Glasbey, James C.Ademuyiwa, AdesojiAdisa, AdewaleAlAmeer, EhabArnaud, Alexis P.Ayasra, FarisAldawbali, M.2025-05-102025-05-1020211470-20451474-548810.1016/S1470-2045(21)00493-92-s2.0-85119114788https://doi.org/10.1016/S1470-2045(21)00493-9https://hdl.handle.net/20.500.14720/8513Mantoglu, Baris/0000-0002-2161-3629; Sidiropoulos, Theodoros/0000-0001-9403-1083; Nikolaidou, Eirini/0000-0003-2367-1248; Silva, Jeancarllo/0000-0002-4517-3357; Marruzzo, Giovanni/0000-0002-6546-8881; Ng, Kin Cheung/0000-0002-7242-2128; Ozmen, Berk Baris/0000-0001-7803-1868; Litvina, Yauheniya/0000-0001-8450-2451; Gallo, Gaetano/0000-0003-1066-4671; Diaz-Feijoo, Berta/0000-0002-6451-1817; Di Maria Grimaldi, Simone/0000-0002-1014-0141; Manickavasagam, Jaiganesh/0000-0002-6717-1520; Olivier, James/0000-0003-3082-8426; Gkrinia, Eleni/0000-0002-7437-3518; Adamina, Michel/0000-0002-5464-6953; Zerbib, Philippe/0000-0002-6466-0716; Aljanadi, Firas/0000-0001-8654-5877; Newman, Tom/0000-0002-7987-9948; Perra, Teresa/0000-0001-7032-1289; Nikaj, Herald/0000-0001-5083-1302; Germinario, Giuliana/0000-0002-8019-1956; Alga, Andreas/0000-0001-5245-7668; Naumann, David/0000-0003-2243-2325; Tawiah, Augustine/0000-0001-6482-738X; Parreno-Manchado, Felipe Carlos/0000-0001-8133-5627; Valdes-Hernandez, Javier/0000-0002-0837-8986; Agrawal, Amit/0000-0002-3144-0493; Negri, Giampiero/0000-0001-7109-9181; Bello, Jibril/0000-0001-5425-6798; Tsai, Lillian/0000-0001-6890-9622; Guariglia, Claudio Antonio/0000-0003-1331-6234; Nouh, Thamer/0000-0002-7118-7453; Diez Alonso, Manuel/0000-0002-0993-8498; Chitul, Andrei/0000-0001-5991-3443; Perez, Daniel/0000-0002-3154-7311; Sallam, Ibrahim/0000-0002-9486-498X; Sena, Giuseppe/0000-0001-9793-3250; Talukder, Sajedul/0000-0001-8054-9770; Cayetano Paniagua, Ladislao/0000-0002-2118-7500; Rutegard, Martin/0000-0002-0974-6373; Frena, Antonio/0000-0001-9461-5345; Mercado, Miguel Angel/0000-0003-3744-9170; Newman, Samuel/0000-0002-2178-6378; Pujol Pina, Rosa/0000-0001-6176-6112; Musini, Luca/0000-0002-6477-2400; Herzberg, Jonas/0000-0003-3562-6575; Slijepcevic, Nikola/0000-0002-3999-1062; Ceelen, Wim/0000-0001-7692-4419; Mancebo Moreno, Gemma/0000-0001-5859-7936; Beatson, Kevin/0000-0001-5824-5009; Chu, Francesco/0000-0003-4813-1475; Macneil, S. 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Ali, Ahmed/0000-0001-7969-4225; Cavalle Busquets, Pere/0000-0002-5683-7219; Dondi, Giulia/0000-0001-8393-1799; Pompili, Cecilia/0000-0001-6746-5441; Ghosh, Dhruva/0000-0003-2976-0241; Sarpietro, Giuseppe/0000-0003-4891-9000; Mortini, Pietro/0000-0003-2320-2281; Pucar, Ana/0000-0002-8470-6670; Stojiljkovic, Dejan/0000-0001-9227-3142; Negoi, Ionut/0000-0002-6950-9599; Buta, Marko/0000-0001-8062-1250; Fahey, Brian A/0000-0002-0609-0954; Pinotti, Enrico/0000-0003-3063-4170; Ozant, Ali/0000-0002-7746-2719; Cabanero Sanchez, Alberto/0000-0002-9617-9935; Alhassan, Noura/0000-0003-0155-100X; Kilinc Tuncer, Gizem/0000-0002-6987-3198; Sibilla, Maria Grazia/0000-0002-9166-6275; Kocher, Hemant