title: Lunar phases and zodiac signs do not influence quality of radical cystectomy--a statistical analysis of 452 patients with invasive bladder cancer.
abstract: OBJECTIVE
  To determine the influence of the lunar phases and the position of the moon in the zodiac on the frequency of complications and the survival of bladder cancer patients after radical cystectomy. It has been postulated that radical cystectomy performed during the waxing moon, or particularly at full moon, or at the zodiac sign Libra is associated with a poorer outcome.
  
  
  METHODS
  We tested this hypothesis by evaluating the progression-free survival, the complication rate and the re-operation rate for 452 consecutive patients after radical cystectomy. In this retrospective review, the dates of surgery were allocated to the lunar phases and the zodiac signs. Based on these classifications, the patients were placed in groups which combined the lunar phase laws and differentiated between evidently unfavorable (full moon or waxing moon and/or the zodiac sign Libra; assigned to group 1) and favorable periods for surgery (new moon or waning moon and other signs of the zodiac apart from Libra; assigned to group 2). The mean follow-up was 49 months (range 0-158 months).
  
  
  RESULTS
  A total of 244 patients (54%) were operated during an unfavorable period (group 1) and 208 (46%) patients during the auspicious period (group 2). The mean age, gender and kind of urinary derivation did not differ significantly in the two groups. Pathological tumor stages were evenly distributed according to the lunar phase groups (P = 0.713). We found no significant differences in the perioperative mortality rates, early re-operation rates, early complications, and late complications across the two groups. No significant differences in progression-free survival were observed when timing of cystectomy during the lunar cycle was considered (P = 0.231).
  
  
  CONCLUSIONS
  Our analysis demonstrated no predictable influence of the lunar phase on survival or complications. Although this was not a prospective randomized trial, the statistical magnitude of the results do not support any recommendations for scheduling patients for radical cystectomy at any particular day of the lunar phase.
authors.affiliation: Department of Urology, Carl-Thiem Hospital, Cottbus, University Teaching Hospital, Charité zu Berlin, Thiemstrasse 111, Cottbus, 03048, Germany. M.May@ctk.de
authors.forename: Matthias
authors.initials: M
authors.lastname: May
authors.forename: Kay-Patrick
authors.initials: KP
authors.lastname: Braun
authors.forename: Christian
authors.initials: C
authors.lastname: Helke
authors.forename: Willi
authors.initials: W
authors.lastname: Richter
authors.forename: Horst
authors.initials: H
authors.lastname: Vogler
authors.forename: Bernd
authors.initials: B
authors.lastname: Hoschke
authors.forename: Michael
authors.initials: M
authors.lastname: Siegsmund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D018572:Disease-Free Survival; D005260:Female; D005495:Folklore; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016081:Moon; D011183:Postoperative Complications; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000601:surgery*