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采用丙泊酚全凭静脉麻醉或无丙泊酚的挥发性吸入全身麻醉进行保乳手术的长期肿瘤学结局:一项倾向评分匹配的基于人群的队列研究。

Long-term oncologic outcomes of breast conserving surgery with propofol-based total intravenous anesthesia or volatile inhalational general anesthesia without propofol: a propensity score-matched, population-based cohort study.

作者信息

Zhang Jiaqiang, Chang Chia-Lun, Lu Chang-Yun, Chen Ho-Min, Wu Szu-Yuan

机构信息

Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital Zhengzhou 450003, Henan, China.

Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University Taipei 116, Taiwan.

出版信息

Am J Cancer Res. 2021 Oct 15;11(10):4966-4980. eCollection 2021.

Abstract

To estimate oncologic outcomes (overall survival [OS], locoregional recurrence [LRR], and distant metastasis [DM]) in patients with breast intraductal carcinoma (IDC) receiving breast conserving surgery (BCS) under propofol-based total intravenous anesthesia (TIVA) or volatile inhalational (INHA) general anesthesia (GA) without propofol. Patients with breast IDC receiving BCS were recruited through propensity score matching and categorized by anesthesia techniques into propofol-based TIVA-GA and non-propofol-based INHA-GA groups, respectively. Cox regression analysis was performed to calculate hazard ratios and 95% confidence intervals (CIs). In multivariate Cox regression analysis, the adjusted hazard ratio (aHR; 95% CI) of all-cause mortality for TIVA-GA with propofol compared with INHA-GA without propofol was 0.94 (0.83-1.31). The aHR (95% CI) of LRR for TIVA-GA with propofol group compared with INHA-GA without propofol was 0.77 (0.58-0.87). The aHR (95% CI) of DM for TIVA-GA with propofol compared with INHA-GA without propofol was 0.91 (0.82-1.24). Propofol-based TIVA-GA might be beneficial for reducing LRR in women with breast IDC receiving BCS compared with non-propofol-based INHA-GA.

摘要

评估接受基于丙泊酚的全静脉麻醉(TIVA)或无丙泊酚的挥发性吸入麻醉(INHA)全身麻醉(GA)下行保乳手术(BCS)的乳腺导管内癌(IDC)患者的肿瘤学结局(总生存期[OS]、局部区域复发[LRR]和远处转移[DM])。通过倾向评分匹配招募接受BCS的乳腺IDC患者,并根据麻醉技术分别分为基于丙泊酚的TIVA-GA组和非丙泊酚的INHA-GA组。进行Cox回归分析以计算风险比和95%置信区间(CI)。在多变量Cox回归分析中,与无丙泊酚的INHA-GA相比,基于丙泊酚的TIVA-GA全因死亡率的调整后风险比(aHR;95%CI)为0.94(0.83-1.31)。与无丙泊酚的INHA-GA相比,基于丙泊酚的TIVA-GA组LRR的aHR(95%CI)为0.77(0.58-0.87)。与无丙泊酚的INHA-GA相比,基于丙泊酚的TIVA-GA的DM的aHR(95%CI)为0.91(0.82-1.24)。与非丙泊酚的INHA-GA相比,基于丙泊酚的TIVA-GA可能有利于降低接受BCS的乳腺IDC女性的LRR。

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