Regional anesthesia is associated with improved metastasis free survival after surgical resection of bone sarcomas

Author:

Abar Bijan1ORCID,Gao Junheng2,Fletcher Amanda N.1,Sachs Elizbeth1,Wong Andrew H.3,Lazarides Alexander L.1,Okafor Chinedu1,Brigman Brian E.1,Eward William C.1,Jung Sin‐Ho2,Kumar Amanda H.3,Visgauss Julia D.1

Affiliation:

1. Department of Orthopaedic Surgery Duke University Durham North Carolina USA

2. Department of Biostatistics & Bioinformatics Duke University Durham North Carolina USA

3. Department of Anesthesiology Duke University Durham North Carolina USA

Abstract

AbstractThere is increasing evidence that perioperative factors, including type of anesthesia, may be an important consideration regarding oncological disease progression. Previous studies have suggested that regional anesthesia can improve oncological outcomes by reducing the surgical stress response that occurs during tumor resection surgery and that may promote metastatic progression. The purpose of this study is to provide the first robust investigation of the impact of adding regional anesthesia to general anesthesia on oncological outcomes following sarcoma resection. One hundred patients with bone sarcoma were retrospectively analyzed in this study. After adjusting for confounding variables such as age and grade of the tumor, patients with bone sarcoma receiving regional anesthesia in addition to general anesthesia during resection had improved metastasis free survival (multivariate hazard ratio of 0.47 and p = 0.034). Future studies are needed to confer the beneficial effect of regional anesthesia, and to further investigate the potential mechanism. Clinical significance: The results from this study provide evidence that regional anesthesia may be advantageous in the setting of bone sarcoma resection surgery, reducing pain while also improving oncological outcomes and should be considered when clinically appropriate.

Funder

National Center for Advancing Translational Sciences

Publisher

Wiley

Subject

Orthopedics and Sports Medicine

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