Association of anesthesia technique for radical prostatectomy with biochemical recurrence: A retrospective cohort study Journal Article
| Authors: | Ehdaie, B.; Sjoberg, D. D.; Dalecki, P. H.; Scardino, P. T.; Eastham, J. A.; Amar, D. |
| Article Title: | Association of anesthesia technique for radical prostatectomy with biochemical recurrence: A retrospective cohort study |
| Abstract: | Introduction: Anesthesia technique has been associated with cancer outcomes after radical prostatectomy (RP). These studies are limited by variability in surgeon experience, bias in patient selection, and in some cases, sample size. We evaluated the impact of anesthesia technique for RP on biochemical recurrence (BCR) using a large cohort of patients operated on by a single experienced surgeon. Methods: We retrospectively reviewed data from a prospective institutional oncologic database on 929 patients treated with RP by a single surgeon from 1999-2008. Spinal anesthesia was used for patients from 2002-2006. We compared outcomes of these patients (n = 264) with outcomes of patients who underwent general anesthesia (n = 665) at Memorial Sloan-Kettering Cancer Center from 1999-2001 and 2006-2008. Cox proportional hazards regression was used to assess differences in BCR rates between the anesthesia groups adjusting for differences in postoperative factors related to anesthetic technique and tumour pathologic characteristics associated with BCR after RP. Results: Median follow-up among patients free from BCR was 4.6 yr. On multivariable analysis, spinal anesthesia did not independently predict the rate of BCR (hazard ratio = 1.10; 95% confidence interval 0.7 to 1.74; P = 0.7). Independent predictors of BCR were preoperative prostate-specific antigen (PSA), pathologic Gleason grade, extracapsular extension, and seminal vesicle invasion. Conclusions: We did not find an association between anesthesia technique and disease recurrence in men with prostate cancer treated with RP. Anesthesia technique is unlikely to alter disease recurrence following RP independent of surgical and pathological factors. |
| Keywords: | treatment outcome; major clinical study; recurrence risk; follow up; preoperative evaluation; prostate specific antigen; cohort analysis; retrospective study; prostate cancer; gleason score; cancer center; prostatectomy; surgeon; general anesthesia; recurrent disease; seminal vesicle; anesthesia induction; spinal anesthesia; biochemical recurrence free survival; human; article |
| Journal Title: | Canadian Journal of Anesthesia/Journal Canadien d'Anesthesie |
| Volume: | 61 |
| Issue: | 12 |
| ISSN: | 0832-610X |
| Publisher: | Springer |
| Date Published: | 2014-12-01 |
| Start Page: | 1068 |
| End Page: | 1074 |
| Language: | English |
| DOI: | 10.1007/s12630-014-0221-y |
| PROVIDER: | scopus |
| PUBMED: | 25141832 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2015 -- Source: Scopus |
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