Department of Anesthesiology, Harbin Medical University Cancer Hospital, No. 150 Haping Rd., Nangang District, Harbin, 150081, China.
Department of Anesthesiology, Guizhou Provincial People's Hospital, No. 83 Zhongshan East Road, Nanming District, Guiyang, 550002, Guizhou, China.
BMC Anesthesiol. 2023 Mar 2;23(1):66. doi: 10.1186/s12871-023-02023-1.
Different anesthetics may have opposite effects on the immune system, thus affecting the prognosis of tumor patients. Cell-mediated immunity forms the primary defense against the invasion of tumor cells, so manipulation of the immune system to produce an enhanced anti-tumor response could be utilized as an adjuvant oncological therapy. Sevoflurane has proinflammatory effects, while propofol, has anti-inflammatory and antioxidant effects. Therefore, we compared the overall survival (OS) and disease-free survival (DFS) of patients with esophageal cancer under total intravenous anesthesia and inhalation anesthesia.
This study collected the electronic medical records of patients undergoing esophagectomy from January 1, 2014 to December 31, 2016. According to the intraoperative anesthetics, the patients were divided into total intravenous anesthesia (TIVA) group or inhalational anesthesia (INHA) group. Stabilized inverse probability of treatment weighting (SIPTW) was used to minimize differences. Kaplan-Meier survival curve was established to evaluate the correlation between different anesthesia methods in overall survival and disease-free survival of patients undergoing esophageal cancer surgery.
A total of 420 patients with elective esophageal cancer were collected, including 363 patients eligible for study (TIVA, n = 147, INHA, n = 216). After SIPTW there were no significant differences between two groups in overall survival and disease-free survival. However, the adjuvant therapy was statistically significant in improving OS, and the degree of differentiation was correlated with OS and DFS.
In conclusion, there were no significant difference in overall survival and disease-free survival between total intravenous anesthesia and inhalational anesthesia in patients undergoing esophageal cancer surgery.
不同的麻醉剂可能对免疫系统产生相反的影响，从而影响肿瘤患者的预后。细胞介导的免疫是抵抗肿瘤细胞侵袭的主要防御机制，因此，操纵免疫系统产生增强的抗肿瘤反应可以作为辅助肿瘤治疗。七氟醚具有促炎作用，而丙泊酚具有抗炎和抗氧化作用。因此，我们比较了全身静脉麻醉和吸入麻醉下食管癌患者的总生存率（OS）和无病生存率（DFS）。
本研究收集了 2014 年 1 月 1 日至 2016 年 12 月 31 日接受食管癌切除术的患者的电子病历。根据术中麻醉方法，患者分为全凭静脉麻醉（TIVA）组或吸入麻醉（INHA）组。采用稳定逆概率治疗加权（SIPTW）最小化差异。建立 Kaplan-Meier 生存曲线，评估不同麻醉方法与食管癌手术患者总生存率和无病生存率的相关性。
共收集 420 例择期食管癌患者，其中 363 例符合研究条件（TIVA，n=147，INHA，n=216）。SIPTW 后，两组总生存率和无病生存率无显著差异。然而，辅助治疗在提高 OS 方面具有统计学意义，且分化程度与 OS 和 DFS 相关。
总之，全身静脉麻醉与吸入麻醉在食管癌手术患者中的总生存率和无病生存率无显著差异。
