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Association between Anaesthetic Technique and Oncological Outcomes after Colorectal Carcinoma Liver Metastasis Resection.
- Source :
-
International journal of medical sciences [Int J Med Sci] 2019 Jan 24; Vol. 16 (2), pp. 337-342. Date of Electronic Publication: 2019 Jan 24 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Background: Recently published studies suggest that the anaesthetic technique used during oncologic surgery can improve patient outcomes. Therefore, the authors evaluated the survival of patients with resected colorectal carcinoma liver metastases (CRCLMs) who received either EGA (general anaesthesia [GA] combined with epidural anaesthesia [EA]) or GA alone. Methods: We conducted an ambispective cohort study including 225 post-surgical CRCLM patients between May 2007 and July 2012 and performed a follow-up investigation of survival in July 2017. Results: The basic characteristics in the two groups were largely similar. The median (quartiles) recurrence interval for all patients was 10 (2.5, 23) months, and the median (quartiles) survival for CRCLM patients post-surgically was 37 (30.5, 51.5) months. Perioperative EA was associated with survival (P =0.039, log-rank test), with an estimated hazard ratio of 0.737 (95% CI 0.551-0.985) in the univariate analysis. Kaplan-Meier estimates of survival for GA and EGA suggested that GA might provide better outcomes than EGA [P=0.028, hazard ratio of 0.7328 (95% CI 0.5433-0.9884)]. Significant differences in anaesthesia techniques were found (P=0.048), with an adjusted estimated hazard ratio of 0.741 (95% CI 0.550-0.998) in the multivariate analysis. Subgroup analyses of patients in different age groups (< 40, ≥ 40 but <60, and ≥ 60 years old) suggested that no significant differences existed among all three subgroups. Conclusions: Compared with EGA, GA may provide a better survival outcome for CRCLM patients. The benefits of anaesthetic techniques in oncological surgery are most likely related to certain cancer types.<br />Competing Interests: Competing Interests: The authors have declared that no competing interest exists.
- Subjects :
- Carcinoma mortality
Carcinoma secondary
China epidemiology
Cohort Studies
Colorectal Neoplasms pathology
Female
Humans
Liver pathology
Liver surgery
Liver Neoplasms mortality
Liver Neoplasms secondary
Male
Middle Aged
Anesthesia, Epidural mortality
Anesthesia, General mortality
Carcinoma surgery
Liver Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1449-1907
- Volume :
- 16
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- International journal of medical sciences
- Publication Type :
- Academic Journal
- Accession number :
- 30745816
- Full Text :
- https://doi.org/10.7150/ijms.28016