Effects of postoperative epidural analgesia on recurrence-free and overall survival in patients with nonsmall cell lung cancer

Study Objective: To determine whether postoperative epidural analgesia is associated with better recurrence-free survival and overall survival after lung cancer surgery. Design: Retrospective study. Setting: Academic hospital. Measurements: Data of patients with stage 1, stage 2, and stage 3 nonsmall cell lung cancer, who underwent tumor resection surgery, were studied. Patient data were grouped into three different postoperative pain management interventions; intravenous patient-controlled analgesia, patient-controlled epidural analgesia, and their combination. Univariate and multicovariate Cox proportional hazards models were applied to assess the effects of covariates of interest on overall survival and recurrence-free survival. Main Results: The type of postoperative analgesia used for patients who underwent surgery for nonsmall cell lung cancer did not affect recurrence-free survival or overall survival. However, certain variables, including age >= 65 years, male gender, body mass index >= 25 kg/m(2), ASA physical status 4, and the need for preoperative blood transfusions, pneumonectomy, and postoperative radiation, were associated with decreased recurrence-free survival and overall survival. Conclusions: The type of postoperative analgesia used after surgery for nonsmall cell lung cancer is not associated with better 2-year or 5-year recurrence-free survival or overall survival rates. (c) 2014 Elsevier Inc. All rights reserved.