Seasonal variation influences outcomes following lung cancer resections

Abstract

Objective The effect of seasonal variation on postoperative outcomes following lung cancer resections is unknown. We hypothesized that postoperative outcomes following surgical resection for lung cancer within the United States would not be impacted by operative season. Methods From 2002 to 2007, 182 507 isolated lung cancer resections (lobectomy (n = 147 937), sublobar resection (n = 21 650), and pneumonectomy (n = 13 916)) were evaluated using the Nationwide Inpatient Sample (NIS) database. Patients were stratified according to operative season: spring (n = 47 382), summer (n = 46 131), fall (n = 45 370) and winter (n = 43 624). Multivariate regression models were applied to assess the effect of operative season on adjusted postoperative outcomes. Results Patient co-morbidities and risk factors were similar despite the operative season. Lobectomy was the most common operation performed: spring (80.0%), summer (81.3%), fall (81.8%), and winter (81.1%). Lung cancer resections were more commonly performed at large, high-volume (>75th percentile operative volume) centers (P < 0.001). Unadjusted mortality was lowest during the spring (2.6%, P < 0.001) season compared with summer (3.1%), fall (3.0%) and winter (3.2%), while complications were most common in the fall (31.7%, P < 0.001). Hospital length of stay was longest for operations performed in the winter season (8.92 ± 0.11 days, P < 0.001). Importantly, multivariable logistic regression revealed that operative season was an independent predictor of in-hospital mortality (P < 0.001) and of postoperative complications (P < 0.001). Risk-adjusted odds of in-hospital mortality were increased for lung cancer resections occurring during all other seasons compared with those occurring in the spring. Conclusions Outcomes following surgical resection for lung cancer are independently influenced by time of year. Risk-adjusted in-hospital mortality and hospital length of stay were lowest during the spring season.

Season and vitamin D status do not affect probability for surgical site infection after colorectal surgery

“…However, there are few studies in other surgical population supporting our results. LaPar et al [11] reported that, the morbidity and mortality of patients were lowest in patients operated in spring after lung resection and Kestle et al [12] reported that complications such as infection and wound dehiscence were higher in July and August after pediatric shunt surgery. Gruskay et al [13] very similar to our results found that surgical infections decreased to the lowest point in the spring (2.8 %) when compared with summer (4.1 %), less postoperative infection rate (4.6 %) [15].…”

Vitamin D-Related Gene Polymorphisms, Plasma 25-Hydroxy-Vitamin D, Cigarette Smoke and Non-Small Cell Lung Cancer (NSCLC) Risk

“…Furthermore, recent epidemiological studies have shown that exposure to solar radiation (in particular ultraviolet B (UVB) radiation) and vitamin D intake is connected with decreased incidence of many cancers including lung, breast, prostate and colon cancer [2,3,4,5,6]. The mortality of lung cancer is lowest during the autumn and summer months, which are associated with the highest vitamin D levels in a year [7]. The vitamin D 3 and vitamin D 2 , two natural primary forms of vitamin D, are endogenously generated from sun exposure or ingestion of food or supplements [8].…”

Lack of any Association between Season of Diagnosis and Survival of Gastric Cancer Cases in Kayseri, Turkey

“…In most of these studies it has been shown that winter months are associated with poorer prognosis that may be explained through the variations in the cutaneous production of vitamin D3 (Lim et al, 2006;Roychoudhuri et al, 2009;La Par et al, 2011).…”

“…The effect of season in which the cancers were diagnosed, on the outcomes of patients with cancer has been studied in several large epidemiologic studies (Lim Roychoudhuri et al, 2009;La Par et al, 2011). In most of these studies it has been shown that winter months are associated with poorer prognosis that may be explained through the variations in the cutaneous production of vitamin D3.…”