# Impact of seasons on elderly patients with esophageal squamous cell carcinoma following esophagectomy: a propensity score matching analysis

## TL;DR

This study finds that seasons do not affect long-term survival in elderly patients with esophageal cancer after surgery, but some complications like fluid buildup are more common in summer.

## Contribution

The study is the first to use propensity score matching to analyze seasonal effects on elderly esophageal cancer patients' postoperative outcomes.

## Key findings

- Seasonal variations do not significantly impact overall or disease-free survival in elderly ESCC patients.
- Summer season is associated with a higher incidence of hydrothorax after esophagectomy.
- RMST and RMDFST analyses confirmed no significant seasonal differences in survival outcomes.

## Abstract

Esophageal squamous cell carcinoma (ESCC) is prevalent in East Asia, with elderly patients facing unique postoperative challenges. This study examines the impact of seasonal variations on postoperative complications and survival in elderly patients undergoing esophagectomy for ESCC.

This retrospective cohort study was conducted using data from the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database. Elderly patients (≥ 70 years) with thoracic ESCC who underwent esophagectomy between May 2016 and August 2021 were included. Patients were stratified into four seasonal groups: Winter (December–February), Spring (March–May), Summer (June–August), and Autumn (September–November). Primary outcomes included overall survival (OS), disease-free survival (DFS). Secondary outcomes assessed postoperative complications using the Clavien-Dindo classification.

A total of 469 elderly ESCC patients were included. The median overall survival was 51.6 months, with no significant differences in OS or DFS across the four seasonal groups. Restricted Mean Survival Time (RMST) and Restricted Mean Disease-Free Survival Time (RMDFST) analyses also showed no significant seasonal variations. The Summer group had a significantly higher incidence of hydrothorax compared to other groups (p < 0.05).

Seasonal variations influence specific short-term postoperative complications but do not significantly impact long-term survival in elderly ESCC patients undergoing esophagectomy.