The use of isoflurane and desflurane as inhalational agents for glioblastoma surgery. A survival analysis

Cata, Juan P.; Hagan, Katherine; Bhavsar, Shreyas; Arunkumar, Radha; Grasu, Roxana; Dang, Anh; Carlson, Richard; Arnold, Benjamin; Potylchansky, Y.; Lipski, Ian; McHugh, Thomas M.; Jimenez, F. Javier; Nguyen, Anh T.; Feng, Lei; Rahlfs, Thomas F.

doi:10.1016/j.jocn.2016.10.006

Cited by 31 publications

(39 citation statements)

References 18 publications

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“…Our entire study population showed progression-free and overall survival rates in close accordance with studies involving larger numbers, indicating a very representative cohort 15 . Given the fact that the impact of these prognostic factors remained unchanged in both subgroups, this underlines the good balance of the cohort.…”

Section: Scientific Reports |supporting

confidence: 86%

“…Due to logistic institutional factors and the different availability of volatile anesthetics, isoflurane, sevoflurane and desflurane had to be summarized as "inhalational group" despite some substance specific difference on tumor biology and immune function may exist 8 . However, a recent retrospective study showed no difference in overall or progression free survival if desflurane or isoflurane have been used for glioblastoma surgery 15 . As a limitation, due to the retrospective nature of the study, variables have not Figure 2.…”

Section: Discussionmentioning

confidence: 99%

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The choice of anaesthesia for glioblastoma surgery does not impact the time to recurrence

Grau

Löhr

Taurisano

et al. 2020

Sci Rep

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Anaesthetics used during cancer surgery may influence tumour cells and immunological response. The aim of this study was to evaluate a potential influence of the anaesthetic method (inhaled anaesthetics versus total-intravenous anaesthesia using propofol) on recurrence-free and overall survival in glioblastoma patients. We retrospectively identified patients undergoing resection of contrast enhancing glioblastoma under general anaesthesia followed by standard adjuvant treatment between January 2010 and February 2017 at two University Hospitals. Matched pairs of patients receiving either balanced with volatile anaesthetics or total intravenous anaesthesia were generated according to the known prognostic factors (extent of resection, methyl-guanine-methyl-transferase (MGMT) promoter methylation, age, Karnofsky performance score). Groups were compared using chi-square and Whitney-Man-U test. Time to recurrence was calculated using Kaplan Meier estimates. Log Rank test was used to assess the influence of the anaesthetic method. One hundred and fifty-eight (79:79) patients were included. Groups showed no significant difference in recurrence-free (volatiles: 8.0 (95% CI 6.5-9.8) vs. propofol: 8.4 (95% CI 7.9-10.1) months; p = 0.54) or overall survival (propofol: 17.4 (95% CI 14.0-20.7) vs. volatiles: 16.9 (95% CI 13.9-20.1) months; p = 0.85). In contrast to potential beneficial effects in some other solid tumours, the choice of anaesthetic method had no impact on survival in patients with glioblastoma in a well-defined cohort.

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Section: Scientific Reports |supporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

The choice of anaesthesia for glioblastoma surgery does not impact the time to recurrence

Grau

Löhr

Taurisano

et al. 2020

Sci Rep

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“…39 A survival investigation indicated that the use of isoflurane or desflurane alone during glioblastoma surgery did not affect overall survival (OS) or progression-free survival (PFS) at 1 or 5 years. 5 Postoperatively, the plasma levels of IL-6 and IL-10 in 35 patients with colorectal cancer after surgery treated with isoflurane were significantly higher than baseline values before surgery. 40 Contrary to the above phenomena, at post-operatively, the percentage of CD4-positive and CD28-positive T-helper cells, and the ratio of IL-4 in the blood samples of 30 lung cancer patients treated with isoflurane did not change compared with before surgery.…”

Section: Isoflurane and Cancer The Impact Of Isoflurane On Clinical Omentioning

confidence: 82%

“…52 But the Kaplan-Meier curves demonstrated that PFS and OS rates at 1 and 5 years were similar for patients given desflurane in comparison with isoflurane during the glioblastoma surgery. 5 When it comes to immune response, desflurane exerted a favorable effect on immune response in breast cancer patients because of preservation of IL-2/IL-4 and CD4(+)/CD8(+) T cell ratio in the perioperative period. 53…”

Section: Vegf and Angiopoietin-1mentioning

confidence: 99%

“…4 Nevertheless, some studies found that inhaled anesthetics did not affect the survival of cancer patients. 5,6 Hence, the key issue of whether inhaled anesthetics influence the cancer progression remains unclear. However, the impacts of choosing different inhaled anesthetics on tumor immune response, cancer cell biology, and the prognosis of cancer patients should be carefully considered.…”

Section: Introductionmentioning

confidence: 99%

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<p>The Role of Inhaled Anesthetics in Tumorigenesis and Tumor Immunity</p>

Xu¹,

Jiang²,

Xie³

et al. 2020

CMAR

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Inhaled anesthetics are widely used for induction and maintenance of anesthesia during surgery, including isoflurane, sevoflurane, desflurane, haloflurane, nitrous oxide (N 2 O), enflurane and xenon. Nowadays, it is controversial whether inhaled anesthetics may influence the tumor progression, which urges us to describe the roles of different inhaled anesthetics in human cancers. In the review, the relationships among the diverse inhaled anesthetics and patient outcomes, immune response and cancer cell biology were discussed. Moreover, the mechanisms of various inhaled anesthetics in the promotion or inhibition of carcinogenesis were also reviewed. In summary, we concluded that several inhaled anesthetics have different immune functions, clinical outcomes and cancer cell biology, which could contribute to opening new avenues for selecting suitable inhaled anesthetics in cancer surgery.

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