Regional anesthesia/analgesia and the risk of cancer recurrence and mortality after prostatectomy: a meta-analysis.

To determine whether the use neuraxial anesthesia/analgesia is associated with longer biochemical recurrence-free survival (BRFS) and overall survival (OS) after radical prostatectomy.

Ten studies were included in the meta-analysis.

A random-effects model was used to estimate the hazard ratios (HRs).

The HR for BRFS was 1. 02 (95% CI: 0. 91-1. 15) for all studies and 1. 08 (95% CI: 0. 91-1. 15) for those that included propensity score matching. For OS, the HR across all studies was 0. 91 (95% CI: 0. 7-1. 15) and 0. 81 (95% CI: 0. 68-0. 96; p = 0. 016) for those reporting propensity score matching.

The anesthetic technique used during oncologic prostatectomy surgery is not associated with longer BRFS. By contrast, the use of regional analgesia appears to improve OS.

Pain management. 2015 Aug 07 [Epub]

Brenda M Lee, Vinny Singh Ghotra, Jose A Karam, Mike Hernandez, Greg Pratt, Juan P Cata

Department of General Surgery, John Hopkins Hospital, MD, USA. , Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA. , Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. , Department of Biostatistics, University of Texas MD Anderson Cancer Center, PO Box 301402 Houston, TX 77230-1402, USA. , Research Medical Library, University of Texas MD Anderson Cancer Center, Houston, TX 77230-1402, USA. , Department of General Surgery, John Hopkins Hospital, MD, USA.

PubMed