Propofol-based intravenous anesthesia is associated with better survival than desflurane anesthesia in pancreatic cancer surgery

Autor:	Kuo-Chuan Hung, Hou Chuan Lai, Zhi-Fu Wu, Kuen Tze Lin, Yin Tzu Liu, Meei-Shyuan Lee, Jen Yin Chen
Rok vydání:	2020
Předmět:	Male Cancer Treatment Metastasis Desflurane 0302 clinical medicine Anesthesiology 030202 anesthesiology Basic Cancer Research Medicine and Health Sciences Anesthesia Propofol Multidisciplinary Pharmaceutics Hazard ratio Drugs Middle Aged Tumor Resection Surgical Oncology Oncology 030220 oncology & carcinogenesis Anesthetics Inhalation Anesthesia Intravenous Medicine Female Anesthetics Intravenous Research Article medicine.drug Clinical Oncology medicine.medical_specialty Death Rates Science Surgical and Invasive Medical Procedures Pancreatic Cancer 03 medical and health sciences Drug Therapy Population Metrics Gastrointestinal Tumors medicine Pain Management Humans Anesthetics Aged Retrospective Studies Pharmacology Population Biology Surgical Resection business.industry Proportional hazards model Cancers and Neoplasms Biology and Life Sciences Retrospective cohort study Survival Analysis Confidence interval Surgery Pancreatic Neoplasms Intravenous anesthesia Anesthetic Clinical Medicine business
Zdroj:	PLoS ONE, Vol 15, Iss 5, p e0233598 (2020) PLoS ONE
ISSN:	1932-6203
DOI:	10.1371/journal.pone.0233598
Popis:	Background Previous researches have shown that anesthetic techniques can influence the patient outcomes of cancer surgery. Here, we studied the relationship between type of anesthetic and patient outcomes following elective, open pancreatic cancer surgery. Methods This was a retrospective cohort study of patients who received elective, open pancreatic cancer surgery between January 2005 and July 2018. Patients were grouped according to the anesthesia they received, namely desflurane or propofol. A Kaplan-Meier analysis was conducted, and survival curves were presented from the date of surgery to death. Univariable and multivariable Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for all-cause mortality, cancer-specific mortality, and disease progression. Results A total of 68 patients (56 deaths, 82.0%) under desflurane anesthesia, and 72 patients (43 deaths, 60.0%) under propofol anesthesia were included. Fifty-eight patients remained in each group after propensity matching. The propofol anesthesia was associated with improved survival (hazard ratio, 0.65; 95% confidence interval, 0.42-0.99; P = 0.047) in the matched analysis. Subgroup analyses showed significantly better cancer-specific survival (hazard ratio, 0.63; 95% confidence interval, 0.40-0.97; P = 0.037) in the propofol group. Additionally, patients under propofol had less postoperative recurrence, but not fewer postoperative metastases formation, than those under desflurane (hazard ratio, 0.55; 95% confidence interval, 0.34-0.90; P = 0.028) in the matched analysis. Conclusions In a limited sample size, we observed that propofol anesthesia was associated with improved survival in open pancreatic cancer surgery compared with desflurane anesthesia. Further investigations are needed to inspect the influences of propofol anesthesia on patient outcomes of pancreatic cancer surgery.
Databáze:	OpenAIRE
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