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麻醉与癌症手术后的长期生存-全静脉与挥发性麻醉:一项回顾性研究。

Anesthetics and long-term survival after cancer surgery-total intravenous versus volatile anesthesia: a retrospective study.

机构信息

Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.

出版信息

BMC Anesthesiol. 2019 Dec 18;19(1):233. doi: 10.1186/s12871-019-0914-4.

Abstract

BACKGROUND

Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital.

METHODS

The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity.

RESULTS

The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test (P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery.

CONCLUSIONS

There were no differences in 5-year overall survival between two groups in the cancer surgery.

TRIAL REGISTRATION

Trial registration: CRIS KCT0004101. Retrospectively registered 28 June 2019.

摘要

背景

静脉麻醉被报道对癌症患者的预后有有利影响。本研究旨在分析我院麻醉与癌症患者预后之间的关系。

方法

回顾性分析 2006 年 1 月至 2009 年 12 月期间接受胃、肺、肝、结肠和乳腺癌手术切除的患者的病历。根据麻醉类型,将其分为全静脉麻醉(TIVA)或挥发性吸入麻醉(VIA)组。采用对数秩检验分析 5 年总生存率。采用 Cox 比例风险模型进行敏感性分析。

结果

倾向性匹配后最终纳入比较的患者数量在每组为 729 例。TIVA 组 5 年存活患者数为 660 例(90.5%),VIA 组为 673 例(92.3%)。根据对数秩检验,麻醉类型并不影响 5 年生存率(P=0.21)。多变量分析显示,男性和手术时转移是死亡风险显著增加的相关变量。

结论

癌症手术中两组患者的 5 年总生存率无差异。

试验注册

CRIS KCT0004101. 2019 年 6 月 28 日回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e89d/6921541/36bacab4b4b6/12871_2019_914_Fig1_HTML.jpg

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