru Hayami, Magnus Nilsson, Johanna Samola Winnberg, and Ioannis Rouvelas
Subjects: Leak, medicine.medical_specialty, business.industry, medicine.medical_treatment, Fistula, Anastomosis, Surgical, Gastroenterology, Anastomotic Leak, Endoscopy, Retrospective cohort study, General Medicine, Anastomosis, medicine.disease, Single Center, Surgery, Esophagectomy, medicine, Humans, Complication, Airway, business, Negative-Pressure Wound Therapy, Retrospective Studies
Abstract: Summary Anastomotic leak is a serious complication after esophagectomy. Endoscopic vacuum therapy (EVT) has become increasingly popular in treating upper gastrointestinal anastomotic leaks over the last years. We are here reporting our current complete experience with EVT as primary treatment for anastomotic leak following esophagectomy. This is a retrospective study analyzing all patients with EVT as primary treatment for anastomotic leak after esophagectomy between November 2016 and January 2020 at Karolinska University Hospital, Sweden. The primary endpoint was anastomotic fistula healing with EVT only. Twenty-three patients primarily treated with EVT after anastomotic leak following esophagectomy were included. Median duration of EVT was 17 days (range 5–56) with a median number of 3 (range 1–14) vacuum sponge changes per patient. A total number of 95 vacuum sponges were placed in the entire cohort, of which 93 (97.9%) were placed intraluminally and 2 (2.1%) extraluminally. The median changing time interval of sponges was 5 days (range 2–8). Successful fistula healing was achieved in 19 of 23 patients (82.6%), of which 17 (73.9%) fistulas healed with EVT only. There were 2 (8.7%) airway fistulas following EVT. No other adverse events occurred. Three patients (13%) died in-hospital. In conclusion EVT seems to be a safe and feasible therapy option for anastomotic leak following esophagectomy. The effect of EVT on the risk for development of airway fistulas needs to be addressed in future studies and until more data are available care should be taken regarding sponge positioning as well as extended treatment duration.
Published: 2020

43. Long-term variation in skeletal muscle and adiposity in patients undergoing esophagectomy

Author: Wesley Jenq, Piers R. Boshier, Keerthini Muthuswamy, George B. Hanna, Donald E. Low, Fredrik Klevebro, Francesco Puccetti, Boshier, P. R., Klevebro, F., Jenq, W., Puccetti, F., Muthuswamy, K., Hanna, G. B., and Low, D. E.
Subjects: medicine.medical_specialty, Sarcopenia, Multivariate analysis, medicine.medical_treatment, Urology, sarcopenia, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, In patient, skeletal muscle, Muscle, Skeletal, Neoadjuvant therapy, Retrospective Studies, AcademicSubjects/MED00260, body composition, adiposity, business.industry, Gastroenterology, Cancer, Skeletal muscle, General Medicine, Esophageal cancer, medicine.disease, Prognosis, Esophagectomy, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Original Article, business
Abstract: Summary This study seeks to define long-term variation in body composition in patients undergoing esophagectomy for cancer and to associate those changes with survival. Assessment of skeletal muscle, visceral (VAT) and subcutaneous adipose tissue (SAT) was performed using computed tomography (CT) images routinely acquired: at diagnosis; after neoadjuvant therapy, and; >6 months after esophagectomy. In cases where multiple CT scans were performed >6 months after surgery, all available images were assessed. Ninty-seven patients met inclusion criteria with a median of 2 (range 1–10) postoperative CT images acquired between 0.5 and 9.7 years after surgery. Following surgical treatment of esophageal cancer, patients lost on average 13.3% of their skeletal muscle, 64.5% of their VAT and 44.2% of their SAT. Sarcopenia at diagnosis was not associated with worse overall survival (66.3% vs. 68.5%; P = 0.331). Sarcopenia 1 year after esophagectomy was however associated with lower 5-year overall survival (53.8% vs. 87.5%; P = 0.019). Survival was lower in those patients who had >10% decrease in skeletal muscle index (SMI; 33.3% vs. 72.1%; P = 0.003) and >40% decrease in SAT 1 year after surgery (40.4% vs. 67.4%; P = 0.015). On multivariate analysis, a decline in SMI 1 year after surgery was predictive of worse survival (HR 0.38, 95%CI 0.20–0.73; P = 0.004). This study provides new insight relating to long-term variation in body composition in patients undergoing esophagectomy for cancer. Findings provide further evidence of the importance of body composition, in particular depletion of skeletal muscle, in predicting survival following esophagectomy.
Published: 2020

