Lagergren J, et al. - Authors planned this work to assess whether weekday of surgery influenced prognosis following commonly performed cancer operations. Based on the findings, later weekday of surgery (Thursday or Friday) seemed to influence the prognosis adversely for cancers of the gastrointestinal tract.

Methods

• Authors performed a nationwide Swedish population-based cohort study from 1997 to 2014 to analyze weekday of elective surgery for ten major cancers in relation to disease-specific and all-cause mortality.
• In this work, 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.

Results

• This study included 228 927 patients.
• Findings revealed an association of later weekday of surgery (Thursdays and, even more so, Fridays) with increased mortality rates for gastrointestinal cancers.
• For disease-specific mortality, adjusted hazard ratios, 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.
• Exclusion of mortality during the initial 90 days of surgery made little difference to these findings, and all-cause mortality was similar to disease-specific mortality.
• In analyses stratified for co-variables, the associations were similar.
• Findings revealed no consistent associations between weekday of surgery and prognosis for cancer of the head and neck, lung, thyroid, breast, kidney/bladder, prostate or ovary/uterus.