M/0000-0001-6771-1905; Ribeiro Junior, Ulysses/0000-0003-1711-7347; Ibrahim, Sufyan/0000-0001-9127-2738; Harrison, Ewen/0000-0002-5018-3066; Catto, James/0000-0003-2787-8828; Ronellenfitsch, Ulrich/0000-0003-1107-813X; Afolabi, Bosede/0000-0002-7511-7567; Vervoort, Dominique/0000-0002-3142-0388; Byrne, Matthew/0000-0002-2414-352X; Rajendran, Luckshi/0000-0002-2716-7121; Persad, Amit/0000-0001-6139-5542; Saeed, Summaya/0000-0001-6162-9900; Nakagawa, Makoto/0000-0001-8243-7705; Munoz-Bellvis, Luis/0000-0002-7809-5201; Zizzo, Maurizio/0000-0001-9841-7856; Rebba, Ephraim/0000-0002-6027-3647; Tsolakidis, Dimitrios/0000-0002-6608-509X; Torne, Ramon/0000-0001-7932-2528; Al Otaibi, Faisal/0000-0002-5871-2209; Fusetti, Stefano/0000-0002-5861-5046; Gkekas, Ioannis/0000-0002-7382-3636; Haynes, Amelia/0000-0002-3497-5178; Soh, Jien Yen/0000-0002-9225-2795; Sanchez Aniceto, Gregorio/0000-0002-9667-336X; Cope, Daron/0000-0002-6567-3359; Davis, Heather/0000-0001-8423-301X; Dilalla, Gayle Ackerman/0000-0002-0962-6734; Alcazar, Jose Antonio/0000-0001-7876-448X; Guerra, Glen R/0000-0002-2505-1643; Rolli, Luigi/0000-0002-6673-5785; Agostini, Carlo/0000-0001-7786-3574; Zubaidi, Ahmad/0000-0003-0994-5310; Yalkin, Omer/0000-0003-0311-5885; Abbadessa, Francesco/0000-0002-3943-5410; Turrado-Rodriguez, Victor/0000-0002-0573-7373; Grigoroiu, Madalina/0000-0002-1654-0859; Guaglio, Marcello/0000-0002-8194-9810; Oguttu, Benson/0000-0002-6686-1669; Malibary, Nadim/0000-0002-1405-331X; Caricato, Marco/0000-0002-5610-1615; Folic, Miljan/0000-0002-6049-0342; Noll, Florencia/0000-0003-4815-3914; Raji, Hadijat Olaide/0000-0003-4859-5405; Mongelli, Francesco/0000-0002-8824-651X; Baili, Efstratia/0000-0001-8745-2269; Issaka, Adamu/0000-0003-0774-6019; Di Bartolomeo, Alessandro/0000-0002-5384-1693; Rodriguez Nino, Juan Nicolas/0000-0002-5381-6340; Menendez, Carolyn/0000-0003-2941-5253; Boutall, Adam/0000-0002-6413-5890; Tedde, Alessandro/0000-0002-7090-0632; Scambia, Giovanni/0000-0002-9503-9041; Scanu, Antonio Mario/0000-0001-7878-1167; Valenzuela, Jose Ignacio/0000-0002-4944-453X; Hardie, Claire M/0000-0002-1271-6159; Riquoir Altamirano, Christophe/0000-0001-7462-2708; Ballabio, Michele/0000-0001-5073-1002; Khatri, Chetan/0000-0002-3961-1314; Esmail, Eslam/0000-0002-7648-8239; Aykanat, Yeliz/0000-0001-6550-2456; Cebi, Sait Sukru/0000-0002-9152-8227; Lee, Rex H/0000-0003-4111-9975; Bhangu, Aneel/0000-0001-5999-4618; Wolfer, Susanne/0000-0002-4134-2301; Bellora, Paolo/0000-0003-3443-3931; Antonelli, Barbara/0000-0001-8435-1294; Salvati, Maurizio/0000-0002-9815-0423; Oleaga, Laura/0000-0001-9702-0451; Cescon, Matteo/0000-0003-1715-3794; Derkaoui Hassani, Fahd/0000-0001-9996-0412; Acero, Julio/0000-0002-0811-1368; Elfiky, Mahmoud/0000-0003-1820-8603; Vacarasu, Andrei Bogdan/0000-0003-3968-3227; Machairas, Nikolaos/0000-0003-3239-3905; Seow, Sean Ezekiel/0000-0002-9331-3473; Brouki Milan, Peiman/0000-0002-3602-2960; Thekkinkattil, Dinesh/0000-0003-1760-2211; Azevedo, Jose/0000-0002-2918-3088; Horn, Callie/0000-0001-8609-2716; Persiani, Roberto/0000-0001-5584-6095; Conde