44. 525 SURGICAL MORBIDITY AND MORTALITY FROM THE NEORESII TRIAL: STANDARD VS. PROLONGED TIME TO SURGERY AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL CANCER

Author: Ingvar Halldestam, Geir Olav Hjortland, Isabel Bartella, Hans-Olaf Johannessen, Gjermund Johnsen, Fredrik Klevebro, Ioannis Rouvelas, Mats Lindblad, Bengt Wallner, Christiane J. Bruns, K Nilsson, Magnus Nilsson, Wolfgang Schröder, E Kjus Ahlin, Jonas Johansson, Ulrika Smedh, and Eva Szabo
Subjects: medicine.medical_specialty, business.industry, Gastroenterology, medicine, Time to surgery, General Medicine, Esophageal cancer, business, medicine.disease, Surgery, Surgical morbidity, Neoadjuvant chemoradiotherapy
Abstract: For carcinoma of the esophagus or esophagogastric junction the time to surgery (TTS) has traditionally been 4-6 weeks after completed neoadjuvant chemoradiotherapy (nCRT). However, the optimal timing is not known. A majority of previous non-randomized studies addressing this issue, have not detected any significant differences in complication rates comparing patients operated with standard TTS compared to prolonged TTS. The aim of this sub-study was to investigate if prolonged TTS after completed nCRT improves postoperative outcomes. Methods A multicenter clinical trial was performed with randomized allocation to standard TTS (4–6 weeks) or prolonged TTS (10–12 weeks). All patients received nCRT according to the CROSS regimen. Patients were enrolled between 2015–2019 from 10 University Hospitals in Sweden, Norway and Germany. The primary endpoint of this sub-study was overall postoperative complications defined as Clavien-Dindo grade II-V. Secondary endpoints included complication severity according to Clavien-Dindo grade IIIb-V, postoperative 90-day mortality and length of hospital stay. The study was registered in Clinicaltrials.gov (NCT02415101). Results In total 248 patients were randomized. There were no significant differences between standard TTS and prolonged TTS regarding overall complications Clavien-Dindo II-V (59.0% vs. 69.8%, P = 0.092) or Clavien-Dindo IIIb-V (31.6% vs. 35.0%, P = 0.603). Furthermore, there were no significant differences regarding anastomotic leak (P = 0.601), conduit necrosis (P = 0.524), chyle leak (P = 0.427), pneumonia (P = 0.548) or respiratory failure (P = 0.723). The 90-day postoperative mortality was 4.3% (5 patients) in the standard TTS, and 3.8% (4 patients) in the prolonged TTS arm (P = 1.0). Median length of hospital stay was 15 days in the standard TTS arm and 17 days in the prolonged TTS arm (P = 0.220). Conclusion The timing of surgery after completed nCRT for carcinoma of the esophagus or esophagogastric junction is not of major importance with regard to short-term postoperative outcomes.
Published: 2020

45. Surgical Morbidity and Mortality From the Multicenter Randomized Controlled NeoRes II Trial: Standard Versus Prolonged Time to Surgery After Neoadjuvant Chemoradiotherapy for Esophageal Cancer

Author: Klara, Nilsson, Fredrik, Klevebro, Ioannis, Rouvelas, Mats, Lindblad, Eva, Szabo, Ingvar, Halldestam, Ulrika, Smedh, Bengt, Wallner, Jan, Johansson, Gjermund, Johnsen, Eirik Kjus, Aahlin, Hans-Olaf, Johannessen, Geir Olav, Hjortland, Isabel, Bartella, Wolfgang, Schröder, Christiane, Bruns, and Magnus, Nilsson
Subjects: Adult, Male, Esophageal Neoplasms, Endpoint Determination, Incidence, Chemoradiotherapy, Adjuvant, Middle Aged, Neoadjuvant Therapy, Time-to-Treatment, Esophagectomy, Europe, Postoperative Complications, Humans, Female, Aged
Abstract: To investigate if prolonged TTS after completed nCRT improves postoperative outcomes for esophageal and esophagogastric junction cancer.TTS has traditionally been 4-6 weeks after completed nCRT. However, the optimal timing is not known.A multicenter clinical trial was performed with randomized allocation of TTS of 4-6 or 10-12 weeks. The primary endpoint of this sub-study was overall postoperative complications defined as Clavien-Dindo grade II-V. Secondary endpoints included complication severity according to Clavien-Dindo grade IIIb-V, postoperative 90-day mortality, and length of hospital stay. The study was registered in Clinicaltrials.gov (NCT02415101).In total 249 patients were randomized. There were no significant differences between standard TTS and prolonged TTS with regard to overall incidence of complications Clavien-Dindo grade II-V (63.2% vs 72.6%, P = 0.134) or regarding Clavien-Dindo grade IIIb-V complications (31.6% vs 34.9%, P = 0.603). There were no statistically significant differences between standard and prolonged TTS regarding anastomotic leak (P = 0.596), conduit necrosis (P = 0.524), chyle leak (P = 0.427), pneumonia (P = 0.548), and respiratory failure (P = 0.723). In the standard TTS arm 5 patients (4.3%) died within 90 days of surgery, compared to 4 patients (3.8%) in the prolonged TTS arm (P = 1.0). Median length of hospital stay was 15 days in the standard TTS arm and 17 days in the prolonged TTS arm (P = 0.234).The timing of surgery after completed nCRT for carcinoma of the esophagus or esophagogastric junction, is not of major importance with regard to short-term postoperative outcomes.
Published: 2020

46. Implementation of minimally invasive gastrectomy for gastric cancer in a western tertiary referral center

Author: Masaru Hayami, Andrianos Tsekrekos, Lars Lundell, Mats Lindblad, Tania Triantafyllou, Magnus Nilsson, Fredrik Klevebro, and Ioannis Rouvelas
Subjects: Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Japan, Blood loss, Gastrectomy, Stomach Neoplasms, Minimally invasive surgery, medicine, Humans, Laparoscopic total gastrectomy, In patient, business.industry, Laparoscopic gastrectomy, Cancer, lcsh:RD1-811, General Medicine, medicine.disease, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Lymph Node Excision, Referral center, Laparoscopy, 030211 gastroenterology & hepatology, Gastric cancer, business, Research Article
Abstract: Background Minimally invasive techniques have gradually come to take a leading position in the surgical treatment of gastrointestinal malignancies. In order to define an effective process for the implementation of similar techniques in the treatment of gastric cancer, patient caseload represents a pivotal factor for education and training, but is a prerequisite not fulfilled in most Western countries. Additionally, as opposed to the East, a variety of additional factors such as the usually advanced stage of the disease and differences in patient characteristics are prevailing and raise further obstacles. Hereby we report a strategy for a safe and effective process for the implementation of laparoscopic gastric cancer surgery in a Western tertiary referral center. Methods The present study describes the stepwise implementation of laparoscopic gastrectomy for the treatment of gastric cancer at a tertiary referral center, comprising the time period 2012–2019. This process was facilitated by a close collaboration with two high-volume centers in Japan, as well as exchanging fellowships and observerships between the Karolinska University Hospital and other European centers. From the initially strict selection of cases for laparoscopic surgery, laparoscopic gastrectomy has gradually become the preferred approach also in patients with locally advanced tumors. Results From January 1st 2010 until December 31st 2019, 249 patients were operated for gastric cancer, of whom 141 (56.6%) had an open and 108 (43.4%) a laparoscopic procedure. In the latter group, total gastrectomy was performed in 33.3% of the patients. While blood loss, operation time and length of stay decreased during the first years after implementation, these variables increased slightly during the last years of the study period, probably due to the higher proportion of advanced gastric cancer cases, as well as the higher rate of laparoscopic total gastrectomy with more extended lymphadenectomy. Conclusions Laparoscopic surgery is currently a valid therapeutic option for gastric cancer, which has expanded to also embrace total gastrectomy and locally advanced tumors. Collaboration between centers in the East and West, centralization to high-volume centers and application of enhanced recovery protocols are essential components in the implementation and further refinement of minimally invasive gastrectomy.
Published: 2020

47. Contrast-enhanced paravertebrogram to confirm paravertebral catheter position in elective thoracic surgery: a proof of concept study

