2020
DOI: 10.1016/j.jclinane.2020.110023
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Effect of regional anaesthesia only versus general anaesthesia on cancer recurrence rate: A systematic review and meta-analysis with trial sequential analysis

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Cited by 11 publications
(7 citation statements)
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“…Still, no meta-analysis is available to investigate the impact of RA in bladder cancer solely. A previous meta-analysis had investigated the impact of RA on cancer recurrence where 30% of the included studies were in bladder cancer (41). When several cancers discussed collectively, metaanalysis results neither supported nor strongly advised against the use of RA intraoperatively (35,41,44,46).…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Still, no meta-analysis is available to investigate the impact of RA in bladder cancer solely. A previous meta-analysis had investigated the impact of RA on cancer recurrence where 30% of the included studies were in bladder cancer (41). When several cancers discussed collectively, metaanalysis results neither supported nor strongly advised against the use of RA intraoperatively (35,41,44,46).…”
Section: Discussionmentioning
confidence: 99%
“…A previous meta-analysis had investigated the impact of RA on cancer recurrence where 30% of the included studies were in bladder cancer (41). When several cancers discussed collectively, metaanalysis results neither supported nor strongly advised against the use of RA intraoperatively (35,41,44,46). To the best of our knowledge, this is the first meta-analysis for the influence of RA on postoperative oncological outcomes exclusively in bladder cancer.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, a Cochrane analysis from 2014 has rated the evidence to support a benefit of RA regarding tumor recurrence as being inadequate due to the lack of prospective, sufficiently powered clinical trials [ 34 ]. Several more recent meta-analyses also failed to provide sufficient evidence to prove the hypothesis of a possible anti-metastatic effect of the perioperative use of RA, although the quality of evidence might still be considered to be low [ 35 , 36 , 37 ]. However, several authors have provided experimental in vitro and in vivo data to support the hypothesis that LA might bear the potential to inhibit crucial signaling events in malignant cells, ultimately inhibiting the cells’ ability to metastasize [ 13 , 15 , 38 , 39 , 40 ].…”
Section: Discussionmentioning
confidence: 99%
“…Further promising mechanistic results were reported in a prospective RCT examining intraperitoneal ropivacaine in 40 women undergoing surgical debulking of ovarian cancer [49 && ]. Intraperitoneal infiltration with ropivacaine combined with infusion for 72 h postoperatively reduced the RIOT (Return to Intended Oncological Therapy) interval from a median of 29 [interquartile range (IQR) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] days in the control group to a median of 21 (IQR 21-29) days (P ¼ 0.021), indicating improvement in readiness for chemotherapy [50]. Larger studies are warranted to confirm these initial findings.…”
Section: Andandmentioning
confidence: 99%