Anesthesia in Combination with Propofol Increases Disease-Free Survival in Bladder Cancer Patients Who Undergo Radical Tumor Cystectomy as Compared to Inhalational Anesthetics and Opiate-Based Analgesia
Background:The effect of anesthetic techniques on cancer recurrence has been the subject of intensive research in the past years, as it affects a large proportion of the population. The use of opioids and halogenated agents in cancer patients during the perioperative period may be related to higher...
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| Veröffentlicht in: | Oncology 2020-02, Vol.98 (3), p.161-167 |
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| creator | Guerrero Orriach, Jose Luis Raigon Ponferrada, Aida Malo Manso, Alfredo Herrera Imbroda, Bernardo Escalona Belmonte, Juan Jose Ramirez Aliaga, Marta Ramirez Fernandez, Alicia Diaz Crespo, Julia Soriano Perez, Angela M. Fontaneda Heredia, Ana Dominguez Recio, Maria Emilia Rubio Navarro, Manuel Cruz Mañas, Jose |
| description | Background:The effect of anesthetic techniques on cancer recurrence has been the subject of intensive research in the past years, as it affects a large proportion of the population. The use of opioids and halogenated agents in cancer patients during the perioperative period may be related to higher rates of cancer recurrence and reduced disease-free survival. Methods:This was a prospective study. The sample was composed of 100 patients who underwent a radical cystectomy for infiltrating bladder cancer in a reference center. We compared disease-free survival associated with combined anesthesia versus opiate-based analgesia. The relationship between the administered hypnotic and disease-free survival was also investigated. Results:The median disease-free survival of the patients who received combined anesthesia was 585 (240–1,005) days versus 210 (90–645) days in the other group. A significant difference was observed between the two groups (p = 0.01). Combined analysis of all groups revealed significant differences in disease-free survival between patients who received combined anesthesia with propofol (510 [315–1,545] disease-free days) and those who received sevoflurane and opioids (150 [90–450] disease-free days) (p = 0.02). Conclusions:Anesthesia may play a crucial role in tumor relapse, as it is administered at the moment of the greatest risk of dissemination: surgical handling of the tumor. Opioids and volatile agents have been related to an increased risk for cancer recurrence. We compared the use of propofol + local anesthesia versus sevoflurane + opioids and also found that disease-free survival was longer among patients who received propofol + local anesthesia. Disease-free survival increases with the use of propofol in combination with epidural anesthesia in patients who undergo surgery for infiltrating bladder cancer. |
| doi_str_mv | 10.1159/000504807 |
| format | Article |
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The use of opioids and halogenated agents in cancer patients during the perioperative period may be related to higher rates of cancer recurrence and reduced disease-free survival. Methods:This was a prospective study. The sample was composed of 100 patients who underwent a radical cystectomy for infiltrating bladder cancer in a reference center. We compared disease-free survival associated with combined anesthesia versus opiate-based analgesia. The relationship between the administered hypnotic and disease-free survival was also investigated. Results:The median disease-free survival of the patients who received combined anesthesia was 585 (240–1,005) days versus 210 (90–645) days in the other group. A significant difference was observed between the two groups (p = 0.01). Combined analysis of all groups revealed significant differences in disease-free survival between patients who received combined anesthesia with propofol (510 [315–1,545] disease-free days) and those who received sevoflurane and opioids (150 [90–450] disease-free days) (p = 0.02). Conclusions:Anesthesia may play a crucial role in tumor relapse, as it is administered at the moment of the greatest risk of dissemination: surgical handling of the tumor. Opioids and volatile agents have been related to an increased risk for cancer recurrence. We compared the use of propofol + local anesthesia versus sevoflurane + opioids and also found that disease-free survival was longer among patients who received propofol + local anesthesia. Disease-free survival increases with the use of propofol in combination with epidural anesthesia in patients who undergo surgery for infiltrating bladder cancer.