Wang Yan, Xue Ruifeng, Xing Wei, Li Qiang, Gei Liba, Yan Fang, Mai Dongmei, Zeng Weian, Yan Yan, Chen Dongtai
Department of Anesthesiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Anesthesiology, Inner Mongolia Autonomous Region Cancer Hospital, Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China.
Front Oncol. 2022 Aug 25;12:947172. doi: 10.3389/fonc.2022.947172. eCollection 2022.
Dopamine is widely used in patients during surgery. We evaluated the association between intraoperative low-dose dopamine administration and recurrence-free survival (RFS) and overall survival (OS) in patients with hepatocellular carcinoma (HCC).
Consecutive patients with nonmetastatic HCC who underwent radical hepatectomy were enrolled between 2008 and 2010. Univariate and multivariate logistic regression analyses were used to evaluate the prognostic factors for RFS and OS. Survival outcomes were evaluated using Kaplan-Meier analyses with the log-rank test. A one-to-one propensity score matching (PSM) analysis was performed to reduce confounding bias.
A total of 805 HCC patients, including 699 patients who did not receive dopamine consumption and 106 patients who received low-dose dopamine during the operation, were retrospectively analyzed. The patients who were assigned low-dose dopamine had worse RFS ( = 0.009) and OS ( = 0.041) than those who did not receive dopamine. Multivariate regression analysis showed that the intraoperative administration of low-dose dopamine was an independent unfavorable predictor for RFS ( = 0.004) but not for OS ( = 0.059). After PSM, the low-dose dopamine-treated group still had significantly poorer RFS ( = 0.003) and OS ( = 0.002). When stratified by time of recurrence, patients with low-dose dopamine use had a significantly greater chance of recurrence within 2 years ( = 0.007) but not after 2 years ( = 0.186).
Intraoperative low-dose dopamine use has a negative impact on RFS and OS in HCC patients who have undergone radical hepatectomy. Further prospective studies are required to assess the effects of low-dose dopamine on surgical outcomes in HCC patients.
多巴胺在手术患者中广泛使用。我们评估了肝细胞癌（HCC）患者术中给予低剂量多巴胺与无复发生存期（RFS）和总生存期（OS）之间的关联。
纳入2008年至2010年间接受根治性肝切除术的连续非转移性HCC患者。采用单因素和多因素逻辑回归分析评估RFS和OS的预后因素。使用Kaplan-Meier分析和对数秩检验评估生存结果。进行一对一倾向评分匹配（PSM）分析以减少混杂偏倚。
共回顾性分析了805例HCC患者，其中699例未使用多巴胺，106例术中接受低剂量多巴胺。接受低剂量多巴胺的患者的RFS（P = 0.009）和OS（P = 0.041）均比未接受多巴胺的患者差。多因素回归分析显示，术中给予低剂量多巴胺是RFS的独立不良预测因素（P = 0.004），但不是OS的独立不良预测因素（P = 0.059）。PSM后，低剂量多巴胺治疗组的RFS（P = 0.003）和OS（P = 0.002）仍然显著较差。按复发时间分层时，使用低剂量多巴胺的患者在2年内复发的可能性显著更高（P = 0.007），但在2年后则不然（P = 0.186）。
术中使用低剂量多巴胺对接受根治性肝切除术的HCC患者的RFS和OS有负面影响。需要进一步的前瞻性研究来评估低剂量多巴胺对HCC患者手术结局的影响。
