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Survival after prim...
Survival after primary breast cancer surgery following propofol or sevoflurane general anesthesia-A retrospective, multicenter, database analysis of 6305 Swedish patients
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- Enlund, Mats (författare)
- Uppsala University,Uppsala universitet,Centrum för klinisk forskning, Västerås
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- Berglund, Anders (författare)
- Epistat, Uppsala, Sweden.,EpiStat (Epidemiology & Statistics Consulting) Sweden
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- Ahlstrand, Rebecca, 1973- (författare)
- Örebro universitet,Institutionen för hälsovetenskaper,Department of Anesthesia & Intensive Care,Univ Hosp, Dept Anesthesia & Intens Care, Örebro, Sweden.,Örebro University Hospital
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- Walldén, Jakob (författare)
- Umeå University,Umeå universitet,Anestesiologi och intensivvård,Umeå Univ, Dept Surg & Perioperat Sci Anesthesiol & Intens C, Sundsvall, Sweden.
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- Lundberg, Johan (författare)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anestesi, smärta och cancerprognos,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Anesthesia, pain and cancer outcome,Lund University Research Groups,Skåne University Hospital
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- Wärnberg, Fredrik (författare)
- Uppsala University,Uppsala universitet,Endokrinkirurgi
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- Ekman, Andreas (författare)
- Kalmar Hospital, Kalmar, Sweden,Kalmar Hosp, Kalmar, Sweden.,Kalmar County Hospital
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- Sjöblom Widfeldt, Nina (författare)
- Södra Älvsborg Hospital, Borås, Sweden,Sodra Alvsborg Hosp, Borås, Sweden.,The County of Västra Götaland
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- Enlund, Anna (författare)
- Uppsala University,Uppsala universitet,Centrum för klinisk forskning, Västerås,Institutionen för kirurgiska vetenskaper
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- Bergkvist, Leif (författare)
- Uppsala University,Uppsala universitet,Centrum för klinisk forskning, Västerås
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(creator_code:org_t)
- 2020-06-10
- 2020
- Engelska.
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 64:8, s. 1048-1054
- Relaterad länk:
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Background: Retrospective studies indicate that the choice of anesthetic can affect long-term cancer survival. Propofol seems to have an advantage over sevoflurane. However, this is questioned for breast cancer. We gathered a large cohort of breast cancer surgery patients from seven Swedish hospitals and hypothesized that general anesthesia with propofol would be superior to sevoflurane anesthesia regarding long-term breast cancer survival.Methods: We identified all patients who were anaesthetized for breast cancer surgery between 2006 and 2012. The patients were matched to the Swedish Breast Cancer Quality Register, to retrieve tumor characteristics, prognostic factors, and adjuvant treatment as well as date of death. Overall survival between patients undergoing sevoflurane and propofol anesthesia was analyzed with different statistical approaches: (a) multiple Cox regression models adjusted for demographic, oncological, and multiple control variables, (b) propensity score matching on the same variables, but also including the participating centers as a cofactor in a separate analysis.Results: The database analysis identified 6305 patients. The 5-year survival rates were 91.0% and 81.8% for the propofol and sevoflurane group, respectively, in the final model (P = .126). Depending on the statistical adjustment method used, different results were obtained, from a non-significant to a "proposed" and even a "determined" difference in survival that favored propofol, with a maximum of 9.2 percentage points higher survival rate at 5 years (hazard ratio 1.46, 95% CI 1.10-1.95).Conclusions: It seems that propofol may have a survival advantage compared with sevoflurane among breast cancer patients, but the inherent weaknesses of retrospective analyses were made apparent.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
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