What Day to Schedule Esophageal Cancer Surgery?

If you’re undergoing surgery for esophageal cancer, you may want to schedule it for a Monday or Tuesday. Researchers at the Karolinska Institutet in Stockholm, Sweden found that patients who undergo esophageal cancer surgery early in the week have a greater chance of long-term survival than those who have surgery at the end of the week. These findings were recently published in the journal Annals of Surgery.

Surgery for esophageal cancer is a highly precise, time-consuming (average 6.5 hours) procedure, and the success of the surgery for improving patient survival depends heavily on the surgeon’s experience. The researchers retrospectively reviewed the records of 1748 patients who had undergone esophageal cancer surgery between 1987 and 2010. Five-year mortality was 13% higher for patients who had undergone surgery on a Wednesday, Thursday, or Friday than for patients who had undergone surgery on a Monday or Tuesday, even after controlling for age, comorbidities, stage and type of tumor, pretreatment with cytostatics and radiotherapy, and surgeon experience with the surgery. The association between weekday and 5-year survival was strongest for early-stage tumors and nonexistent for advanced stage cancer, possibly because the survival rate is generally low (about 10%) for the latter.

Although the reason for the link between weekday and 5-year survival is not completely clear, the authors suggests that surgical precision may decline toward the end of the week due to the accumulated burden on the surgeon and his or her team. However, Jesper Lagergren, professor of surgery and lead author of the study, indicated more studies are needed before issuing clinical recommendations.

Source: Lagergren J, et al. (2015) Weekday of Esophageal Cancer Surgery and Its Relation to Prognosis. Annals of Surgery.