Author: Wyndam Strodtbeck, Madhan Kumar Kuppusamy, Shiwei Han, Fredrik Klevebro, Joseph M. Neal, Sara Nikravan, Neil A. Hanson, Daniel E. Warren, David L. Coy, Michal Hubka, and Donald E. Low
Subjects: medicine.medical_specialty, Catheters, Postoperative pain treatment, medicine.drug_class, Radiography, Proof of Concept Study, Article, 03 medical and health sciences, 0302 clinical medicine, Paravertebral pain catheters, medicine, Humans, Retrospective Studies, Pain, Postoperative, Local anesthetic, business.industry, Retrospective cohort study, Nerve Block, Surgery, Catheter, Thoracic surgery, Paravertebrogram, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Quality standard, 030211 gastroenterology & hepatology, Catheter placement, business, Abdominal surgery
Abstract: Background Paravertebral pain catheters have been shown to be equally effective as epidural pain catheters for postoperative analgesia after thoracic surgery with the possible additional benefit of less hemodynamic effect. However, a methodology for verifying correct paravertebral catheter placement has not been tested or objectively confirmed in previous studies. The aim of the current study was to describe a technique to confirm the correct position of a paravertebral pain catheter using a contrast-enhanced paravertebrogram. Methods A retrospective cohort proof of concept study was performed including 10 consecutive patients undergoing elective thoracic surgery with radiographic contrast-enhanced confirmation of intraoperative paravertebral catheter placement (paravertebrogram). Results The results of the paravertebrograms, which were done in the operating room at the end of the procedure, verified correct paravertebral catheter placement in 10 of 10 patients. The radiographs documented dissemination of local anesthetic within the paravertebral space. Conclusion This proof of concept study demonstrated that a contrast-enhanced paravertebrogram could be used in conjunction with standard postoperative chest radiography to add valuable information for the assessment of paravertebral catheter placement. This technique has the potential to increase the accuracy and efficiency of postoperative analgesia, and to set a quality standard for future studies of paravertebral pain catheters.
Published: 2020

48. Health-related quality of life following total minimally invasive, hybrid minimally invasive or open oesophagectomy: a population-based cohort study

Author: Pernilla Lagergren, Fredrik Klevebro, Asif Johar, Joonas H. Kauppila, and Sheraz R. Markar
Subjects: Adult, Male, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, Population, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Surveys and Questionnaires, medicine, Humans, Minimally Invasive Surgical Procedures, Patient Reported Outcome Measures, Prospective Studies, education, Neoadjuvant therapy, Aged, Aged, 80 and over, education.field_of_study, business.industry, Confounding, Cancer, Esophageal cancer, Middle Aged, medicine.disease, Confidence interval, Surgery, Esophagectomy, Quality of Life, Female, business
Abstract: Background Minimally invasive oesophagectomy has been shown to reduce the risk of pulmonary complications compared with open oesophagectomy, but the effects on health-related quality of life (HRQoL) and oesophageal cancer survivorship remain unclear. The aim of this study was to assess the longitudinal effects of minimally invasive compared with open oesophagectomy for cancer on HRQoL. Methods All patients who had surgery for oesophageal cancer in Sweden from January 2013 to April 2018 were identified. The exposure was total or hybrid minimally invasive oesophagectomy, compared with open surgery. The study outcome was HRQoL, evaluated by means of the European Organisation for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-OG25 at 1 and 2 years after surgery. Mean differences and 95 per cent confidence intervals were adjusted for confounders. Results Of the 246 patients recruited, 153 underwent minimally invasive oesophagectomy, of which 75 were hybrid minimally invasive and 78 were total minimally invasive procedures. After adjustment for age, sex, Charlson Co-morbidity Index score, pathological tumour stage and neoadjuvant therapy, there were no clinically and statistically significant differences in overall or disease-specific HRQoL after oesophagectomy between hybrid minimally invasive and total minimally invasive surgical technique versus open surgery. Conclusion In this population-based nationwide Swedish study, longitudinal HRQoL after minimally invasive oesophagectomy was similar to that of the open surgical approach.
Published: 2020

49. Relevant issues in tumor regression grading of histopathological response to neoadjuvant treatment in adenocarcinomas of the esophagus and gastroesophageal junction