Redondo, Consuelo/0000-0002-2263-9150; Fernandez Martinez, Daniel/0000-0001-7586-9489; Caballero Silva, Usue/0000-0001-5912-9747; Dean, Harry/0000-0003-0842-8987; Teoh, Li Ying/0000-0003-1282-8895; Caretto, Marta/0000-0002-1157-9930; Ravaioli, Matteo/0000-0001-5862-6151; Aguilo Pedret, Oriol/0000-0001-8695-8508; Negri, Serena/0000-0003-2991-8184; Papagni, Vincenzo/0000-0001-6102-6069; Mercante, Giuseppe/0000-0002-1009-7892; Violante, Tommaso/0000-0003-4439-5254; Tercero-Uribe, Ana Isabel/0000-0002-2321-9684; Tufo, Andrea/0000-0002-4495-1241; Plichta, Jennifer/0000-0002-7411-0558; Gradinariu, George/0000-0003-3554-3585; Sinha, Saurabh/0000-0001-7453-9576; Maione, Francesco/0000-0001-7043-9295; Yebes, Alvaro/0000-0002-4246-8184; Watson, Laura Jayne/0000-0003-4489-3093; Zonta, Sandro/0000-0001-5781-5030; Munro, Allana/0000-0001-5616-1696; Marino, Marco V./0000-0002-0466-4467; Bouhuwaish, Ahmad/0000-0001-7182-1277; Otify, Mohamed/0000-0002-7884-8680; Di Martino, Marcello/0000-0001-6510-7210; Jenkinson, Michael/0000-0003-4587-2139; Shaikh, Shafaque/0000-0002-4536-9595; Kelly, Michael E/0000-0002-0757-6411; Tejero-Pintor, Francisco J/0000-0002-8807-8229; Bernante, Paolo/0000-0002-4156-078X; Aiken, Taylor/0000-0003-1139-9822; Kudchadkar, Shantata/0000-0003-2637-5970; Novello, Simone/0000-0001-7375-3140; Castano-Leon, Ana M/0000-0002-7918-5049; Correia, Ana Margarida/0000-0003-0112-7401; Sen, Soumendu/0000-0002-3114-3712; Bascarevic, Vladimir/0000-0002-1490-4567; Ruggiero, Federica/0000-0001-5184-5271; Groot, Gary/0000-0002-8307-5125; Ng, Calvin S.H./0000-0002-8074-0900; Migliore, Marcello/0000-0002-6272-8983; Rosenberger, Laura/0000-0002-6829-6747; Choi, David/0000-0002-3320-6609; Jensen, Pernille Tine/0000-0002-1637-6040; Awad, Selmy/0000-0002-2724-5599; Adegbola, Samuel/0000-0003-2522-3895; Tanabayeva, Shynar/0000-0003-1826-0460; Pellino, Gianluca/0000-0002-8322-6421; De Crescenzo, Eugenia Maria/0000-0003-0633-1970; Gonullu, Emre/0000-0001-6391-4414; Ismail, Muhamad Izwan/0000-0002-6782-9556; Yildirim, Ayberk/0000-0003-4691-1638; Firat, Necattin/0000-0003-0684-8187; Nankivell, Paul/0000-0003-4664-6117; Fumagalli Romario, Uberto/0000-0002-6865-8971; Fra Fernandez, Sara/0000-0001-7723-0347; Jeftic, Nikola/0000-0002-5768-6256; Charalabopoulos, Alexandros/0000-0003-1835-4723; Brunelli, Alessandro/0000-0002-6505-1656; Moug, Susan/0000-0001-9969-9760; Steen, Christopher/0000-0001-5057-6436; Saliev, Timur/0000-0001-5696-6363; Liang, Rhea/0000-0002-8219-0631; Sultania, Mahesh/0000-0003-1008-8694; Chisthi, Meer/0000-0003-2794-0062; Garcia-Moreno Nisa, Francisca/0000-0001-5360-0577; Higgs, Simon/0000-0003-2791-1237; Lun, Elizabeth Weng Yan/0000-0002-7971-4190; Ashmore, Christopher/0000-0003-0244-5241; Chiarella, Vito/0000-0003-0286-2256; Giacometti, Marco/0000-0002-7743-8428; Sebastian, Ajit/0000-0002-0145-6654; Angelou, Dimitrios/0000-0002-8653-3742; Mourad, Mohamed/0000-0003-4714-7192; Chumbinho, Beatriz/0000-0001-9132-8586; Chinnery, Galya/0000-0002-9097-8648; Guadagni, Simone/0000-0001-9072-8166; Gaino, Francesca/0000-0001-5670-0848; Humes, David/0000-0002-7071-4098; Hoyos