Does epidural analgesia improve the cancer outcome in hepatocellular carcinoma after resection surgery? A retrospective analysis

A comparison of inflammation markers for predicting oncological outcomes after surgical resection of non-small-cell lung cancer: a validated analysis of 2,066 patients

“…Clinical variables included cigarette smoking, Eastern Cooperative Oncology Group (ECOG) grade, co-existing diseases, preoperative FVC and FEV1 39 , preoperative levels of CEA. Surgical and anaesthetic variables were extent of resection (sublobar resection, lobectomy, bilobectomy, or pneumonectomy), uses of thoracoscopic surgery, radical lymph node dissection, intraoperative blood loss, perioperative blood transfusion (during or within 7 days after surgery) 40,41 , and epidural analgesia 38,42 . Pathologic variables were cancer stage, subtype, tumour differentiation, microscopic necrosis, lymphocytic infiltration, lymphovascular invasion, and perineural infiltration 43,44 .…”

Association Between Epidural Analgesia and Cancer Recurrence or Survival After Surgery for Renal Cell Carcinoma: a Propensity Weighted Analysis

“…Perioperative EA is administered near the nerve roots to block sensory and sympathetic nerves. It attenuates the neuroendocrine stress responses of the hypothalamicpituitary-adrenal axis and sympathetic nervous system activation 4 and minimizes volatile agent and opioid consumption 7,9 . Therefore, it has been suggested that EA preserves immune function and prevents cancer recurrence after curative surgery but previous studies have reported inconsistent results 7,10 .…”

“…Also, accumulating evidence shows that anesthetic intervention and analgesia could affect the pathophysiological processes associated with long-term cancer outcomes 6 . Since immunity plays a major role in cancer progression 7 , perioperative pain management could be very important for preventing surgery-induced immunosuppression. Perioperative epidural anesthesia and analgesia (EA) effectively attenuate neuroendocrine stress responses related to surgery, they also reduce intraoperative volatile anesthetics and opioid consumption by blocking noxious afferent inputs transmitted to the central nervous system, and further preserve host immunity 4,7,8 .…”

“…Since immunity plays a major role in cancer progression 7 , perioperative pain management could be very important for preventing surgery-induced immunosuppression. Perioperative epidural anesthesia and analgesia (EA) effectively attenuate neuroendocrine stress responses related to surgery, they also reduce intraoperative volatile anesthetics and opioid consumption by blocking noxious afferent inputs transmitted to the central nervous system, and further preserve host immunity 4,7,8 . Previous studies have demonstrated that patients with perioperative EA had better prostate, ovarian, colon, gastro-esophageal and breast cancer outcomes compared with those without 7,9 .…”

“…Perioperative epidural anesthesia and analgesia (EA) effectively attenuate neuroendocrine stress responses related to surgery, they also reduce intraoperative volatile anesthetics and opioid consumption by blocking noxious afferent inputs transmitted to the central nervous system, and further preserve host immunity 4,7,8 . Previous studies have demonstrated that patients with perioperative EA had better prostate, ovarian, colon, gastro-esophageal and breast cancer outcomes compared with those without 7,9 . Nevertheless, few studies have investigated the association between EA and postoperative outcomes after surgery for renal cell carcinoma (RCC).…”