Comparison of 1-year recurrence-free survival between sevoflurane and propofol use for general anesthesia management in primary breast cancer surgery

Abstract EDITOR’S PERSPECTIVE What We Know about This Topic IV anesthesia may impair anticancer immunity less than volatile anesthesia and therefore reduce recurrence risk What This Article Tells Us That Is New In a large propensity-matched retrospective cohort analysis, the authors compared total IV and volatile anesthesia for breast cancer surgery Recurrence hazard was similar with each approach Selection of IV or volatile anesthesia should be based on factors other than cancer recurrence Background The association between type of anesthesia used and recurrence of cancer remains controversial. This retrospective cohort study compared the influence of total IV anesthesia and inhalation anesthesia on the primary outcome of recurrence-free survival after breast cancer surgery. Methods The authors reviewed the electronic medical records of patients who had breast cancer surgery at a tertiary care teaching hospital between January 2005 and December 2013. The patients were grouped according to whether IV or inhalation anesthesia was used for surgery. Propensity score matching was used to account for differences in baseline characteristics. Kaplan–Meier survival curves were constructed to evaluate the influence of type of anesthesia on recurrence-free survival and overall survival. The risks of cancer recurrence and all-cause mortality were compared between each type of anesthesia. Results Of 7,678 patients who had breast cancer surgery during the study period, data for 5,331 patients were available for analysis (IV group, n = 3,085; inhalation group, n = 2,246). After propensity score matching, 1,766 patients remained in each group. Kaplan–Meier survival curves showed that there was no significant difference in recurrence-free survival or overall survival between the two groups, with 5-yr recurrence-free survival rates of 93.2% (95% CI, 91.9 to 94.5) in the IV group and 93.8% (95% CI, 92.6 to 95.1) in the inhalation group. Inhalation anesthesia had no significant impact on recurrence-free survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.32; P = 0.782) or overall survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.33, P = 0.805) when compared with total IV anesthesia. Conclusions The authors found no association between type of anesthesia used and the long-term prognosis of breast cancer. The results of this retrospective cohort study do not suggest specific selection of IV or inhalation anesthesia for breast cancer surgery.

Download Full-text

PO139 RECEPTOR ACTIVATOR OF NUCLEAR FACTOR KAPPA B (RANK) EXPRESSION IN PRIMARY BREAST CANCER CORRELATES WITH RECURRENCE FREE SURVIVAL AND DEVELOPMENT OF BONE METASTASES IN THE I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657)

The Breast ◽

10.1016/s0960-9776(15)30151-x ◽

2015 ◽

Vol 24 ◽

pp. S69-S70

Author(s):

Neelima Vidula ◽

Christina Yau ◽

Jiali Li ◽

Hope S. Rugo

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Primary Breast Cancer ◽

Nuclear Factor Kappa B ◽

Nuclear Factor ◽

Recurrence Free Survival ◽

Free Survival ◽

Nuclear Factor Kappa ◽

Receptor Activator ◽

Survival And Development

Download Full-text

Can Anesthetic Technique for Primary Breast Cancer Surgery Affect Recurrence or Metastasis?

Survey of Anesthesiology ◽

10.1097/01.sa.0000296332.74182.39 ◽

2007 ◽

Vol 51 (6) ◽

pp. 321-322

Author(s):

&NA;

Keyword(s):

Breast Cancer ◽

Primary Breast Cancer ◽

Cancer Surgery ◽

Breast Cancer Surgery ◽

Anesthetic Technique

Download Full-text

Prediction of total hospital expenses of patients undergoing breast cancer surgery in Shanghai, China by comparing three models

BMC Health Services Research ◽

10.1186/s12913-021-07334-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Minjie Chen ◽

Xiaopin Wu ◽

Jidong Zhang ◽

Enhong Dong

Keyword(s):

Breast Cancer ◽

Minimally Invasive ◽

General Anesthesia ◽

Medical Insurance ◽

Cancer Surgery ◽

Classification And Regression Tree ◽

Breast Cancer Surgery ◽

Total Hospital ◽

Hospital Managers ◽

Hospital Expenses

Abstract Background Breast cancer imposes a considerable burden on both the health care system and society, and becomes increasingly severe among women in China. To reduce the economic burden of this disease is crucial for patients undergoing the breast cancer surgery, hospital managers, and medical insurance providers. However, few studies have evidenced the prediction of the total hospital expenses (THE) for breast cancer surgery. The aim of the study is to predict THE for breast cancer surgery and identify the main influencing factors. Methods Data were retrieved from the first page of medical records of 3699 patients undergoing breast cancer surgery in one tertiary hospital from 2017 to 2018. Multiple liner regression (MLR), artificial neural networks (ANNs), and classification and regression tree (CART) were constructed and compared. Results The dataset from 3699 patients were randomly divided into training and test sets at a 70:30 ratio (2599 and 1100 records, respectively). The average total hospital expenses were 12520.54 ± 7844.88 ¥ (US$ 1929.20 ± 1208.11). MLR results revealed six factors to be significantly associated with THE: age, LOS, type of disease, having medical insurance, minimally invasive surgery, and receiving general anesthesia. After comparing three models, ANNs was the best model to predict THEs in patients undergoing breast cancer surgery, and its strong predictive performance was also validated. Conclusions To reduce the THEs, more attention should be paid to related factors of LOS, major and minimally invasive surgeries, and general anesthesia for these patient groups undergoing breast cancer surgery. This may reduce the information asymmetry between doctors and patients and provide more reliable cost, practical inpatient medical consumption standards and reimbursement standards reference for patients, hospital managers, and medical insurance providers ,respectively.

Download Full-text