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@ARTICLE{Maier:277433,
      author       = {C. Maier$^*$ and C. Schölch and L. Zhu$^*$ and M. M. Nzomo
                      and H. L'hoest and U. Marschall and C. Reißfelder and S.
                      Schölch$^*$},
      title        = {{W}eekday-dependent long-term outcomes in gastrointestinal
                      cancer surgery: a german population-based retrospective
                      cohort study.},
      journal      = {International journal of surgery},
      volume       = {109},
      number       = {10},
      issn         = {1743-9191},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2023-01370},
      pages        = {3126-3136},
      year         = {2023},
      note         = {#EA:A430#LA:A430# / 2023 Oct 1;109(10):3126-3136},
      abstract     = {For most solid cancers, surgery represents the mainstay of
                      curative treatment. Several studies investigating the
                      effects of the weekday of surgery (WOS) on patient outcomes
                      have yielded conflicting results. Barmer, the second-largest
                      health insurance company in Germany, serves roughly $10\%$
                      of the German population. We have used the Barmer database
                      to evaluate how the weekday on which the surgery is
                      performed influences long-term oncologic outcomes.For this
                      retrospective cohort study, the Barmer database was used to
                      investigate the effect of the WOS (Monday-Friday) on
                      outcomes following oncological resections of the colorectum
                      (n=49,003), liver (n=1,302), stomach (n=5027), esophagus
                      (n=1126), and pancreas (n=6,097). In total, 62,555 cases
                      from 2008 to 2018 were included in the analysis. The
                      endpoints were overall survival (OS), postoperative
                      complications, and necessity for therapeutic interventions
                      or re-operations. We furthermore examined whether the annual
                      caseload or certification as a cancer center influenced the
                      weekday effect.We observed a significantly impaired OS for
                      patients receiving gastric or colorectal resections on a
                      Monday. Colorectal surgery performed on Mondays was
                      associated with more postoperative complications and higher
                      probability of re-operations. The annual caseload or a
                      certification as a colorectal cancer center had no bearing
                      on the observed weekday effect. There is evidence that
                      hospitals schedule older patients with more comorbidities
                      earlier in the week, possibly explaining these findings.This
                      is the first study investigating the influence of the WOS on
                      long-term survival in Germany. Our findings indicate that,
                      in the German healthcare system, patients undergoing
                      colorectal cancer surgery on Mondays have more postoperative
                      complications and, therefore, require significantly more
                      re-operations, ultimately lowering OS. This surprising
                      finding appears to reflect an attempt to schedule patients
                      with higher postoperative risk earlier in the week as well
                      as semi-elective patients admitted on weekends scheduled for
                      surgery on the next Monday.},
      cin          = {A430},
      ddc          = {610},
      cid          = {I:(DE-He78)A430-20160331},
      pnm          = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
      pid          = {G:(DE-HGF)POF4-311},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37418560},
      doi          = {10.1097/JS9.0000000000000580},
      url          = {https://inrepo02.dkfz.de/record/277433},
}