Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea,
Med Princ Pract. 2020;29(5):422-428. doi: 10.1159/000506637. Epub 2020 Feb 20.
Previous studies have reported that propofol has antitumor, anti-inflammatory, and antioxidant effects in addition to its anesthetic properties. To confirm this, a retrospective investigation was conducted to determine whether different anesthetic agents, particularly propofol and inhalation anesthetics, have an effect on the recurrence of hepatocellular carcinoma (HCC) in patients who were diagnosed with primary HCC and underwent laparoscopic hepatectomy.
Patients with Barcelona Clinic Liver Cancer stages 0, A, and B HCC, who underwent laparoscopic hepatic resection, were enrolled in this study. Post-operative HCC recurrence, which was determined from postoperative liver CT, was evaluated 24 months postoperatively with respect to the main anesthetic agents. The characteristics of HCC and other patient-related or surgery-related variables were evaluated together.
During the 24-month period after hepatic resection, less HCC patients in the propofol group than in the inhalation group recurred (p = 0.046). The mean time to recurrence was 20.8 months (95% CI, 19.7-22.0) and 19.1 months (95% CI, 17.8-20.4) in the propofol group and the inhalation group, respectively. In addition, multivariable Cox proportional regression analysis revealed that the propofol group showed significantly decreased recurrence versus the inhalation group (hazard ratio, 0.57; 95% CI, 0.47-0.69; p = 0.029). When propofol was used as the main general anesthetic agent for laparoscopic hepatic resection, the postoperative 2-year recurrence rate decreased in early- and intermediate-stage HCC.
先前的研究报告称，除了具有麻醉特性外，丙泊酚还具有抗肿瘤、抗炎和抗氧化作用。为了证实这一点，进行了一项回顾性调查，以确定不同的麻醉剂，特别是丙泊酚和吸入麻醉剂，是否对原发性肝癌（HCC）患者腹腔镜肝切除术后 HCC 的复发有影响。
本研究纳入了巴塞罗那临床肝癌分期为 0、A 和 B 期、接受腹腔镜肝切除术的 HCC 患者。术后 HCC 复发通过术后肝脏 CT 确定，术后 24 个月评估主要麻醉剂的复发情况。评估 HCC 的特征和其他与患者相关或与手术相关的变量。
在肝切除术后的 24 个月期间，丙泊酚组 HCC 患者复发的比例低于吸入组（p = 0.046）。丙泊酚组和吸入组的中位复发时间分别为 20.8 个月（95%CI，19.7-22.0）和 19.1 个月（95%CI，17.8-20.4）。此外，多变量 Cox 比例风险回归分析显示，与吸入组相比，丙泊酚组的复发率显著降低（风险比，0.57；95%CI，0.47-0.69；p = 0.029）。当丙泊酚作为腹腔镜肝切除术的主要全身麻醉剂时，早期和中期 HCC 的术后 2 年复发率降低。
