Which days are the worst for surgery?
Patients who were operated on for oesophageal cancer had a higher survival rate if the surgery took place early in the week.
Researchers at Karolinska Institute in Stockholm have investigated the outcomes of surgery among over 1,700 patients with cancer in the oesophagus.
They found that patients whose operations were on a Wednesday, Thursday or Friday ran a considerably lower chance of surviving the next five years than those whose operations were on a Monday or Tuesday.
But the researchers behind the study are not prepared to suggest new guidelines for surgery scheduling.
Don’t know why
The Swedish researchers looked at the cases of nearly all patients in Sweden who had surgery for oesophageal cancer from 1987 to 2010. The researchers found significant differences after making allowances for factors such as age, other diseases, previous treatment, how experienced the surgeons were and which stages the malignant tumours were in.
The findings were recently published in the medical journal Annals of Surgery.
The patients whose surgery took place in the last three weekdays ran a 13 percent higher chance of dying within the following five years.
“The causes behind these findings are still unknown,” says Jesper Lagergren in a press release. Lagergren is a professor of surgery at the Karolinska Institute.
“But it is possible that surgical precision, to a certain extent, declines toward the end of the week, perhaps because of the increased pressure on the surgeon and his or her team,” he continues.
The strongest link between survivability and the days of the operations were seen in operations on patients whose tumours were in an early stage. But the researchers found no such connections when the tumours were in an advanced state. They explain this lack of a link with the lowered chances of a five-year survival among anyone whose oesophageal cancer was in a later stage of development when surgery was performed.
“We need more studies to confirm these results before we can issue any clinical recommendations,” says Lagergren
“But it the results end up being confirmed by future research, operations on cancer of the oesophagus should be scheduled for the start of the week,” asserts the Swedish professor.
Men and the elderly more at risk
Oesophagael cancer forms as a tumour which grows after cancer cells develop in the in the mucous membrane of the oesophagus. This is a relatively rare type of cancer. Among Norway’s population of five million, about 200 persons are diagnosed with this cancer annually. Men and elderly persons are more at risk than women and the young.
Hospitals usually use radiotherapy to cure these patients, but in about 20 percent of cases doctors will remove the tumour surgically. Some 30 to 40 percent of patients who receive such surgery are subsequently cured of their cancer.
Common symptoms of oesophageal cancer are difficulties swallowing, poor appetite and chest pains when eating. Several things can cause cancer in the oesophagus. Many patients have had problems with hyperacidity. Other factors are smoking and overweightness.
Read the Norwegian version of this article at forskning.no
Translated by: Glenn Ostling
- Lagergren, J. et.al: Weekday of Esophageal Cancer Surgery and its Relation to Prognosis. Annals of Surgery, November 2015. doi: 10.1097/SLA.0000000000001324.