Regional anesthesia did not improve postoperative long-term survival of tumor patients: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective Experimental research and clinical trials have reported a positive effect of regional anesthesia (RA) on prognosis of cancers. We systematically reviewed the efficacy of RA on recurrence-free survival (RFS) and overall survival (OS) after oncology surgeries. Methods PubMed, Cochrane library, and Embase were searched from inception to June 20, 2022 for RCTs in which any form of RA was initiated perioperatively. Time-to-event data (hazard ratio (HR)) were extracted independently and in duplicate. The primary outcome was the association of RA with RFS and OS, while the secondary outcomes included time to tumor progression, 5-year RFS, and 5-year OS. Results Fifteen RCTs with 5981 participants were included. Compared to GA, RA has no positive effect on RFS (HR, − 0.02; 95% CI, − 0.11 to 0.07), OS (HR, − 0.03; 95% CI, − 0.28 to 0.23), time to tumor progression (0.11; 95% CI, − 0.33 to 0.55), 5-year RFS (risk ratio (RR), 1.24; 95% CI, 0.88 to 1.76)), and 5-year OS (RR, 1.11; 95% CI, 0.85 to 1.44). Subgroup analysis based on study design, patient characteristics and tumor types also showed no effect of RA on RFS or OS. Conclusions Our results demonstrated that there is no significant evidence supporting the role of RA in improving long-term survival after oncology surgeries.

Anesthesia-related intervention for long-term survival and cancer recurrence following breast cancer surgery: A systematic review of prospective studies

“…The serum of the patients under regional anesthesia was associated with higher human donor natural killer cell cytotoxicity levels [ 22 ]. However, previous systematic reviews and meta-analyses failed to establish the clinical significance of regional anesthesia in oncological outcomes [ 10 , 23 ]. Herein, 3 of 9 prospective studies examined the effect of the paravertebral block on long-term outcomes (2 studies were excluded from the outcome analysis owing to the limited sample sizes).…”

The effects of local anesthetics on cancer cells

“…However, the recent meta-analysis of 15 randomized clinical trials with 5,981 patients showed that when compared to general anesthesia, the regional anesthesia increased neither overall survival, nor recurrence-free days (35). It can be explai ned by the heterogeneity of patients involved (possible differences in SNP profi les of patients (36)), variations in anesthetic protocols, duration of administration and type of local anesthetic used, as well as by small cohorts of patients, and a small number of RCTs.…”

A műtéti érzéstelenítés hatása a daganatkiújulásra.

“…A témáról a legújabb és egyben a legkomplexebb metaanalízist Li és mtsai végezték [22]. A 2023-ben megjelent tanulmányukba 15, randomizált klinikai vizsgálatot vontak be.…”