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用于胶质母细胞瘤手术的麻醉选择不会影响复发时间。

The choice of anaesthesia for glioblastoma surgery does not impact the time to recurrence.

机构信息

University of Cologne, Medical Faculty and University Hospital of Cologne, Center for Neurosurgery, Dept of General Neurosurgery, Kerpener Strasse 62, D-50937, Cologne, Germany.

University Hospital of Wuerzburg, Department of Neurosurgery, Josef Schneider Strasse 11, D-97080, Wuerzburg, Germany.

出版信息

Sci Rep. 2020 Mar 27;10(1):5556. doi: 10.1038/s41598-020-62087-8.

Abstract

Anaesthetics used during cancer surgery may influence tumour cells and immunological response. The aim of this study was to evaluate a potential influence of the anaesthetic method (inhaled anaesthetics versus total-intravenous anaesthesia using propofol) on recurrence-free and overall survival in glioblastoma patients. We retrospectively identified patients undergoing resection of contrast enhancing glioblastoma under general anaesthesia followed by standard adjuvant treatment between January 2010 and February 2017 at two University Hospitals. Matched pairs of patients receiving either balanced with volatile anaesthetics or total intravenous anaesthesia were generated according to the known prognostic factors (extent of resection, methyl-guanine-methyl-transferase (MGMT) promoter methylation, age, Karnofsky performance score). Groups were compared using chi-square and Whitney-Man-U test. Time to recurrence was calculated using Kaplan Meier estimates. Log Rank test was used to assess the influence of the anaesthetic method. One hundred and fifty-eight (79:79) patients were included. Groups showed no significant difference in recurrence-free (volatiles: 8.0 (95% CI 6.5-9.8) vs. propofol: 8.4 (95% CI 7.9-10.1) months; p = 0.54) or overall survival (propofol: 17.4 (95% CI 14.0-20.7) vs. volatiles: 16.9 (95% CI 13.9-20.1) months; p = 0.85). In contrast to potential beneficial effects in some other solid tumours, the choice of anaesthetic method had no impact on survival in patients with glioblastoma in a well-defined cohort.

摘要

在癌症手术中使用的麻醉剂可能会影响肿瘤细胞和免疫反应。本研究旨在评估麻醉方法(吸入麻醉与使用异丙酚的全静脉麻醉)对胶质母细胞瘤患者无复发生存和总生存的潜在影响。我们回顾性地确定了在 2010 年 1 月至 2017 年 2 月期间,在两家大学医院接受全身麻醉下的对比增强胶质母细胞瘤切除术并接受标准辅助治疗的患者。根据已知的预后因素(切除范围、甲基鸟嘌呤甲基转移酶(MGMT)启动子甲基化、年龄、卡诺夫斯基表现评分),生成接受平衡挥发性麻醉剂或全静脉麻醉的患者匹配对。使用卡方检验和惠特尼曼-乌检验比较两组。使用 Kaplan-Meier 估计计算复发时间。对数秩检验用于评估麻醉方法的影响。共纳入 158 例(79:79)患者。两组在无复发生存(挥发性麻醉剂:8.0(95%CI6.5-9.8)与异丙酚:8.4(95%CI7.9-10.1)个月;p=0.54)或总生存(异丙酚:17.4(95%CI14.0-20.7)与挥发性麻醉剂:16.9(95%CI13.9-20.1)个月;p=0.85)方面无显著差异。与一些其他实体瘤中潜在的有益作用相反,在明确界定的队列中,麻醉方法的选择对胶质母细胞瘤患者的生存没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ded6/7101324/9a57ce5577ec/41598_2020_62087_Fig1_HTML.jpg

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