Castro, Jhon Alexander/0000-0003-1728-2318; Papatheodorou, Panayiotis/0000-0002-1936-3333; Hamad, Omar/0000-0003-0717-1358; Jezdic, Zoran/0000-0002-9339-2730; Penumadu, Prasanth/0000-0002-2189-5056; Mariani, Nicolo Maria/0000-0003-4360-187X; Qasem, Abdulrahman/0000-0002-6286-7836; D'Ugo, Domenico/0000-0001-6657-6318; Jones, Terence/0000-0002-4058-6013; Paiella, Salvatore/0000-0001-6893-8618; Jonker, Pascal Klaas Christiaan/0000-0002-4652-7014; /0000-0003-1189-9907; Turkington, Richard/0000-0003-3164-1890; Mazzotti, Federico/0000-0002-4590-3540; Elhadi, Muhammed/0000-0001-6406-4212; Demirli Atici, Semra/0000-0002-8287-067X; Yang, Wah/0000-0003-2341-3310; Turri, Giulia/0000-0001-6150-6812; Smith, Michelle Terry Dolores/0000-0002-6954-153X; Mir, Pablo/0000-0003-1656-302X; Ferrero, Annamaria/0000-0002-2909-3699; Santarius, Thomas/0000-0002-1416-9566; Betz, Christian Stephan/0000-0003-3188-1026; Rizzo, Davide/0000-0003-1830-3731; Caiado, Andre/0000-0002-0356-8326; Herrod, Philip/0000-0002-6839-3897; Khan, Danyal Zaman/0000-0001-9213-2550; Mihai, Radu/0000-0001-6153-1970; Siddiqui, M. Tayyab/0000-0003-0592-3077; Rogers, Luke/0000-0001-6240-0120; Langdon, Cristobal/0000-0003-1540-8095; Zamvar, Vipin/0000-0003-2447-828X; Giray, Burak/0000-0002-3832-6634; Toogood, Giles/0000-0003-4535-6249; Wang, Wanxin/0000-0003-3402-955X; Gouvas, Nikolaos/0000-0002-6541-4226; Agrawal, Abhishek/0000-0002-9202-1233; Ferrari, Federico/0000-0001-7065-2432; Lovece, Andrea/0000-0002-5176-7303; Nikolic, Srdjan/0000-0001-7027-9834; Corbellini, Carlo/0000-0003-0814-0537; Santas Alegret, Mario/0000-0002-3388-0476; Adiamah, Alfred/0000-0002-0624-6197; Granieri, Stefano/0000-0001-9167-3400; Tawheed, Ahmed/0000-0002-9382-8733; Gianni', Aldo Bruno/0000-0002-5983-9674; Bartolini, Ilenia/0000-0003-0387-2042; Tesei, Marco/0000-0003-0789-3991; Nepogodiev, Dmitri/0000-0002-2171-2862; Tenreiro, Nadia/0000-0002-6869-0795; Gonzalez Argente, F. Xavier/0000-0003-0003-9055; Ng, Michael/0000-0003-4877-5633; Yanar, Hakan/0000-0002-6162-0989; Mazzaferro, Vincenzo Maria/0000-0002-4013-8085; Abdulwahed, Eman/0000-0002-0570-4678; Phung, Daniel/0000-0001-8487-9371; Nunes, Quentin/0000-0002-7513-8595; Hammond, John Stotesbury/0000-0003-4400-8461; Cuadrado-Garcia, Angel/0000-0003-4868-0634; Sosa Duran, Erik Efrain/0000-0003-3039-9211; Tolani, Musliu Adetola/0000-0003-4296-9744; Elkhayat, Hussein/0000-0002-0090-1189; Paniagua Garcia-Senorans, Marta/0000-0003-2402-4106; Mazzotta, Erica/0000-0002-9609-9767; Majbar, Anass Mohammed/0000-0003-4329-2026; Parry-Smith, William/0000-0002-0017-7266; Kayyal, Mohd Yasser/0000-0002-8189-3239; Gabrilovich, Sofia/0000-0001-5649-4319; Baiocchi, Glauco/0000-0002-8193-5582; Kommu, Sashi