Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy
Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy. This was a retros...
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| Veröffentlicht in: | PloS one 2020-03, Vol.15 (3), p.e0230290 |
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| description | Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy.
This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 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 tumor-node-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence.
A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis. Subgroup analyses showed that patients under propofol anesthesia had less postoperative biochemical recurrence than those under desflurane (hazard ratio, 0.20; 95% confidence interval, 0.05-0.91; P = 0.038) in the matched analysis.
Propofol anesthesia was associated with improved overall survival in robot-assisted radical prostatectomy compared with desflurane anesthesia. In addition, patients under propofol anesthesia had less postoperative biochemical recurrence. |
| doi_str_mv | 10.1371/journal.pone.0230290 |
| format | Article |
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This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 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 tumor-node-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence.
A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis. Subgroup analyses showed that patients under propofol anesthesia had less postoperative biochemical recurrence than those under desflurane (hazard ratio, 0.20; 95% confidence interval, 0.05-0.91; P = 0.038) in the matched analysis.
Propofol anesthesia was associated with improved overall survival in robot-assisted radical prostatectomy compared with desflurane anesthesia. In addition, patients under propofol anesthesia had less postoperative biochemical recurrence.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0230290</identifier><identifier>PMID: 32182262</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Anesthesia ; Anesthesiology ; Biochemistry ; Biology and Life Sciences ; Blood pressure ; Blood transfusions ; Cancer ; Cancer metastasis ; Cancer patients ; Cancer research ; Cancer surgery ; Cancer therapies ; Cisatracurium ; Clinical outcomes ; Confidence intervals ; Death ; Development and progression ; Diseases ; Fatalities ; Fentanyl ; Health hazards ; Hospitals ; Intravenous administration ; Matching ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Metabolism ; Metastases ; Metastasis ; Morbidity ; Mortality ; Patient outcomes ; Patients ; Phenols (Class of compounds) ; Propofol ; Prostate cancer ; Prostatectomy ; Regression analysis ; Regression models ; Robotic surgery ; Robots ; Statistical analysis ; Subgroups ; Surgery ; Surgical outcomes ; Survival ; Tumors ; Urological surgery</subject><ispartof>PloS one, 2020-03, Vol.15 (3), p.e0230290</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Lai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Lai et al 2020 Lai et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-bd521929136002a885e31e5fd5d82f9b4cc91afbacd9cf412238dacc3dc27b7f3</citedby><cites>FETCH-LOGICAL-c692t-bd521929136002a885e31e5fd5d82f9b4cc91afbacd9cf412238dacc3dc27b7f3</cites><orcidid>0000-0001-6376-9085</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077845/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077845/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32182262$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lai, Hou-Chuan</creatorcontrib><creatorcontrib>Lee, Meei-Shyuan</creatorcontrib><creatorcontrib>Lin, Kuen-Tze</creatorcontrib><creatorcontrib>Huang, Yi-Hsuan</creatorcontrib><creatorcontrib>Chen, Jen-Yin</creatorcontrib><creatorcontrib>Lin, Yao-Tsung</creatorcontrib><creatorcontrib>Hung, Kuo-Chuan</creatorcontrib><creatorcontrib>Wu, Zhi-Fu</creatorcontrib><title>Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy.
This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 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 tumor-node-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence.
A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis. Subgroup analyses showed that patients under propofol anesthesia had less postoperative biochemical recurrence than those under desflurane (hazard ratio, 0.20; 95% confidence interval, 0.05-0.91; P = 0.038) in the matched analysis.
