Regional anesthesia/analgesia and the risk of cancer recurrence and mortality after prostatectomy: a meta-analysis

Pain Manag. 2015 Sep;5(5):387-95. doi: 10.2217/pmt.15.30. Epub 2015 Aug 7.

Abstract

Aims: To determine whether the use neuraxial anesthesia/analgesia is associated with longer biochemical recurrence-free survival (BRFS) and overall survival (OS) after radical prostatectomy.

Methods: Ten studies were included in the meta-analysis. A random-effects model was used to estimate the hazard ratios (HRs).

Results: The HR for BRFS was 1.02 (95% CI: 0.91-1.15) for all studies and 1.08 (95% CI: 0.91-1.15) for those that included propensity score matching. For OS, the HR across all studies was 0.91 (95% CI: 0.7-1.15) and 0.81 (95% CI: 0.68-0.96; p = 0.016) for those reporting propensity score matching.

Conclusion: The anesthetic technique used during oncologic prostatectomy surgery is not associated with longer BRFS. By contrast, the use of regional analgesia appears to improve OS.

Keywords: biochemical recurrence-free survival; overall survival; prostate cancer; regional anesthesia.

Publication types

  • Meta-Analysis

MeSH terms

  • Analgesia, Epidural*
  • Anesthesia, Epidural*
  • Anesthesia, Spinal*
  • Disease-Free Survival
  • Humans
  • Male
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / surgery
  • Proportional Hazards Models
  • Prostatectomy*
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / surgery*
  • Risk Factors
  • Treatment Outcome