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000504807</identifier><identifier>PMID: 31962315</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - adverse effects ; Anesthesia, Inhalation - adverse effects ; Anesthesia, Inhalation - mortality ; Anesthesia, Intravenous - adverse effects ; Anesthesia, Intravenous - mortality ; Anesthetics, Intravenous - administration & dosage ; Anesthetics, Intravenous - adverse effects ; Bladder cancer ; Cancer ; Care and treatment ; Clinical Study ; Complications and side effects ; Cystectomy ; Cystectomy - adverse effects ; Cystectomy - mortality ; Disease-Free Survival ; Dosage and administration ; Humans ; Methods ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Perioperative care ; Propofol ; Propofol - administration & dosage ; Propofol - adverse effects ; Prospective Studies ; Protective Factors ; Relapse ; Risk Assessment ; Risk Factors ; Time Factors ; Urinary Bladder Neoplasms - mortality ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - surgery</subject><ispartof>Oncology, 2020-02, Vol.98 (3), p.161-167</ispartof><rights>2020 S. Karger AG, Basel</rights><rights>2020 S. Karger AG, Basel.</rights><rights>COPYRIGHT 2020 S. Karger AG</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-63b7742fbcc011d9892ed8a2b24538fccd0354be9737cea17b495aa6ac321eb43</citedby><cites>FETCH-LOGICAL-c432t-63b7742fbcc011d9892ed8a2b24538fccd0354be9737cea17b495aa6ac321eb43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31962315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guerrero Orriach, Jose Luis</creatorcontrib><creatorcontrib>Raigon Ponferrada, Aida</creatorcontrib><creatorcontrib>Malo Manso, Alfredo</creatorcontrib><creatorcontrib>Herrera Imbroda, Bernardo</creatorcontrib><creatorcontrib>Escalona Belmonte, Juan Jose</creatorcontrib><creatorcontrib>Ramirez Aliaga, Marta</creatorcontrib><creatorcontrib>Ramirez Fernandez, Alicia</creatorcontrib><creatorcontrib>Diaz Crespo, Julia</creatorcontrib><creatorcontrib>Soriano Perez, Angela M.</creatorcontrib><creatorcontrib>Fontaneda Heredia, Ana</creatorcontrib><creatorcontrib>Dominguez Recio, Maria Emilia</creatorcontrib><creatorcontrib>Rubio Navarro, Manuel</creatorcontrib><creatorcontrib>Cruz Mañas, Jose</creatorcontrib><title>Anesthesia in Combination with Propofol Increases Disease-Free Survival in Bladder Cancer Patients Who Undergo Radical Tumor Cystectomy as Compared to Inhalational Anesthetics and Opiate-Based Analgesia</title><title>Oncology</title><addtitle>Oncology</addtitle><description>Background:The effect of anesthetic techniques on cancer recurrence has been the subject of intensive research in the past years, as it affects a large proportion of the population. The use of opioids and halogenated agents in cancer patients during the perioperative period may be related to higher rates of cancer recurrence and reduced disease-free survival. Methods:This was a prospective study. The sample was composed of 100 patients who underwent a radical cystectomy for infiltrating bladder cancer in a reference center. We compared disease-free survival associated with combined anesthesia versus opiate-based analgesia. The relationship between the administered hypnotic and disease-free survival was also investigated. Results:The median disease-free survival of the patients who received combined anesthesia was 585 (240–1,005) days versus 210 (90–645) days in the other group. A significant difference was observed between the two groups (p = 0.01). Combined analysis of all groups revealed significant differences in disease-free survival between patients who received combined anesthesia with propofol (510 [315–1,545] disease-free days) and those who received sevoflurane and opioids (150 [90–450] disease-free days) (p = 0.02). Conclusions:Anesthesia may play a crucial role in tumor relapse, as it is administered at the moment of the greatest risk of dissemination: surgical handling of the tumor. Opioids and volatile agents have been related to an increased risk for cancer recurrence. We compared the use of propofol + local anesthesia versus sevoflurane + opioids and also found that disease-free survival was longer among patients who received propofol + local anesthesia. Disease-free survival increases with the use of propofol in combination with epidural anesthesia in patients who undergo surgery for infiltrating bladder cancer.