Survival after radical cystectomy during holiday periods

Scand J Urol. 2021 Aug;55(4):276-280. doi: 10.1080/21681805.2021.1938665. Epub 2021 Jun 14.

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; holiday periods; radical cystectomy; survival.

MeSH terms

  • Cystectomy*
  • Holidays
  • Humans
  • Proportional Hazards Models
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Bladder Neoplasms* / surgery