Weekday of cancer surgery in relation to prognosis.
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
Authors: J. Ranstam, J. A. Cook
In situ preservation of the inferior parathyroid gland during central neck dissection for papillary thyroid carcinoma. BJS 2017; 104: 1514-1522.
Authors: J. B. Wang, K. Wu, L. H. Shi, Y. Y. Sun, F. B. Li, L. Xie et al.
Notes: Simple and efficient
Randomized clinical trial
Randomized clinical trial of Appendicitis Inflammatory Response score‐based management of patients with suspected appendicitis. BJS 2017; 104: 1451-1461.
Authors: M. Andersson, B. Kolodziej, R. E. Andersson, R. E. Andersson, M. Andersson, T. Eriksson et al.
Notes: Reduces imaging and admissions
Authors: C. Brown, T. Abdelrahman, N. Patel, C. Thomas, M. J. Pollitt, W. G. Lewis et al.
Notes: Highly variable
Cost‐effectiveness of intraoperative nerve monitoring in avoidance of bilateral recurrent laryngeal nerve injury in patients undergoing total thyroidectomy. BJS 2017; 104: 1523-1531.
Authors: Z. Al‐Qurayshi, E. Kandil, G. W. Randolph
Notes: Cost‐effective in this scenario
Authors: V. Wylde, J. Dennis, A. D. Beswick, J. Bruce, C. Eccleston, N. Howells et al.
Notes: Flimsy evidence base
Economic evaluation of antibiotic therapy versus appendicectomy for the treatment of uncomplicated acute appendicitis from the APPAC randomized clinical trial. BJS 2017; 104: 1355-1361.
Authors: S. Sippola, J. Grönroos, R. Tuominen, H. Paajanen, T. Rautio, P. Nordström et al.
Notes: Antibiotics cheaper
Meta‐analysis of randomized and quasi‐randomized clinical trials of topical antibiotics after primary closure for the prevention of surgical‐site infection. BJS 2017; 104: n/a-n/a.
Authors: C. F. Heal, J. L. Banks, P. Lepper, E. Kontopantelis, M. L. van Driel
Notes: May work, poor evidence
Minimally invasive surgery and its impact on 30‐day postoperative complications, unplanned readmissions and mortality. BJS 2017; 104: 1372-1381.
Authors: A. Sood, C. P. Meyer, F. Abdollah, J. D. Sammon, M. Sun, S. R. Lipsitz et al.
Notes: Generally better outcomes after laparoscopic surgery
Meta‐analysis of hybrid natural‐orifice transluminal endoscopic surgery versus laparoscopic surgery. BJS 2017; 104: 977-989.
Authors: D. C. Steinemann, P. C. Müller, P. Probst, A.‐C. Schwarz, M. W. Büchler, B. P. Müller‐Stich et al.
Notes: Less pain was the only gain
Authors: J.‐N. Vauthey
Safety, productivity and predicted contribution of a surgical task‐sharing programme in Sierra Leone. BJS 2017; 104: 1315-1326.
Authors: H. A. Bolkan, A. van Duinen, B. Waalewijn, M. Elhassein, T. B. Kamara, G. F. Deen et al.
Notes: Benchmark analysis