RT Journal Article
SR Electronic
T1 Surgery during holiday periods and prognosis in oesophageal cancer: a population-based nationwide Swedish cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e013069
DO 10.1136/bmjopen-2016-013069
VO 6
IS 9
A1 Sheraz R Markar
A1 Karl Wahlin
A1 Fredrik Mattsson
A1 Pernilla Lagergren
A1 Jesper Lagergren
YR 2016
UL http://bmjopen.bmj.com/content/6/9/e013069.abstract
AB Objective Previous studies indicate an increased short-term and long-term mortality from major cancer surgery performed towards the end of the working week or during the weekend. We hypothesised that the prognosis after major cancer surgery is also negatively influenced by surgery conducted during holiday periods.Setting Population-based nationwide Swedish cohort study.Participants Patients undergoing oesophagectomy for oesophageal cancer between 1987 and 2010. Among 1820 included patients, 206 (11.3%) and 373 (20.5%) patients were operated on during narrow and wide holiday periods, respectively.Interventions Narrow (7 weeks) and wide (14 weeks) Swedish holiday periods.Primary and secondary outcome measures 90-day all-cause, 5-year all-cause and 5-year disease-specific mortality.Results Narrow holiday period did not increase all-cause 90-day (HR=0.84, 95% CI 0.53 to 1.33), all-cause 5-year (HR=1.01, 95% CI 0.85 to 1.21) or disease-specific 5-year mortality (HR=1.04, 95% CI 0.87 to 1.26). Similarly, wide holiday period did not increase the risk of 90-day (HR=0.79, 95% CI 0.55 to 1.13), all-cause 5-year (HR=0.96, 95% CI 0.84 to 1.1) or disease-specific 5-year mortality (HR=1.03, 95% CI 0.89 to 1.19).Conclusions No measurable effects of holiday periods on short-term or longer term mortality following surgery for oesophageal cancer were observed in this population-based study, indicating that an adequate surgical experience was maintained during holiday periods.