Propofol-based intravenous anesthesia is associated with better survival than desflurane anesthesia in pancreatic cancer surgery

被引:28
作者
Lai, Hou-Chuan [1 ,2 ]
Lee, Meei-Shyuan [3 ]
Liu, Yin-Tzu [4 ]
Lin, Kuen-Tze [2 ,5 ]
Hung, Kuo-Chuan [6 ]
Chen, Jen-Yin [6 ,7 ]
Wu, Zhi-Fu [6 ]
机构
[1] Triserv Gen Hosp, Dept Anesthesiol, Taipei, Taiwan
[2] Natl Def Med Ctr, Taipei, Taiwan
[3] Natl Def Med Ctr, Sch Publ Hlth, Taipei, Taiwan
[4] Wanfang Hosp, Div Anesthesiol, Taipei, Taiwan
[5] Triserv Gen Hosp, Dept Radiat Oncol, Taipei, Taiwan
[6] Chi Mei Med Ctr, Dept Anesthesiol, Tainan, Taiwan
[7] Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management, Tainan, Taiwan
来源
PLOS ONE | 2020年 / 15卷 / 05期
关键词
TUMOR-METASTASIS; ISOFLURANE; MANAGEMENT; VOLATILE; INVASION; OVEREXPRESSION; ADENOCARCINOMA; RECURRENCE; HALOTHANE; PROGNOSIS;
D O I
10.1371/journal.pone.0233598
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Previous researches have shown that anesthetic techniques can influence the patient outcomes of cancer surgery. Here, we studied the relationship between type of anesthetic and patient outcomes following elective, open pancreatic cancer surgery. Methods This was a retrospective cohort study of patients who received elective, open pancreatic cancer surgery between January 2005 and July 2018. Patients were grouped according to the anesthesia they received, namely desflurane or propofol. A Kaplan-Meier analysis was conducted, and survival curves were presented from the date of surgery to death. Univariable and multivariable Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for all-cause mortality, cancer-specific mortality, and disease progression. Results A total of 68 patients (56 deaths, 82.0%) under desflurane anesthesia, and 72 patients (43 deaths, 60.0%) under propofol anesthesia were included. Fifty-eight patients remained in each group after propensity matching. The propofol anesthesia was associated with improved survival (hazard ratio, 0.65; 95% confidence interval, 0.42-0.99; P = 0.047) in the matched analysis. Subgroup analyses showed significantly better cancer-specific survival (hazard ratio, 0.63; 95% confidence interval, 0.40-0.97; P = 0.037) in the propofol group. Additionally, patients under propofol had less postoperative recurrence, but not fewer postoperative metastases formation, than those under desflurane (hazard ratio, 0.55; 95% confidence interval, 0.34-0.90; P = 0.028) in the matched analysis. Conclusions In a limited sample size, we observed that propofol anesthesia was associated with improved survival in open pancreatic cancer surgery compared with desflurane anesthesia. Further investigations are needed to inspect the influences of propofol anesthesia on patient outcomes of pancreatic cancer surgery.
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页数:14
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