Peridural analgesia does not impact survival in patients after colon cancer resection: a retrospective propensity score-adjusted analysis.

Int J Colorectal Dis 2019 Jul 6;34(7):1283-1293. Epub 2019 Jun 6.

Surgical Department I, Städtische Kliniken Neuss Lukaskrankenhaus GmbH, Lukaskrankenhaus GmbH, Preußenstraße 84, 41464, Neuss, Germany.

Purpose: To assess the putative impact of peridural analgesia on oncological outcome in patients undergoing resection of stages I-IV colon cancer.

Methods: In a single-center study, 876 patients undergoing resection for primary colon cancer (AJCC stages I-IV) between 2001 and 2014 were analyzed. Mean follow-up of the entire cohort was 4.2 ± 3.5 years. Patients who did and did not receive peridural analgesia were compared using Cox regression and propensity score analyses.

Results: Overall, 208 patients (23.7%) received peridural analgesia. Patients' characteristics were biased with regard to the use of peridural analgesia (propensity score 0.296 ± 0.129 vs. 0.219 ± 0.108, p < 0.001). After propensity score matching, the use of peridural analgesia had no impact on overall (HR 0.81, 95% CI 0.59-1.11, p = 0.175), cancer-specific (HR 0.72, 95% CI 0.48-1.09, p = 0.111), and disease-free survival (HR 0.89, 95% CI 0.66-1.19, p = 0.430). The 5-year overall survival after propensity score matching was 60.9% (95% CI 54.8-67.7%) for patients treated with peridural analgesia compared with 54.1% (95% CI 49.5-59.1%) for patients not treated with peridural analgesia. Cancer-specific and disease-free survival showed similar non-significant results.

Conclusions: Peridural analgesia in patients after colon cancer resection was not associated with a better oncological outcome after risk adjusting in multivariable Cox regression and propensity score analyses. Hence, oncological outcome should not serve as a reason for the use of peridural analgesia in patients with colon cancer.

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http://dx.doi.org/10.1007/s00384-019-03315-0DOI Listing
July 2019
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References

(Supplied by CrossRef)

CL Wu et al.
Anesthesiology 2005

J Guay et al.
Anesth Analg 2016

DM Popping et al.
Ann Surg 2014

R Warschkow et al.
J Gastrointest Surg 2011

MC Grant et al.
Ann Surg 2017

A Elsharydah et al.
Proc (Bayl Univ Med Cent) 2017

JP Holler et al.
Ann Surg 2013

MP Sijp van der et al.
Int J Color Dis 2016

W Hohenberger et al.
Color Dis 2009

C Pox et al.
Z Gastroenterol 2013

H Ishwaran et al.
Ann Appl Stat 2008

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