Retrospective analysis of 1-year mortality after gastric cancer surgery

Total intravenous anesthesia versus volatile anesthesia

Tak Kyu Oh, Hyung Ho Kim, Young Tae Jeon

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: It remains controversial whether propofol-based total intravenous anesthesia (TIVA) or inhalation anesthesia is associated with better outcomes after cancer surgery. We investigated whether there is a difference in the 1-year overall or cancer-related mortality between propofol-based TIVA and inhalation anesthesia in patients who underwent gastric cancer surgery. Methods: This retrospective cohort study was based on medical records of ll patients aged ≥18 years who underwent elective gastric cancer surgery with curative intent between January 2005 and December 2015 at a single tertiary academic hospital. Propensity score (PS) matching and Cox proportional hazard models were used for analyses. Results: After PS matching, 1538 patients (769 patients in each group) were included in the final analysis. The 1-year overall mortality risk was not significantly different between the TIVA and inhalation groups in either the PS-matched analysis [hazard ratio (HR): 0.92, 95% confidence interval (CI): 0.52-1.64; P = 0.774] or entire cohorts (HR: 0.82 95% CI: 0.52-1.33; P = 0.417) after multivariable adjustment. The 1-year cancer-related mortality risk was similar between the groups in both the PS-matched cohort (HR: 0.91, 95% CI: 0.50-1.67; P = 0.764) and the entire cohort after multivariable adjustment (HR: 0.82, 95% CI: 0.50-1.33; P = 0.406). Conclusions: We show that propofol-based TIVA was not significantly associated with a decrease in the 1-year overall or cancer-related mortality after gastric cancer surgery, as compared with inhalation anesthesia. Further studies are required to ascertain the optimal anesthetic choice for gastric cancer surgery.

Original languageEnglish
Pages (from-to)1169-1177
Number of pages9
JournalActa Anaesthesiologica Scandinavica
Volume63
Issue number9
DOIs
StatePublished - 1 Oct 2019

Fingerprint

Intravenous Anesthesia
Propensity Score
Stomach Neoplasms
Inhalation Anesthesia
Anesthesia
Propofol
Mortality
Confidence Intervals
Neoplasms
Proportional Hazards Models
Tertiary Care Centers
Inhalation
Medical Records
Anesthetics
Cohort Studies
Retrospective Studies

Keywords

  • anesthesia
  • inhalation
  • propofol
  • stomach neoplasms
  • surgery

Cite this

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title = "Retrospective analysis of 1-year mortality after gastric cancer surgery: Total intravenous anesthesia versus volatile anesthesia",
abstract = "Background: It remains controversial whether propofol-based total intravenous anesthesia (TIVA) or inhalation anesthesia is associated with better outcomes after cancer surgery. We investigated whether there is a difference in the 1-year overall or cancer-related mortality between propofol-based TIVA and inhalation anesthesia in patients who underwent gastric cancer surgery. Methods: This retrospective cohort study was based on medical records of ll patients aged ≥18 years who underwent elective gastric cancer surgery with curative intent between January 2005 and December 2015 at a single tertiary academic hospital. Propensity score (PS) matching and Cox proportional hazard models were used for analyses. Results: After PS matching, 1538 patients (769 patients in each group) were included in the final analysis. The 1-year overall mortality risk was not significantly different between the TIVA and inhalation groups in either the PS-matched analysis [hazard ratio (HR): 0.92, 95{\%} confidence interval (CI): 0.52-1.64; P = 0.774] or entire cohorts (HR: 0.82 95{\%} CI: 0.52-1.33; P = 0.417) after multivariable adjustment. The 1-year cancer-related mortality risk was similar between the groups in both the PS-matched cohort (HR: 0.91, 95{\%} CI: 0.50-1.67; P = 0.764) and the entire cohort after multivariable adjustment (HR: 0.82, 95{\%} CI: 0.50-1.33; P = 0.406). Conclusions: We show that propofol-based TIVA was not significantly associated with a decrease in the 1-year overall or cancer-related mortality after gastric cancer surgery, as compared with inhalation anesthesia. Further studies are required to ascertain the optimal anesthetic choice for gastric cancer surgery.",
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author = "Oh, {Tak Kyu} and Kim, {Hyung Ho} and Jeon, {Young Tae}",
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Retrospective analysis of 1-year mortality after gastric cancer surgery : Total intravenous anesthesia versus volatile anesthesia. / Oh, Tak Kyu; Kim, Hyung Ho; Jeon, Young Tae.