Propofol anesthesia was associated with improved overall survival in robot-assisted radical prostatectomy compared with desflurane anesthesia. In addition, patients under propofol anesthesia had less postoperative biochemical recurrence.</description><subject>Analysis</subject><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Biochemistry</subject><subject>Biology and Life Sciences</subject><subject>Blood pressure</subject><subject>Blood transfusions</subject><subject>Cancer</subject><subject>Cancer metastasis</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Cancer surgery</subject><subject>Cancer therapies</subject><subject>Cisatracurium</subject><subject>Clinical outcomes</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Development and progression</subject><subject>Diseases</subject><subject>Fatalities</subject><subject>Fentanyl</subject><subject>Health hazards</subject><subject>Hospitals</subject><subject>Intravenous administration</subject><subject>Matching</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Metabolism</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Phenols (Class of compounds)</subject><subject>Propofol</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Robotic surgery</subject><subject>Robots</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Tumors</subject><subject>Urological 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total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy</title><author>Lai, Hou-Chuan ; Lee, Meei-Shyuan ; Lin, Kuen-Tze ; Huang, Yi-Hsuan ; Chen, Jen-Yin ; Lin, Yao-Tsung ; Hung, Kuo-Chuan ; Wu, Zhi-Fu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-bd521929136002a885e31e5fd5d82f9b4cc91afbacd9cf412238dacc3dc27b7f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Analysis</topic><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Biochemistry</topic><topic>Biology and Life Sciences</topic><topic>Blood pressure</topic><topic>Blood transfusions</topic><topic>Cancer</topic><topic>Cancer metastasis</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Cancer surgery</topic><topic>Cancer therapies</topic><topic>Cisatracurium</topic><topic>Clinical 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lai, Hou-Chuan</au><au>Lee, Meei-Shyuan</au><au>Lin, Kuen-Tze</au><au>Huang, Yi-Hsuan</au><au>Chen, Jen-Yin</au><au>Lin, Yao-Tsung</au><au>Hung, Kuo-Chuan</au><au>Wu, Zhi-Fu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-03-17</date><risdate>2020</risdate><volume>15</volume><issue>3</issue><spage>e0230290</spage><pages>e0230290-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Previous researches have shown that anesthetic techniques may influence the patients' outcomes after cancer surgery. Here, we studied the relationship between the type of anesthetic techniques and patients' outcomes following elective robot-assisted radical prostatectomy.
This was a retrospective cohort study of patients who received elective, robot-assisted radical prostatectomy between January 2008 and December 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 tumor-node-metastasis stage and disease progression. The primary outcome was overall survival, and the secondary outcome was postoperative biochemical recurrence.
A total of 365 patients (24 deaths, 7.0%) under desflurane anesthesia, and 266 patients (2 deaths, 1.0%) under propofol anesthesia were included. The all-cause mortality rate was significantly lower in the propofol anesthesia than in the desflurane anesthesia during follow-up (P = 0.001). Two hundred sixty-four patients remained in each group after propensity matching. The propofol anesthesia was associated with improved overall survival (hazard ratio, 0.11; 95% confidence interval, 0.03-0.48; P = 0.003) in the matched analysis. Subgroup analyses showed that patients under propofol anesthesia had less postoperative biochemical recurrence than those under desflurane (hazard ratio, 0.20; 95% confidence interval, 0.05-0.91; P = 0.038) in the matched analysis.
Propofol anesthesia was associated with improved overall survival in robot-assisted radical prostatectomy compared with desflurane anesthesia. In addition, patients under propofol anesthesia had less postoperative biochemical recurrence.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32182262</pmid><doi>10.1371/journal.pone.0230290</doi><tpages>e0230290</tpages><orcidid>https://orcid.org/0000-0001-6376-9085</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Anesthesia Anesthesiology Biochemistry Biology and Life Sciences Blood pressure Blood transfusions Cancer Cancer metastasis Cancer patients Cancer research Cancer surgery Cancer therapies Cisatracurium Clinical outcomes Confidence intervals Death Development and progression Diseases Fatalities Fentanyl Health hazards Hospitals Intravenous administration Matching Medical prognosis Medical research Medicine and Health Sciences Metabolism Metastases Metastasis Morbidity Mortality Patient outcomes Patients Phenols (Class of compounds) Propofol Prostate cancer Prostatectomy Regression analysis Regression models Robotic surgery Robots Statistical analysis Subgroups Surgery Surgical outcomes Survival Tumors Urological surgery |
| title | Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in robot-assisted radical prostatectomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T06%3A03%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Propofol-based%20total%20intravenous%20anesthesia%20is%20associated%20with%20better%20survival%20than%20desflurane%20anesthesia%20in%20robot-assisted%20radical%20prostatectomy&rft.jtitle=PloS%20one&rft.au=Lai,%20Hou-Chuan&rft.date=2020-03-17&rft.volume=15&rft.issue=3&rft.spage=e0230290&rft.pages=e0230290-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0230290&rft_dat=%3Cgale_plos_%3EA617767800%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2377944107&rft_id=info:pmid/32182262&rft_galeid=A617767800&rft_doaj_id=oai_doaj_org_article_95fbd7bc7e04421c9b0a39d6cf128011&rfr_iscdi=true |