The Relationship Between Neuraxial Anesthesia and Advanced Ovarian Cancer-Related Outcomes in the Chilean Population

Lacassie, Héctor J.; Cartagena, Jaime; Brañes, Jorge; Assel, Melissa; Echevarría, Ghislaine C.

doi:10.1213/ane.0b013e3182a07046

Cited by 54 publications

(24 citation statements)

References 30 publications

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“…De Oliveira et al [73] also published a retrospective study the same year that included 182 patients stating that epidural anesthesia was associated with increased time to recurrence in a follow-up period of 3-9 years. A recent retrospective study of 80 patients with a follow-up period of 5 years published in 2013 by Lacassie et al [74], however, described no benefit from epidural anesthesia. The different results between studies are very interesting because in the Oliveira study, the authors insisted that an epidural should be used for intraoperative and postoperative purposes, highlighting the interest of both phases: stress-free surgery and perfect postoperative analgesia.…”

Section: Retrospective Reviews: Human Studiesmentioning

confidence: 98%

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Le-Wendling

Nin

Capdevila³

2016

Pain Med

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Objective. More than one million people each year in the United States are diagnosed with cancer. Surgery is considered curative, but the perioperative phase represents a vulnerable period for residual disease to spread. Regional anesthesia has been proposed to reduce the incidence of recurrence by attenuating the sympathetic nervous system's response during surgery, reducing opioid requirements thus diminishing their immunosuppressant effects, and providing antitumor and antiinflammatory effects directly through systemic local anesthetic action. In this article, we present a description of the perioperative period, a summary of the proposed hypotheses and available literature on the effects of regional anesthesia on cancer recurrence, and put regional anesthesia in context in regard to its potential role in reducing cancer recurrence during the perioperative period.Methods. A literature review was conducted through PubMed by examining the following topics: effects of surgery on tumor progression, roles of multiple perioperative variables (analgesics, hypothermia, blood transfusion, beta-blockade) in cancer recurrence, and available in vitro, animal, and human studies regarding the effects of regional anesthesia on cancer recurrence.Results. in vitro, animal and human retrospective studies suppport the hypothesis that in certain types of cancer, regional anesthesia may be associated with lower recurrence rates. A few well-planned human randomized clinical trials are currently under way that may provide more solid evidence to substantiate or refute the benefits of regional anesthesia in reducing cancer recurrence.Conclusions. The benefits of regional anesthesia in reducing cancer recurrence have a sound theoretical basis and, in certain cancers, are supported by the existing body of literature. This article outlines the current state of our knowledge on the relationship between cancer progression and regional analgesia.

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Section: Retrospective Reviews: Human Studiesmentioning

confidence: 98%

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Le-Wendling

Nin

Capdevila³

2016

Pain Med

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“…Another retrospective study looking at the effects of regional anesthesia in surgery for colorectal carcinoma found that it did not reduce overall recurrence in patients younger than 64 years of age, but did find a small difference in those patients above this age 187. A long-term follow-up analysis of the Multicenter Australian Study of Epidural Anesthesia and Analgesia in Major Surgery (MASTER) trial, the first prospective clinical study in which patients undergoing laparotomy were randomized to receive GA with either epidural or opioid analgesia, found no difference in cancer-free survival rates between study groups.…”

Section: Perioperative Pain Interventions and Cancermentioning

confidence: 99%

Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

Missair

Cata

Votta-Velis

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Cancer causes considerable suffering and 80% of advanced cancer patients experience moderate to severe pain. Surgical tumor excision remains a cornerstone of primary cancer treatment, but is also recognized as one of the greatest risk factors for metastatic spread. The perioperative period, characterized by the surgical stress response, pharmacologic-induced angiogenesis, and immunomodulation results in a physiologic environment that supports tumor spread and distant reimplantation.In the perioperative period, anesthesiologists may have a brief and uniquewindow of opportunity to modulate the unwanted consequences of the stressresponse on the immune system and minimize residual disease. This reviewdiscusses the current research on analgesic therapies and their impact ondisease progression, followed by an evidence-based evaluation of perioperativepain interventions and medications.

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“…Lacassie et al 86 conducted a retrospective analysis of patients undergoing laparotomy for ovarian cancer with or without epidural analgesia. After propensity score matching, the median time to recurrence was 1.6 and 1.4 years for the epidural and the control groups, respectively (P = 0.3).…”

Section: Positive Studiesmentioning

confidence: 99%

Do Amide Local Anesthetics Play a Therapeutic Role in the Perioperative Management of Cancer Patients?

Piegeler¹,

Hollmann

Borgeat

et al. 2016

International Anesthesiology Clinics

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The Relationship Between Neuraxial Anesthesia and Advanced Ovarian Cancer-Related Outcomes in the Chilean Population

Abstract: After PS matching and weighting, we found no benefit in overall survival or time to recurrence in patients with advanced stages (International Federation of Gynecologists and Obstetricians IIIC and IV) of ovarian cancer after the use of EA during and after tumor debulking surgery.

Cited by 54 publications

References 30 publications

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Impact of perioperative pain management on cancer recurrence: an ASRA/ESRA special article

Do Amide Local Anesthetics Play a Therapeutic Role in the Perioperative Management of Cancer Patients?

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