Association of surgeon−patient sex concordance with postoperative outcomes following complex cancer surgery

Abstract

AbstractBackground and ObjectivesSex concordance may impact the therapeutic relationship and provider−patient interactions. We sought to define the association of surgeon−patient sex concordance on postoperative patient outcomes following complex cancer surgery.MethodsPatients who underwent surgery for lung, breast, hepato‐pancreato‐biliary, or colorectal cancer between 2014 and 2020 were identified from the Medicare Standard Analytic Files. The impact of surgeon−patient sex concordance or discordance on achieving an optimal postoperative textbook outcome (TO) was assessed using multivariable logistic regression.ResultsAmong 495 628 patients, 241 938 (48.8%) patients were sex concordant with their surgeon while 253 690 (51.2%) patients were sex discordant. Sex discordance between surgeon and patient was associated with a decreased likelihood to achieve a postoperative TO (odds ratio [OR]: 0.95, 95% CI: 0.93−0.97; p < 0.001). Sex discordance was associated with a higher risk of complications (OR: 1.05, 95% CI: 1.03−1.07; p < 0.001) and 90‐day mortality (OR: 1.05, 95% CI: 1.01−1.09; p = 0.011). Of note, male patients treated by female surgeons (OR: 0.96, 95% CI: 0.93−0.99; p = 0.017) had a similar lower likelihood to achieve a TO as female patients treated by male surgeons (OR: 0.90, 95% CI: 0.86−0.93; p < 0.001).ConclusionsSex discordance was associated with a reduced likelihood of achieving an “optimal” postoperative course following complex cancer surgery.