Surgery during holiday periods and prognosis in oesophageal cancer: a population-based nationwide Swedish cohort study.
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.



Population-based nationwide Swedish cohort study.



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.



Narrow (7 weeks) and wide (14 weeks) Swedish holiday periods.



90-day all-cause, 5-year all-cause and 5-year disease-specific mortality.



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).



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.
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden Department of Surgery & Cancer, Imperial College London, London, UK.
Sheraz R
SR
Markar
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Karl
K
Wahlin
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Fredrik
F
Mattsson
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Pernilla
P
Lagergren
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden Division of Cancer Studies, King's College London, and Guy's and St Thomas' NHS Foundation Trust, London, UK.
Jesper
J
Lagergren
D000368:Aged; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006693:Holidays; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012107:Research Design; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors