Effects of epidural analgesia on cancer recurrence and long-term mortality in patients after non-small-cell lung cancer resection: A propensity score-matched study
BMJ Open Jun 06, 2019
Wu HL, et al. – In this retrospective study, researchers utilized propensity scoring methods to examine the impact of thoracic epidural analgesia on oncological results following resection for lung cancer. The study sample consisted of 2,191 patients with stages I–III non-small-cell lung cancer (NSCLC) who underwent primary tumor resection between January 2005 and December 2015, and had either epidural analgesia, placed preoperatively and used intra- and postoperatively, or intravenous analgesia. In all, 82.1% of participants received epidural analgesia. In the epidural group, the 3-year recurrence-free and overall survival rates were 69.8% and 92.4%; in the non-epidural group, these rates were 67.4% and 89.6%, respectively. In patients receiving surgical resection for stages I–III NSCLC, thoracic epidural analgesia was not related to better recurrence-free or overall survival. Independent risk factors for both recurrence and mortality included male sex, higher pretreatment carcinoembryonic antigen level, advanced cancer stage, poor differentiation, lymphovascular invasion, microscopic necrosis, and postoperative radiotherapy.
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