Impact of analgesia on cancer recurrence and mortality within 5 years after stage I non-small cell lung cancer resection.

OBJECTIVE: The choice of analgesia after cancer surgery may play a role in the onset of cancer recurrence. Particularly opioids seem to promote cancer cell proliferation and migration. Based on this consideration, we assessed the impact of perioperative analgesia choice on cancer recurrence after curative surgery for stage I non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of all patients undergoing lung resection for stage I NSCLC between January 2005 and December 2012. Patients received analgesia either by peridural (PERI group) or intravenous analgesia with opioids (EV group). Follow-up was concluded in August 2019. Five-year cumulative incidence of recurrence and overall survival were evaluated and adjusted using a propensity score matching method. RESULTS: A total of 382 patients were evaluated, 312 belonging to the PERI group (81.7%) and 70 to the EV group (18.3%). There was no statistically significant difference between the two groups in 5-year cumulative incidence of recurrence (p = 0.679) or overall survival rates (p = 0.767). These results were confirmed after adjustment for propensity score matching for cumulative incidence of recurrence (p = 0.925) or overall survival (p = 0.663). CONCLUSIONS: We found no evidence suggesting an association between perioperative analgesia choice and recurrence-free survival or overall survival in patients undergoing surgical resection of stage I NSCLC.

Application of the Repetitive Behavior Scale-Revised--Italian version--in preschoolers with autism spectrum disorder.

Restricted repetitive and stereotyped patterns of behavior, interests, and activities (RRB) are mandatory features for a diagnosis of Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of mental disorders-fifth edition (DSM-5). Despite the strong diagnostic role of RRB, their expressiveness and their relationship with other clinical/demographic features in ASD is not fully elucidated. The Italian version of the Repetitive Behavior Scale-Revised (RBS-R) was applied to a relatively large sample of preschool-aged children with ASD who underwent a comprehensive clinical assessment. The relationship between RRB and sex, age, non-verbal IQ, autism severity, as well as the diagnostic accuracy of the RBS-R were explored. Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in preschoolers with ASD, without widespread differences between males and females. No significant correlations between RRB and chronological age, or non-verbal IQ were detected. The expressiveness of ritualistic/sameness behaviors positively correlated with autism severity, assessed through the Calibrated Severity Score (CSS) derived from the Autism Diagnostic Observation Schedule (ADOS). Receiver Operator Characteristic (ROC) analysis showed high diagnostic accuracy using the Global Rating Score, which represents the judgment of the parents of as the RRB affect the child's life. However, while the Global Rating Score performed well, the remaining subscales did not. This investigation extends the limited research on early pattern and associated features of RRB in young children with ASD. The use of the RBS-R may increase the knowledge of the RRB complexity and variability and in turn improve the diagnostic and therapeutic procedures within the autistic spectrum.