Survival after radical cystectomy during holiday periods

Abstract

Objective

For patients undergoing radical cystectomy for bladder cancer, a procedure requiring complex urinary tract reconstruction prone to major postoperative complications, the timing and quality of the surgery have been associated with outcomes.

Patients and methods

This study investigated if radical cystectomy for bladder cancer performed during holiday periods had worse disease-specific (DSS) and overall survival (OS), higher 90-day mortality and risk of readmissions. All patients operated on with radical cystectomy for primary bladder cancer during 1997–2014 with holiday periods as exposure (with one narrow (7 weeks) and one wider (14 weeks) definition) in the Swedish population-based bladder cancer research-database (BladderBaSe) were studied. DSS and OS after radical cystectomy during holiday periods were analysed with Cox regression models adjusted for sex, age, comorbidity, marital status, T-stage and nodal metastases, neoadjuvant chemotherapy, hospital volume and year of cystectomy.

Results

Surgery during the holiday periods (narrow and wide definitions) were not associated with DSS (Hazard ratio [HR] = 1.05, 95% confidence interval [95% CI] = 0.90–1.21 and HR = 1.04, 95% CI = 0.91–1.17), respectively. HRs for OS were similar, and no associations between radical cystectomy during any of the holiday period definitions and 90-day mortality and readmission were found.

Conclusion

Survival after radical cystectomy in Sweden is similar during holiday and non-holiday periods.

Keywords:

• Bladder cancer
• radical cystectomy
• holiday periods
• survival

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Swedish Cancer Society [grant numbers CAN 2019/62 and CAN 2017/278], Lund Medical Faculty (ALF), Skåne University Hospital Research Funds, the Gyllenstierna Krapperup ́s Foundation, Skåne County Council’s Research and Development Foundation [REGSKANE-622351], Gösta Jönsson Research Foundation, The Foundation of Urological Research (Ove and Carin Carlsson bladder cancer donation) and Hillevi Fries Research Foundation. The funding sources had no role in the study design, data analyses, interpretation or writing the manuscript.