Regional anesthesia cuts recurrence and metastasis rates in cancer patients after surgery
A comprehensive meta-analysis investigating the influence of anaesthesia techniques on cancer recurrence and metastasis following oncological surgery has revealed intriguing findings. This meta-analysis provides compelling evidence suggesting that regional anaesthesia (RA), whether used alone or adjunctively with general anaesthesia (GA), is associated with a lower risk of cancer recurrence, particularly in patients with prostate cancer.
This study was published in the BMC Anaesthesiology by Shuang Xie and colleagues. The study, encompassing 32 studies with 24,724 cancer patients, focused on the potential effects of regional anaesthesia (RA), either independently or combined with general anaesthesia (GA), on these critical outcomes.
Researchers conducted an extensive search across PubMed, Embase, and the Cochrane Library databases. The primary outcome assessed was cancer recurrence, with secondary outcomes including local recurrence and distant metastasis. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Quality assessments were performed using the Newcastle-Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias Tool for Randomized Trials (Rob 2.0). The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was utilized to assess all outcomes.
The study, including a large cohort of 24,724 cancer patients across 32 studies, revealed a significant association between RA, either alone or combined with GA, and reduced cancer recurrence compared to GA alone (OR = 0.82; 95% CI = 0.72 to 0.94; p < 0.01).
Subgroup analyses highlighted a particularly noteworthy association for prostate cancer patients (OR = 0.71; 95% CI = 0.51 to 0.98; p = 0.04) and in the context of epidural anesthesia combined with GA.
However, the analysis did not reveal significant associations with local recurrence or distant metastasis.
However, the study did not find significant effects on local recurrence or distant metastasis. The findings underscore the need for further prospective studies to clarify this critical issue and shed more light on the impact of anesthesia techniques on long-term cancer outcomes.
Reference:
Xie, S., Li, L., Meng, F., & Wang, H. Regional anesthesia might reduce recurrence and metastasis rates in adult patients with cancers after surgery: a meta-analysis. BMC Anesthesiology,2024;24(1). https://doi.org/10.1186/s12871-023-02400-w
