Weekday of cancer surgery in relation to prognosis. BJS 2017; 104: 1735-1743.
Published: 31st August 2017
Authors: J. Lagergren, F. Mattsson, P. Lagergren
Later weekday of surgery seems to affect the prognosis adversely in oesophageal cancer, whereas any such influence on other cancer sites is unknown. This study aimed to test whether weekday of surgery influenced prognosis following commonly performed cancer operations.
This nationwide Swedish population‐based cohort study from 1997 to 2014 analysed weekday of elective surgery for ten major cancers in relation to disease‐specific and all‐cause mortality. Cox regression provided hazard ratios with 95 per cent confidence intervals, adjusted for the co‐variables age, sex, co‐morbidity, hospital volume, calendar year and tumour stage.
A total of 228 927 patients were included. Later weekday of surgery (Thursdays and, even more so, Fridays) was associated with increased mortality rates for gastrointestinal cancers. Adjusted hazard ratios for disease‐specific mortality, comparing surgery on Friday with that on Monday, were 1·57 (95 per cent c.i. 1·31 to 1·88) for oesophagogastric cancer, 1·49 (1·17 to 1·88) for liver/pancreatic/biliary cancer and 1·53 (1·44 to 1·63) for colorectal cancer. Excluding mortality during the initial 90 days of surgery made little difference to these findings, and all‐cause mortality was similar to disease‐specific mortality. The associations were similar in analyses stratified for co‐variables. No consistent associations were found between weekday of surgery and prognosis for cancer of the head and neck, lung, thyroid, breast, kidney/bladder, prostate or ovary/uterus.
Later weekday of surgery (Thursday or Friday) seems to influence the prognosis adversely for cancers of the gastrointestinal tract.Read more
You may also be interested in
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei of appendicular and extra‐appendicular origin.
Authors: J.‐B. Delhorme, F. Severac, G. Averous, O. Glehen, G. Passot, N. Bakrin et al.
Notes: Survival similar
Randomized clinical trial
Randomized clinical trial of intraoperative parathyroid gland angiography with indocyanine green fluorescence predicting parathyroid function after thyroid surgery.
Authors: J. Vidal Fortuny, S. M. Sadowski, V. Belfontali, S. Guigard, A. Poncet, F. Ris et al.
Notes: Simplifies post‐op monitoring
Systematic review and simulation study of ignoring clustered data in surgical trials. BJS 2018; 105: 182-191.
Authors: S. Dell‐Kuster, R. A. Droeser, J. Schäfer, V. Gloy, H. Ewald, S. Schandelmaier et al.
Notes: A statistical lesson
Authors: J. Church
Surgeon volume and prognosis of patients with advanced papillary thyroid cancer and lateral nodal metastasis. BJS 2018; 105: 270-278.
Authors: H. I. Kim, T. H. Kim, J.‐H. Choe, J.‐H. Kim, J. S. Kim, Y. N. Kim et al.
Notes: Volume is key
Effect of parathyroidectomy on quality of life and non‐specific symptoms in normocalcaemic primary hyperparathyroidism. BJS 2018; 105: 223-229.
Authors: S. Bannani, N. Christou, C. Guérin, A. Hamy, F. Sebag, M. Mathonnet et al.
Notes: Little improvement
Authors: S. A. Liu, C. C. Wang, R. S. Jiang, W. Y. Wang, J. C. Lin
Notes: Microsatellite instability predicts recurrence
Authors: A. M. Altman, J. Y. C. Hui, T. M. Tuttle
Notes: Can be significant
Authors: H. M. Rossitti, P. Söderkvist, O. Gimm
Notes: Genotype dictates type of surgery
Long‐term outcome of prophylactic thyroidectomy in children carrying RET germline mutations. BJS 2018; 105: e150-e157.
Authors: A. Machens, M. Elwerr, K. Lorenz, F. Weber, H. Dralle
Notes: Early surgery better
Authors: P. M. Ferguson, G. V. Long, R. A. Scolyer, J. F. Thompson
Notes: Great advances