Background and Aims:The aim is to evaluate the association between the use of intraoperative dexmedetomidine with an increase in recurrence-free survival (RFS) and overall survival (OS) after nonsmall cell lung cancer (NSCLC) surgery.Material and Methods:This was a propensity score-matched (PSM) retrospective study. Single academic center. The study comprised patients with Stage I through IIIa NSCLC. Patients were excluded if they were younger than 18 years. Primary outcomes of the study were RFS and OS. RFS and OS were evaluated using univariate and multivariate Cox proportional hazards models after PSM (n = 251/group) to assess the association between intraoperative dexmedetomidine use and the primary outcomes. The value of P < 0.05 was considered statistically significant.Results:After PSM and adjusting for significant covariates, the multivariate analysis demonstrated no association between the use of dexmedetomidine and RFS (hazard ratio [HR] [95% confidence interval (CI)]: HR = 1.18, 95% CI: 0.91–1.53; P = 0.199). The multivariate analysis also demonstrated an association between the administration of dexmedetomidine and reduced OS (HR = 1.28, 95% CI: 1.03–1.59; P = 0.024).Conclusions:This study demonstrated that the intraoperative use of dexmedetomidine to NSCLC patients was not associated with a significant impact on RFS and but worsening OS. A randomized controlled study should be conducted to confirm the results of this study.

Aims:To determine whether the use neuraxial anesthesia/analgesia is associated with longer biochemical recurrence-free survival (BRFS) and overall survival (OS) after radical prostatectomy. Methods: Ten studies were included in the meta-analysis. A random-effects model was used to estimate the hazard ratios (HRs). Results: The HR for BRFS was 1.02 (95% CI: 0.91-1.15) for all studies and 1.08 (95% CI: 0.91-1.15) for those that included propensity score matching. For OS, the HR across all studies was 0.91 (95% CI: 0.7-1.15) and 0.81 (95% CI: 0.68-0.96; p = 0.016) for those reporting propensity score matching. Conclusion: The anesthetic technique used during oncologic prostatectomy surgery is not associated with longer BRFS. By contrast, the use of regional analgesia appears to improve OS. KEYWORDS• biochemical recurrence-free survivalProstate cancer is the most common malignancy and the second leading cause of cancer death in males [1]. Radical prostatectomy (RP) has been shown to decrease mortality and is the treatment of choice in many patients with localized cancer [2]. However, ∼25% of patients still develop local recurrence or distant metastasis after primary tumor resection [3]. Recurrences are related to tumor stage, Gleason score, lymph node stage, surgical margin status and preoperative serum prostate-specific antigen level [4,5]. Practice points• Regional anesthesia/analgesia has sparing opioid effects.• Local anesthetics have anti-inflammatory and immune protective effects.• Both, sparing opioid and anti-inflammatory effects have been proposed to be the mechanisms by which regional anesthesia might prolong the survival of cancer patients.• Regional anesthesia/analgesia has shown to reduce cancer recurrence in some retrospective studies but not in other similar clinical reports.• The findings of this study do not support the association between regional anesthesia/analgesia and improved recurrence-free survival after radical prostatectomy.• Regional anesthesia/analgesia is associated with a better overall survival after radical prostatectomy.For reprint orders, please contact: reprints@futuremedicine.com

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Background/Aims: Dopamine (DA) uptake inhibition in the renal cortex, elicited by angiotensin II (ANG II), is mediated by AT₁ receptors and signals through the phospholipase C pathway and activation of protein kinase C and CaM-kinase II. By this indirect way, ANG II stimulates renal Na⁺,K⁺-ATPase activity through DA intracellular reduction. In the present work, we continued to study different aspects of renal DA metabolism in DA-ANG II interaction, such as DA synthesis, release, catabolism and turnover. Methods: ANG II effects on DA synthesis, release, catabolism and turnover were measured in samples from the outer renal cortex of Sprague-Dawley rats. Results: ANG II reduced renal aromatic acid decarboxylate activity without affecting basal secretion of DA or its KCl-induced release. Moreover, ANG II enhanced monoamine oxidase activity without altering catechol-o-methyl transferase activity and increased DA turnover. Conclusion: Current results as well as previous findings show that ANG II modifies DA metabolism in rat renal cortex by reducing DA uptake, decreasing DA synthesis enzyme activity and increasing monoamine oxidase activity, and DA turnover. Together, all these effects may reduce DA accumulation into renal cells and decrease its endogenous content and availability. This would prevent D1 receptor recruitment and stimulation, while diminishing DA inhibition of Na⁺,K⁺-ATPase activity and stimulating sodium reabsorption.