根治性肾输尿管切除术术后生存与麻醉技术的关系：倾向评分匹配研究。
Association Between Anesthetic Technique and Survival After Radical Nephroureterectomy: A Propensity Score-matching Study.
机构信息
Department of Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
出版信息
In Vivo. 2022 Jan-Feb;36(1):458-464. doi: 10.21873/invivo.12725.
BACKGROUND/AIM: Whether anesthesia can affect oncological outcomes in urothelial carcinoma of the upper urinary tract undergoing radical nephroureterectomy (RNU) is not clear.
PATIENTS AND METHODS
One-hundred an ninety-seven patients who underwent RNU were retrospectively recruited and divided into total intravenous (TIVA, n=90) and volatile inhalation anesthesia (VIA, n=107) groups. A 1:1 propensity score-matching method was employed to minimize selection bias (n=70 each). Cancer-specific (CSS), overall (OS) and metastasis-free (MFS) survival were compared between groups before and after matching.
RESULTS
For all survival endpoints, no significant differences were observed between the two study groups, both before (hazard ratio for TIVA: CSS: 0.70, OS: 0.75, MFS: 0.78) and after (hazard ratios for TIV: CSS: 1.21, OS: 0.82, MFS: 0.84) matching.
CONCLUSION
With no survival difference observed according to anesthetic technique for RNU, the choice should be based on factors such as accessibility, prevention of side-effects, or costs.
背景/目的：接受根治性肾输尿管切除术（RNU）的上尿路上皮癌患者，麻醉是否会影响其肿瘤学结局尚不清楚。
患者和方法
回顾性招募了 197 名接受 RNU 的患者，并将其分为全静脉（TIVA，n=90）和挥发性吸入麻醉（VIA，n=107）组。采用 1:1 倾向评分匹配法（propensity score-matching method）以最小化选择偏倚（每组 n=70）。比较两组匹配前后的癌症特异性（CSS）、总生存期（OS）和无转移生存期（MFS）。
结果
在所有生存终点，两组在匹配前（TIVA 的 CSS：0.70、OS：0.75、MFS：0.78）和匹配后（TIVA 的 CSS：1.21、OS：0.82、MFS：0.84）均无显著差异。
结论
根据 RNU 的麻醉技术，未观察到生存差异，应根据可及性、预防副作用或成本等因素进行选择。
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