</description><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Anesthesia, Inhalation - adverse effects</subject><subject>Anesthesia, Inhalation - mortality</subject><subject>Anesthesia, Intravenous - adverse effects</subject><subject>Anesthesia, Intravenous - mortality</subject><subject>Anesthetics, Intravenous - administration & dosage</subject><subject>Anesthetics, Intravenous - adverse effects</subject><subject>Bladder cancer</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Clinical Study</subject><subject>Complications and side effects</subject><subject>Cystectomy</subject><subject>Cystectomy - adverse effects</subject><subject>Cystectomy - mortality</subject><subject>Disease-Free Survival</subject><subject>Dosage and administration</subject><subject>Humans</subject><subject>Methods</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Recurrence, Local</subject><subject>Perioperative care</subject><subject>Propofol</subject><subject>Propofol - administration & dosage</subject><subject>Propofol - adverse effects</subject><subject>Prospective Studies</subject><subject>Protective Factors</subject><subject>Relapse</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Urinary Bladder Neoplasms - mortality</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - surgery</subject><issn>0030-2414</issn><issn>1423-0232</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpt0s9v0zAUB_AIgVgZHLgjZGkSgkOGf6Vpjl1hMKlSJ9jEMXpxXhpDYgfbGeq_yF-FQ0vFpCkHR36fZ38TvSR5yeg5Y1nxnlKaUbmg-aNkxiQXKeWCP05mlAqacsnkSfLM---R5ZmcP01OBCvmXLBslvxeGvShRa-BaENWtq-0gaCtIb90aMm1s4NtbEeujHIIHj35oP30kl46RPJ1dHf6Drqp-aKDukZHVmBUXK7jMWiCJ99aS25NrGwt-QK1VpHfjL2NcucDqmD7HQE_XT6Aw5oEG69rofubI-JDxqCVJ2Bqshk0BEwvYoo6FqHbTvmfJ08a6Dy-OKynye3lx5vV53S9-XS1Wq5TJQUP6VxUeS55UylFGauLRcGxXgCvuMzEolGqpiKTFRa5yBUCyytZZABzUIIzrKQ4Td7uzx2c_TnGZGWvvcKuA4N29CUXUmRsLvIi0rM93UKHpTaNDQ7UxMvlPONFtpCMRnX-gIpPjb1W1mCj4_69hjf_NbQIXWi97cbpd_n78N0eKme9d9iUg9M9uF3JaDmNTnkcnWhfHz5rrHqsj_LfrETwag9-gNuiO4Jj_9mD5c1qvRflUDfiD24y1DY</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Guerrero Orriach, Jose Luis</creator><creator>Raigon Ponferrada, Aida</creator><creator>Malo Manso, Alfredo</creator><creator>Herrera Imbroda, Bernardo</creator><creator>Escalona Belmonte, Juan Jose</creator><creator>Ramirez Aliaga, Marta</creator><creator>Ramirez Fernandez, Alicia</creator><creator>Diaz Crespo, Julia</creator><creator>Soriano Perez, Angela M.</creator><creator>Fontaneda Heredia, Ana</creator><creator>Dominguez Recio, Maria Emilia</creator><creator>Rubio Navarro, Manuel</creator><creator>Cruz Mañas, Jose</creator><general>S. Karger AG</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200201</creationdate><title>Anesthesia in Combination with Propofol Increases Disease-Free Survival in Bladder Cancer Patients Who Undergo Radical Tumor Cystectomy as Compared to Inhalational Anesthetics and Opiate-Based Analgesia</title><author>Guerrero Orriach, Jose Luis ; Raigon Ponferrada, Aida ; Malo Manso, Alfredo ; Herrera Imbroda, Bernardo ; Escalona Belmonte, Juan Jose ; Ramirez Aliaga, Marta ; Ramirez Fernandez, Alicia ; Diaz Crespo, Julia ; Soriano Perez, Angela M. ; Fontaneda Heredia, Ana ; Dominguez Recio, Maria Emilia ; Rubio Navarro, Manuel ; Cruz Mañas, Jose</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-63b7742fbcc011d9892ed8a2b24538fccd0354be9737cea17b495aa6ac321eb43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Analgesics, Opioid - administration & dosage</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Anesthesia, Inhalation - adverse effects</topic><topic>Anesthesia, Inhalation - mortality</topic><topic>Anesthesia, Intravenous - adverse effects</topic><topic>Anesthesia, Intravenous - mortality</topic><topic>Anesthetics, Intravenous - administration & dosage</topic><topic>Anesthetics, Intravenous - adverse effects</topic><topic>Bladder cancer</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Clinical Study</topic><topic>Complications and side effects</topic><topic>Cystectomy</topic><topic>Cystectomy - adverse effects</topic><topic>Cystectomy - mortality</topic><topic>Disease-Free Survival</topic><topic>Dosage and administration</topic><topic>Humans</topic><topic>Methods</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Recurrence, Local</topic><topic>Perioperative care</topic><topic>Propofol</topic><topic>Propofol - administration & dosage</topic><topic>Propofol - adverse effects</topic><topic>Prospective Studies</topic><topic>Protective Factors</topic><topic>Relapse</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Urinary Bladder Neoplasms - mortality</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guerrero Orriach, Jose Luis</creatorcontrib><creatorcontrib>Raigon Ponferrada, Aida</creatorcontrib><creatorcontrib>Malo Manso, Alfredo</creatorcontrib><creatorcontrib>Herrera Imbroda, Bernardo</creatorcontrib><creatorcontrib>Escalona Belmonte, Juan Jose</creatorcontrib><creatorcontrib>Ramirez Aliaga, Marta</creatorcontrib><creatorcontrib>Ramirez Fernandez, Alicia</creatorcontrib><creatorcontrib>Diaz Crespo, Julia</creatorcontrib><creatorcontrib>Soriano Perez, Angela M.