Epidural analgesia associated with better survival in colon cancer
| العنوان: | Epidural analgesia associated with better survival in colon cancer |
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| المؤلفون: | R. Abegg, Valery E.P.P. Lemmens, F. J. Vogelaar, J.C. van der Linden, F. R. C. van Dorsten, H. G. J. M. Cornelisse, Koop Bosscha |
| المساهمون: | Public Health |
| المصدر: | International Journal of Colorectal Disease, 30(8), 1103-1107. Springer-Verlag |
| بيانات النشر: | Springer Science and Business Media LLC, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Surgical stress, business.industry, Proportional hazards model, Colorectal cancer, Hazard ratio, Gastroenterology, Cancer, medicine.disease, Survival Analysis, Comorbidity, Surgery, Analgesia, Epidural, SDG 3 - Good Health and Well-being, Risk Factors, Colon surgery, Colonic Neoplasms, Humans, Medicine, Female, business, Survival analysis, Aged |
| الوصف: | Surgery remains the mainstay of treatment for potentially curable colon cancer. Otherwise, the surgical stress response might increase the likelihood of cancer dissemination during and after cancer surgery. There is growing evidence that the type of anaesthesia during cancer surgery plays a role in the metastatic process. Therefore, we assessed if the method of anaesthesia is associated with long-term survival after colon cancer surgery. A retrospective single-centre study was conducted including 588 patients who underwent colorectal cancer surgery, TNM stage I-IV, in the Jeroen Bosch Hospital between 1995 and 2003. The Cox proportional hazard model was used for statistical analysis. Adjustments were made for age, sex, comorbidity, TNM stage, chemotherapy, emergency surgery status and year of incidence. Of the 588 primary colon cancer patients with a median age of 70 years, 399 (68 %) patients underwent colon surgery with epidural anaesthesia, whilst 189 (32 %) patients were operated without epidural anaesthesia. Five-year survival for patients not receiving epidural analgesia was 42 % versus 51 % for patients receiving epidural analgesia (p = 0.03). This effect remained after adjustment for relevant patient, tumour, and treatment characteristics (hazard ratio (HR) 1.30 (95 % confidence interval (CI) 1.05-1.59), p = 0.01). Subgroup analysis in patients of 80 years and older (n = 100) showed also a better overall survival after receiving epidural analgesia (HR 1.74 (95 % CI 1.11-2.72), p = 0.01). Epidural analgesia during colon cancer surgery was associated with a better overall survival. Prospective trials evaluating the effects of locoregional analgesia on colon cancer recurrence are warranted. |
| تدمد: | 1432-1262 0179-1958 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7a7d106b92c6809abc61af5c6e8892f8Test https://doi.org/10.1007/s00384-015-2224-8Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....7a7d106b92c6809abc61af5c6e8892f8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321262 01791958 |
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