S./0000-0003-4257-2157; Creavin, Ben/0000-0001-8209-4810; Marzi, Federica/0000-0001-6767-0461; Conci, Simone/0000-0001-7110-1974; Ghosh, Anik/0000-0003-3663-848X; Waledziak, Maciej/0000-0003-4311-9995; Manecksha, Rustom/0000-0003-3437-744X; Carvello, Michele Maria/0000-0002-8650-2321; Moris, Dimitrios/0000-0002-5276-0699; Zouzoulas, Dimitrios/0000-0003-2518-5657; Kovacevic, Bojan/0000-0001-6595-337X; Sud, Ajay/0000-0001-9134-3479; Choudhry, Asad/0000-0001-7752-3625; Ng, Hwei Jene/0000-0002-9077-2367; Lammy, Simon/0000-0003-3199-0038; Maffioli, Anna/0000-0001-7116-4019; Alconchel, Felipe/0000-0002-5483-0312; Kroon, Hidde M/0000-0002-8923-7527; Marafante, Chiara/0000-0001-7555-7784; Sundar, Sudha/0000-0002-5843-3015; Msherghi, Ahmed/0000-0001-5601-889X; Faria, Carlos Silva/0000-0002-8470-152X; Yahaya, Ahmad Shuib/0000-0002-1765-6765; Janjic, Tijana/0000-0003-2466-8622; Ponchietti, Luca/0000-0003-3994-1169; Melchor Corcostegui, Inigo/0000-0002-4190-3180; Ilic, Rosanda/0000-0002-4883-7999; Brown, Oliver/0000-0001-5781-7116; Moszkowicz, David/0000-0002-6735-9769; Goran, Merima/0000-0001-5756-1587; Narahari, Krishna/0000-0003-0257-7033; Aoun, Salah/0000-0003-3499-7569; Parise, Paolo/0000-0003-0404-4118; Dudi-Venkata, Nagendra/0000-0002-9775-3599; Hompes, Roel/0000-0001-6094-8950; Ladjevic Likic, Ivana/0000-0001-9743-2528; Schache, Andrew/0000-0001-9466-6038; Bruzzaniti, Placido/0000-0003-1873-7687; Mcintosh, Stuart/0000-0002-4123-9611; Asti, Emanuele Luigi Giuseppe/0000-0002-2485-8269; Taffurelli, Mario/0000-0001-9474-995X; Gracia, Myriam/0000-0002-8717-5270; Cox, Daniel/0000-0002-5092-4370; Adisa, Adewale/0000-0003-1927-3992; Praetorius, Christian/0000-0001-7514-5333; Lozano Lominchar, Pablo/0000-0002-5413-8449; Belvedere, Angela/0000-0003-3662-8273; Litta, Francesco/0000-0003-1415-621X; Sund, Malin/0000-0002-7516-9543; Paredes, Igor/0000-0002-3846-4164; De Pastena, Matteo/0000-0001-5244-4357; Liu, Jerry/0000-0002-6393-9029; Lakkis, Zaher/0000-0002-2608-5896; Saeed, Shakeel/0000-0002-2316-5655; Santana, Diana/0000-0002-3277-1497; Rahim, Fakher/0000-0002-2857-4562; Tizmaghz, Adnan/0000-0003-4384-6543; Bertoglio, Pietro/0000-0002-6267-0099; Boddy, Alex/0000-0001-7243-0155; Latincic, Stojan/0000-0003-4192-9687; Warren, Oliver/0000-0001-8948-7473; Tang, Chu Yik/0000-0001-5416-5888; Hamid, Hytham K. S./0000-0001-8068-0154; Donati, Davide Maria/0000-0002-9170-0576; Akin, Emrah/0000-0003-0224-3834; Espin-Basany, Eloy/0000-0002-9139-4548; Sachdeva, Ashwin/0000-0002-7359-7114; Brown, Steven/0000-0002-0980-2793; Wong, Michael Pak-Kai/0000-0001-9137-3096; Ovejero Merino, Enrique/0000-0002-4254-3594; Sivarajah, Gausihi/0000-0002-4686-5849; Watson, Eleanor/0000-0003-3614-5132; Abad Gurumeta, Alfredo/0000-0003-3331-5589; Aisuodionoe-Shadrach, Oseremen/0000-0001-7436-6337; Martin, Janet/0000-0002-3599-8427; Loch, Florian N/0000-0003-1513-8339; Mishra, N T Pramathesh/0000-0001-9268-841X; Elbahnasawy, Mohamed/0000-0001-8706-4389; Dulgeroglu, Onur/0000-0002-6427-9077; Perrone, Emanuele/0000-0002-0938-2493; Micic, Dusan/0000-0002-1461-7920; Takeda, Flavio