Author: Michael Vieth, Donald E. Low, Fredrik Klevebro, Lars Lundell, Andrianos Tsekrekos, and Sönke Detlefsen
Subjects: neoadjuvant treatment, medicine.medical_specialty, Esophageal Neoplasms, esophageal adenocarcinoma, overall survival, Adenocarcinoma, Gastroesophageal Junction Adenocarcinoma, Gastroesophageal Junction, Neoadjuvant treatment, medicine, Tumor regression, Humans, Esophagus, Grading (education), AcademicSubjects/MED00260, Tumor Regression Grade, business.industry, Gastroenterology, tumor tissue response, General Medicine, Esophageal cancer, medicine.disease, Neoadjuvant Therapy, Editor's Choice, medicine.anatomical_structure, gastroesophageal junction carcinoma, Lymph Node Excision, delphi survey, Esophagogastric Junction, Radiology, Expert Review, business
Abstract: Multimodality treatment combining surgery and oncologic treatment has become widely applied in curative treatment of esophageal and gastroesophageal junction adenocarcinoma. There is a need for a standardized tumor regression grade scoring system for clinically relevant effects of neoadjuvant treatment effects. There are numerous tumor regression grading systems in use and there is no international standardization. This review has found nine different international systems currently in use. These systems all differ in detail, which inhibits valid comparisons of results between studies. Tumor regression grading in esophageal and gastroesophageal junction adenocarcinoma needs to be improved and standardized. To achieve this goal, we have invited a significant group of international esophageal and gastroesophageal junction adenocarcinoma pathology experts to perform a structured review in the form of a Delphi process. The aims of the Delphi include specifying the details for the disposal of the surgical specimen and defining the details of, and the reporting from, the agreed histological tumor regression grade system including resected lymph nodes. The second step will be to perform a validation study of the agreed tumor regression grading system to ensure a scientifically robust inter- and intra-observer variability and to incorporate the consented tumor regression grading system in clinical studies to assess its predictive and prognostic role in treatment of esophageal and gastroesophageal junction adenocarcinomas. The ultimate aim of the project is to improve survival in esophageal and gastroesophageal adenocarcinoma by increasing the quality of tumor regression grading, which is a key component in treatment evaluation and future studies of individualized treatment of esophageal cancer.
Published: 2020

50. Assessment of Health Related Quality of Life and Digestive Symptoms in Long-term, Disease Free Survivors After Esophagectomy

Author: Piers R, Boshier, Fredrik, Klevebro, Katerina V, Savva, Anabelle, Waller, Lory, Hage, George B, Hanna, and Donald E, Low
Subjects: Male, Esophageal Neoplasms, Middle Aged, Disease-Free Survival, United Kingdom, United States, Esophagectomy, Survival Rate, Quality of Life, Humans, Female, Esophagogastric Junction, Survivors, Aged, Follow-Up Studies, Forecasting
Abstract: The aim of this study was to investigate long-term HRQOL and symptom evolution in disease free patients up to 20 years after esophagectomy.Esophagectomy has been associated with decreased HRQOL and persistent gastrointestinal symptoms.The study cohort was identified from 2 high volume centers for the management of esophageal cancer. Patients completed HRQOL and symptom questionnaires, including: Digestive Symptom Questionnaire, EORTC QLQ-C30, EORTC QLQ-OG25 Euro QoL 5D, and SF36. Patients were assessed in 3 cohorts:1 year; 1-5 years, and;5 years after surgery.In total 171 of 222 patients who underwent esophagectomy between 1991 and 2017 who met inclusion criteria and were contactable, responded to the questionnaires, corresponding to a response rate of 77%. Median age was 66.2 years, and median time from operation to survey was 5.6 years (range 0.3-23.1). Early satiety was the most commonly reported symptom in all patients irrespective of timeframe (87.4%; range 82%-92%). Dysphagia was seen to decrease over time (58% at2 years; 28% at 2-5 years; 20% at5 years; P = 0.013). Weight loss scores demonstrated nonstatistical improvement over time. All other symptom scores including heartburn, regurgitation, respiratory symptoms, and pain scores remained constant over time. Average HRQOL did not improve from levels 1 year after surgery compared to patients up to 23 years after esophagectomy.With the exception of dysphagia, which improved over time, esophagectomy was associated with decreased HRQOL and lasting gastrointestinal symptoms up to 20 years after surgery. Pertinently however long-term survivors after oesophagectomy demonstrated comparable to improved HRQOL compared to the general population. The impact of esophagectomy on gastrointestinal symptoms and long-term HRQOL should be considered when counseling and caring for patients undergoing esophagectomy.
Published: 2020

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