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Propofol-based total intravenous anesthesia is associated with better survival than desflurane anesthesia in limb-salvage surgery for osteosarcoma: A retrospective analysis.
Sun, Ting-Yi; Hsu, Chun-Liang; Lee, Meei-Shyuan; Yeh, Tsu-Te; Lai, Hou-Chuan; Wu, Ke-Li; Wu, Zhi-Fu; Tseng, Wei-Cheng.
Afiliação
  • Sun TY; Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Hsu CL; Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Lee MS; Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Yeh TT; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
  • Lai HC; Department of Orthopedic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Wu KL; Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Wu ZF; Department of General Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Tseng WC; Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Medicine (Baltimore) ; 101(38): e30840, 2022 Sep 23.
Article em En | MEDLINE | ID: mdl-36197229
ABSTRACT
Previous studies have demonstrated that anesthetic techniques can affect the outcomes of cancer surgery. We investigated the association between anesthetic techniques and patient outcomes after elective limb-salvage surgery for osteosarcoma (OS). This was a retrospective cohort study of patients who underwent elective limb-salvage surgery for OS between January 2007 and December 2018. Patients were grouped according to the administration of propofol-based total intravenous anesthesia (TIVA) or desflurane (DES) anesthesia. Kaplan-Meier analysis was performed, and survival curves were constructed from the date of surgery to death. Univariate and multivariate Cox regression models were applied to compare the hazard ratios (HRs) for death after propensity matching. Subgroup analyses were done for postoperative recurrence, metastasis, and tumor-node-metastasis (TNM) staging. A total of 30 patients (17 deaths, 56.7%) who received DES anesthesia and 26 (4 deaths, 15.4%) who received TIVA were eligible for analysis. After propensity matching, 22 patients were included in each group. In the matched analysis, patients who received TIVA had better survival with a HR of 0.30 (95% confidence interval [CI], 0.11-0.81; P = .018). Subgroup analyses also showed significantly better survival in the presence of postoperative metastasis (HR, 0.24; 95% CI, 0.06-0.87; P = .030) and with TNM stage II to III (HR, 0.26; 95% CI, 0.09-0.73; P = .011) in the matched TIVA group. In addition, patients administered with TIVA had lower risks of postoperative recurrence and metastasis than those administered with DES anesthesia in the matched analyses. Propofol-based TIVA was associated with better survival in patients who underwent elective limb-salvage surgery for OS than DES anesthesia. Prospective studies are needed to assess the effects of TIVA on oncological outcomes in patients with OS.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osteossarcoma / Propofol / Anestésicos Inalatórios Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Medicine (Baltimore) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Taiwan

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Osteossarcoma / Propofol / Anestésicos Inalatórios Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Medicine (Baltimore) Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Taiwan