Peridural Anesthesia and Cancer-Related Survival after Surgery for Pancreatic Cancer—A Retrospective Cohort Study

Background: In patients with prostatic and breast cancer the application of peridural anesthesia (PDA) showed a beneficial effect on prognosis. This was explained by reduced requirements for general anesthetics and perioperative opioids as well as a lower perioperative stress level. The impact of PD...

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Bibliographic Details
Published in:Clinics and practice 2021-08, Vol.11 (3), p.532-542
Main Authors: Alexander, Andrea, Lehwald-Tywuschik, Nadja, Rehders, Alexander, Rabenalt, Stefanie, Verde, Pablo E., Eisenberger, Claus F., Picker, Nina, Knoefel, Wolfram Trudo, Kienbaum, Peter
Format: Article
Language:English
Subjects:
Abdomen
Cancer surgery
Catheters
Cohort analysis
General anesthesia
Medical prognosis
Medical records
Narcotics
oncological outcome
pancreatic adenocarcinoma
Pancreatic cancer
Patients
recurrence
Regional anesthesia
staging
Statistical analysis
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Summary:Background: In patients with prostatic and breast cancer the application of peridural anesthesia (PDA) showed a beneficial effect on prognosis. This was explained by reduced requirements for general anesthetics and perioperative opioids as well as a lower perioperative stress level. The impact of PDA in patients with more aggressive types of cancer has not been completely elucidated. Here, we analyzed the prognostic influence of PDA on overall survival after surgery as primary in patients that underwent radical resection of pancreatic adenocarcinoma. Methods: Records of 98 consecutive patients were reviewed. In 70 of these cases PDA was applied. Patient characteristics such as demographics, TNM stage, and operative data were retrospectively collected from medical records and analyzed. Survival data were analyzed by Cox’s proportional hazard regression model. Results: Overall, no significant prognostic influence of PDA on recurrence or overall survival (p = 0.762, Hazard Ratio [HR] 0.884, 95% confidence interval [CI] 0.398–1.961) was found. However, there was a trend towards a longer overall survival (p = 0.069, HR 0.394, 95% CI 0.144–1.078) associated with PDA in a subgroup of patients with better differentiation of pancreatic adenocarcinoma. Conclusion: The observation of longer survival associated with PDA in our subgroup of patients with better-differentiated pancreatic carcinomas is in line with previous reports on various other less aggressive tumor entities. Our results indicate that PDA might improve the oncological outcome of patients with pancreatic adenocarcinoma.
ISSN:2039-7283
2039-7275
2039-7283
DOI:10.3390/clinpract11030070