In: Acta Anaesthesiologica Scandinavica, Vol. 63, No. 9, 01.10.2019, p. 1169-1177.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Retrospective analysis of 1-year mortality after gastric cancer surgery

T2 - Total intravenous anesthesia versus volatile anesthesia

AU - Oh, Tak Kyu

AU - Kim, Hyung Ho

AU - Jeon, Young Tae

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: It remains controversial whether propofol-based total intravenous anesthesia (TIVA) or inhalation anesthesia is associated with better outcomes after cancer surgery. We investigated whether there is a difference in the 1-year overall or cancer-related mortality between propofol-based TIVA and inhalation anesthesia in patients who underwent gastric cancer surgery. Methods: This retrospective cohort study was based on medical records of ll patients aged ≥18 years who underwent elective gastric cancer surgery with curative intent between January 2005 and December 2015 at a single tertiary academic hospital. Propensity score (PS) matching and Cox proportional hazard models were used for analyses. Results: After PS matching, 1538 patients (769 patients in each group) were included in the final analysis. The 1-year overall mortality risk was not significantly different between the TIVA and inhalation groups in either the PS-matched analysis [hazard ratio (HR): 0.92, 95% confidence interval (CI): 0.52-1.64; P = 0.774] or entire cohorts (HR: 0.82 95% CI: 0.52-1.33; P = 0.417) after multivariable adjustment. The 1-year cancer-related mortality risk was similar between the groups in both the PS-matched cohort (HR: 0.91, 95% CI: 0.50-1.67; P = 0.764) and the entire cohort after multivariable adjustment (HR: 0.82, 95% CI: 0.50-1.33; P = 0.406). Conclusions: We show that propofol-based TIVA was not significantly associated with a decrease in the 1-year overall or cancer-related mortality after gastric cancer surgery, as compared with inhalation anesthesia. Further studies are required to ascertain the optimal anesthetic choice for gastric cancer surgery.

AB - Background: It remains controversial whether propofol-based total intravenous anesthesia (TIVA) or inhalation anesthesia is associated with better outcomes after cancer surgery. We investigated whether there is a difference in the 1-year overall or cancer-related mortality between propofol-based TIVA and inhalation anesthesia in patients who underwent gastric cancer surgery. Methods: This retrospective cohort study was based on medical records of ll patients aged ≥18 years who underwent elective gastric cancer surgery with curative intent between January 2005 and December 2015 at a single tertiary academic hospital. Propensity score (PS) matching and Cox proportional hazard models were used for analyses. Results: After PS matching, 1538 patients (769 patients in each group) were included in the final analysis. The 1-year overall mortality risk was not significantly different between the TIVA and inhalation groups in either the PS-matched analysis [hazard ratio (HR): 0.92, 95% confidence interval (CI): 0.52-1.64; P = 0.774] or entire cohorts (HR: 0.82 95% CI: 0.52-1.33; P = 0.417) after multivariable adjustment. The 1-year cancer-related mortality risk was similar between the groups in both the PS-matched cohort (HR: 0.91, 95% CI: 0.50-1.67; P = 0.764) and the entire cohort after multivariable adjustment (HR: 0.82, 95% CI: 0.50-1.33; P = 0.406). Conclusions: We show that propofol-based TIVA was not significantly associated with a decrease in the 1-year overall or cancer-related mortality after gastric cancer surgery, as compared with inhalation anesthesia. Further studies are required to ascertain the optimal anesthetic choice for gastric cancer surgery.

KW - anesthesia

KW - inhalation

KW - propofol

KW - stomach neoplasms

KW - surgery

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U2 - 10.1111/aas.13414

DO - 10.1111/aas.13414

M3 - Article

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JO - Acta Anaesthesiologica Scandinavica

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SN - 0001-5172

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