Roberto/0000-0001-7338-922X; Kulkarni, Nikhil/0000-0002-8172-761X; Singh, Aminder/0000-0002-9099-4162; Vishnoi, Jeewan Ram/0000-0003-1484-8929; Bueno Canones, Alejandro David/0000-0001-6093-505X; Ascensao, Joao/0000-0001-6317-1569; Al Sayed, Mohamed/0000-0001-9361-7007; Kerin, Michael/0000-0003-4164-5561; Gil Ibanez, Blanca/0000-0002-0361-8741; Sodergren, Mikael/0000-0002-7141-3924; Rasoul-Pelinska, Karolina/0000-0002-7520-0213; Gilabert-Estelles, Juan/0000-0002-3992-1929; Van Ramshorst, Gabrielle/0000-0002-5368-582X; Martin-Arevalo, Jose/0000-0001-5337-9577; Reijers, Sophie/0000-0003-4872-7746; Yadev, Ip/0000-0002-5086-6246; Lagares, Alfonso/0000-0003-3996-0554; Karamarkovic, Aleksandar/0000-0001-5716-2009; Coughlin, Patrick/0000-0003-1342-1114; Nakas, Apostolos/0000-0001-6993-1514; Lima Buarque, Igor/0000-0002-9953-500X; Ruiz Manzanera, Juan Jose/0000-0001-9448-8657; Lim, Christopher Seng Hong/0000-0003-4772-7170; Perovic, Milan/0000-0002-9054-6407; Scafa, Anthony Kevin/0000-0002-8705-3783; Mohammed, Mahmoud M/0000-0002-2690-0790; Vasiljevic, Jovica/0000-0001-8062-8305; Dawson, Amanda Caroline/0000-0003-2447-3251; Tilaveridis, Ioannis/0000-0002-3399-4553; Sileri, Pierpaolo/0000-0002-1104-6237; Li, Elizabeth/0000-0001-5961-2894; Minaya Bravo, Ana Maria/0000-0002-7982-5499; Scrima, Ottavio/0000-0003-2489-6414; Colletti, Gaia/0000-0001-9859-836X; Serrano-Navidad, Monica/0000-0001-8165-744X; Inic, Zorka/0000-0002-3159-891X; Kaya, Tayfun/0000-0001-7101-1952; Parente, Alessandro/0000-0001-5506-224X; Sharma, Anil/0000-0002-9768-1644; Ooi, Rucira/0000-0002-1051-780X; Noel, Jonathan/0000-0003-3404-993X; Cohen, Paul/0000-0002-4860-9232; Sen, Comert/0000-0002-5101-8599; Alomar, Osama/0000-0003-4715-9396; Altintoprak, Fatih/0000-0002-3939-8293; Jimenez-Roldan, Luis/0000-0002-9864-0385; Angele, Martin/0000-0003-0565-7688; Travaglio, Elisabetta/0000-0001-6952-1259Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restrictions. Methods This international, prospective, cohort study enrolled 20 006 adult (>= 18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20-60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10middot0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0middot6% non-operation rate (26 of 4521), moderate lockdowns with a 5middot5% rate (201 of 3646; adjusted hazard ratio [HR] 0middot81, 95% CI 0middot77-0middot84; p<0middot0001), and full lockdowns with a 15middot0% rate (1775 of 11 827; HR 0middot51, 0middot50-0middot53; p<0middot0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0middot84, 95% CI 0middot80-0middot88; p<0middot001), and full lockdowns (0middot57, 0middot54-0middot60; p<0middot001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9middot1%] of 4521 in light restrictions, 317 [10middot4%] of 3646 in moderate lockdowns, 2001 [23middot8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and longterm investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license.eninfo:eu-repo/semantics/openAccessArticle