The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis
BACKGROUND AND OBJECTIVESPotentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surge...
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| Veröffentlicht in: | Regional anesthesia and pain medicine 2015-09, Vol.40 (5), p.589-598 |
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| container_title | Regional anesthesia and pain medicine |
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| creator | Sun, Yanxia Li, Tianzuo Gan, Tong J |
| description | BACKGROUND AND OBJECTIVESPotentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surgery.
METHODSThe authors searched computerized databases (from inception to December 2014) and reference lists and considered all studies comparing the effects of RA on cancer recurrence or overall survival with that of general anesthesia (GA). Risk estimates were pooled to determine the effects of RA on risks of cancer recurrence and mortality. Twenty eligible studies were included.
RESULTSPerioperative RA use was associated with improved overall survival (Hazard ratio [HR] = 0.84, 95% CI, 0.75 − 0.94; I =41%), but not with reduced cancer recurrence (HR=0.91, 95% CI, 0.70 − 1.18; I=83%).
CONCLUSIONSOur meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery. |
| doi_str_mv | 10.1097/AAP.0000000000000273 |
| format | Article |
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METHODSThe authors searched computerized databases (from inception to December 2014) and reference lists and considered all studies comparing the effects of RA on cancer recurrence or overall survival with that of general anesthesia (GA). Risk estimates were pooled to determine the effects of RA on risks of cancer recurrence and mortality. Twenty eligible studies were included.
RESULTSPerioperative RA use was associated with improved overall survival (Hazard ratio [HR] = 0.84, 95% CI, 0.75 − 0.94; I =41%), but not with reduced cancer recurrence (HR=0.91, 95% CI, 0.70 − 1.18; I=83%).
CONCLUSIONSOur meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery.</description><identifier>ISSN: 1098-7339</identifier><identifier>EISSN: 1532-8651</identifier><identifier>DOI: 10.1097/AAP.0000000000000273</identifier><identifier>PMID: 26263074</identifier><language>eng</language><publisher>England: Copyright by American Society of Regional Anesthesia and Pain Medicine</publisher><subject>Analgesia - mortality ; Analgesia - trends ; Analgesics ; Anesthesia, Conduction - mortality ; Anesthesia, Conduction - trends ; Cancer ; Humans ; Meta-analysis ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - mortality ; Neoplasms - diagnosis ; Neoplasms - mortality ; Neoplasms - surgery ; Pain Management - mortality ; Pain Management - trends ; Perioperative care ; Regional anesthesia ; Surgery ; Survival Rate - trends ; Systematic review ; Treatment Outcome</subject><ispartof>Regional anesthesia and pain medicine, 2015-09, Vol.40 (5), p.589-598</ispartof><rights>Copyright © 2015 by American Society of Regional Anesthesia and Pain Medicine.</rights><rights>Copyright © 2015 by American Society of Regional Anesthesia and Pain Medicine2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3843-c7a0e800c120a391bd29baf05a483ffddac73f13ce371c8c472abed5c7a78c573</citedby><cites>FETCH-LOGICAL-c3843-c7a0e800c120a391bd29baf05a483ffddac73f13ce371c8c472abed5c7a78c573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26263074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Yanxia</creatorcontrib><creatorcontrib>Li, Tianzuo</creatorcontrib><creatorcontrib>Gan, Tong J</creatorcontrib><title>The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis</title><title>Regional anesthesia and pain medicine</title><addtitle>Reg Anesth Pain Med</addtitle><description>BACKGROUND AND OBJECTIVESPotentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surgery.
METHODSThe authors searched computerized databases (from inception to December 2014) and reference lists and considered all studies comparing the effects of RA on cancer recurrence or overall survival with that of general anesthesia (GA). Risk estimates were pooled to determine the effects of RA on risks of cancer recurrence and mortality. Twenty eligible studies were included.
RESULTSPerioperative RA use was associated with improved overall survival (Hazard ratio [HR] = 0.84, 95% CI, 0.75 − 0.94; I =41%), but not with reduced cancer recurrence (HR=0.91, 95% CI, 0.70 − 1.18; I=83%).
