General Anesthesia Worsens Prostate Cancer Outcomes
Neuraxial + General Anesthesia May Up Prostate CA Outcomes
(HealthDay News) -- Supplementing general anesthesia (GA) with neuraxial anesthesia during prostate cancer surgery is associated with improved oncological outcomes compared with GA alone, according to a study published online Dec. 16 in the British Journal of Anaesthesia.
Federica Scavonetto, MD, from the Mayo Clinic in Rochester, Minn., and colleagues reviewed medical records from 1,642 patients with prostate cancer who had GA with neuraxial analgesia, matched in a 1:1 ratio with controls who had GA alone, based on age, surgical year, pathological stage, Gleason scores, and presence of lymph node disease. Participants were followed for a median of 9 years.
The researchers found that GA alone correlated with significantly increased risk for systemic progression (hazard ratio [HR] = 2.81; P = 0.008) and elevated overall mortality (HR = 1.32; P = 0.047) after adjustment for comorbidities, positive surgical margins and adjuvant hormonal and radiation therapies within 90 postoperative days.
Similar findings were observed for the outcome of prostate cancer deaths, although the association was not significant (adjusted HR = 2.2; P = 0.091).
"This large retrospective analysis suggests a possible beneficial effect of regional anesthetic techniques on oncological outcomes after prostate surgery for cancer; however, these findings need to be confirmed (or refuted) in randomized trials," the authors conclude.