</creatorcontrib><creatorcontrib>Fontaneda Heredia, Ana</creatorcontrib><creatorcontrib>Dominguez Recio, Maria Emilia</creatorcontrib><creatorcontrib>Rubio Navarro, Manuel</creatorcontrib><creatorcontrib>Cruz Mañas, Jose</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guerrero Orriach, Jose Luis</au><au>Raigon Ponferrada, Aida</au><au>Malo Manso, Alfredo</au><au>Herrera Imbroda, Bernardo</au><au>Escalona Belmonte, Juan Jose</au><au>Ramirez Aliaga, Marta</au><au>Ramirez Fernandez, Alicia</au><au>Diaz Crespo, Julia</au><au>Soriano Perez, Angela M.</au><au>Fontaneda Heredia, Ana</au><au>Dominguez Recio, Maria Emilia</au><au>Rubio Navarro, Manuel</au><au>Cruz Mañas, Jose</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anesthesia in Combination with Propofol Increases Disease-Free Survival in Bladder Cancer Patients Who Undergo Radical Tumor Cystectomy as Compared to Inhalational Anesthetics and Opiate-Based Analgesia</atitle><jtitle>Oncology</jtitle><addtitle>Oncology</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>98</volume><issue>3</issue><spage>161</spage><epage>167</epage><pages>161-167</pages><issn>0030-2414</issn><eissn>1423-0232</eissn><abstract>Background:The effect of anesthetic techniques on cancer recurrence has been the subject of intensive research in the past years, as it affects a large proportion of the population. The use of opioids and halogenated agents in cancer patients during the perioperative period may be related to higher rates of cancer recurrence and reduced disease-free survival. Methods:This was a prospective study. The sample was composed of 100 patients who underwent a radical cystectomy for infiltrating bladder cancer in a reference center. We compared disease-free survival associated with combined anesthesia versus opiate-based analgesia. The relationship between the administered hypnotic and disease-free survival was also investigated. Results:The median disease-free survival of the patients who received combined anesthesia was 585 (240–1,005) days versus 210 (90–645) days in the other group. A significant difference was observed between the two groups (p = 0.01). Combined analysis of all groups revealed significant differences in disease-free survival between patients who received combined anesthesia with propofol (510 [315–1,545] disease-free days) and those who received sevoflurane and opioids (150 [90–450] disease-free days) (p = 0.02). Conclusions:Anesthesia may play a crucial role in tumor relapse, as it is administered at the moment of the greatest risk of dissemination: surgical handling of the tumor. Opioids and volatile agents have been related to an increased risk for cancer recurrence. We compared the use of propofol + local anesthesia versus sevoflurane + opioids and also found that disease-free survival was longer among patients who received propofol + local anesthesia. Disease-free survival increases with the use of propofol in combination with epidural anesthesia in patients who undergo surgery for infiltrating bladder cancer.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>31962315</pmid><doi>10.1159/000504807</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Oncology, 2020-02, Vol.98 (3), p.161-167 |
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| language | eng |
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| subjects | Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Anesthesia, Inhalation - adverse effects Anesthesia, Inhalation - mortality Anesthesia, Intravenous - adverse effects Anesthesia, Intravenous - mortality Anesthetics, Intravenous - administration & dosage Anesthetics, Intravenous - adverse effects Bladder cancer Cancer Care and treatment Clinical Study Complications and side effects Cystectomy Cystectomy - adverse effects Cystectomy - mortality Disease-Free Survival Dosage and administration Humans Methods Neoplasm Metastasis Neoplasm Recurrence, Local Perioperative care Propofol Propofol - administration & dosage Propofol - adverse effects Prospective Studies Protective Factors Relapse Risk Assessment Risk Factors Time Factors Urinary Bladder Neoplasms - mortality Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - surgery |
| title | Anesthesia in Combination with Propofol Increases Disease-Free Survival in Bladder Cancer Patients Who Undergo Radical Tumor Cystectomy as Compared to Inhalational Anesthetics and Opiate-Based Analgesia |
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