CONCLUSIONSOur meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery.</description><subject>Analgesia - mortality</subject><subject>Analgesia - trends</subject><subject>Analgesics</subject><subject>Anesthesia, Conduction - mortality</subject><subject>Anesthesia, Conduction - trends</subject><subject>Cancer</subject><subject>Humans</subject><subject>Meta-analysis</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - mortality</subject><subject>Neoplasms - surgery</subject><subject>Pain Management - mortality</subject><subject>Pain Management - trends</subject><subject>Perioperative care</subject><subject>Regional anesthesia</subject><subject>Surgery</subject><subject>Survival Rate - trends</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>1098-7339</issn><issn>1532-8651</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1v1DAQhi0Eoh_wDxCyxIVLij_i2OEWrUpBKmpFy9nyOuPdFG-82Mmu8mf6W-vdLajqob54xn7embFfhD5QckZJLb80zfUZebqY5K_QMRWcFaoS9HWOSa0KyXl9hE5SusuMkmX1Fh2xilWcyPIY3d8uAZ87B3ZIODh8DbELa4hm6DaAf8GiC73xuOkhDUtIncGmb3Nq_GKfhR7PTG8hZtaOMUKO98jNGDfdZid1Q7696m3wYTHtzhcQp6-4wTdTGmCVO9ks3nSw3Qt_wmCKXYMpdekdeuOMT_D-cT9Fv7-d386-F5dXFz9mzWVhuSp5YaUhoAixlBHDazpvWT03jghTKu5c2xoruaPcApfUKltKZubQiqyTygrJT9HnQ911DH_H_Fa96pIF700PYUyaSiIkUxVTGf30DL0LY8zzJs2E4JQQXotMlQfKxpBSBKfXsVuZOGlK9M4_nf3Tz_3Lso-Pxcf5Ctr_on-GZUAdgG3w-V_THz9uIeolGD8sX679AOYpqD8</recordid><startdate>201509</startdate><enddate>201509</enddate><creator>Sun, Yanxia</creator><creator>Li, Tianzuo</creator><creator>Gan, Tong J</creator><general>Copyright by American Society of Regional Anesthesia and Pain Medicine</general><general>BMJ Publishing Group LTD</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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201509</creationdate><title>The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis</title><author>Sun, Yanxia ; Li, Tianzuo ; Gan, Tong J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3843-c7a0e800c120a391bd29baf05a483ffddac73f13ce371c8c472abed5c7a78c573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analgesia - mortality</topic><topic>Analgesia - trends</topic><topic>Analgesics</topic><topic>Anesthesia, Conduction - mortality</topic><topic>Anesthesia, Conduction - trends</topic><topic>Cancer</topic><topic>Humans</topic><topic>Meta-analysis</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - mortality</topic><topic>Neoplasms - surgery</topic><topic>Pain Management - mortality</topic><topic>Pain Management - trends</topic><topic>Perioperative care</topic><topic>Regional anesthesia</topic><topic>Surgery</topic><topic>Survival Rate - trends</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Yanxia</creatorcontrib><creatorcontrib>Li, Tianzuo</creatorcontrib><creatorcontrib>Gan, Tong J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Regional anesthesia and pain medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Yanxia</au><au>Li, Tianzuo</au><au>Gan, Tong J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis</atitle><jtitle>Regional anesthesia and pain medicine</jtitle><addtitle>Reg Anesth Pain Med</addtitle><date>2015-09</date><risdate>2015</risdate><volume>40</volume><issue>5</issue><spage>589</spage><epage>598</epage><pages>589-598</pages><issn>1098-7339</issn><eissn>1532-8651</eissn><abstract>BACKGROUND AND OBJECTIVESPotentially, perioperative regional anesthesia and analgesia (RA) could influence the outcomes of patients with cancer. The aim of this systematic review and meta-analysis was to evaluate the effects of perioperative RA on survival and cancer recurrence after oncologic surgery.
METHODSThe authors searched computerized databases (from inception to December 2014) and reference lists and considered all studies comparing the effects of RA on cancer recurrence or overall survival with that of general anesthesia (GA). Risk estimates were pooled to determine the effects of RA on risks of cancer recurrence and mortality. Twenty eligible studies were included.
RESULTSPerioperative RA use was associated with improved overall survival (Hazard ratio [HR] = 0.84, 95% CI, 0.75 − 0.94; I =41%), but not with reduced cancer recurrence (HR=0.91, 95% CI, 0.70 − 1.18; I=83%).
CONCLUSIONSOur meta-analysis suggests that RA may improve overall survival but not reduce cancer recurrence after oncologic surgery.</abstract><cop>England</cop><pub>Copyright by American Society of Regional Anesthesia and Pain Medicine</pub><pmid>26263074</pmid><doi>10.1097/AAP.0000000000000273</doi><tpages>10</tpages></addata></record> |
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| ispartof | Regional anesthesia and pain medicine, 2015-09, Vol.40 (5), p.589-598 |
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| subjects | Analgesia - mortality Analgesia - trends Analgesics Anesthesia, Conduction - mortality Anesthesia, Conduction - trends Cancer Humans Meta-analysis Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - mortality Neoplasms - diagnosis Neoplasms - mortality Neoplasms - surgery Pain Management - mortality Pain Management - trends Perioperative care Regional anesthesia Surgery Survival Rate - trends Systematic review Treatment Outcome |
| title | The Effects of Perioperative Regional Anesthesia and Analgesia on Cancer Recurrence and Survival After Oncology Surgery: A Systematic Review and Meta-Analysis |
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